Is a denial letter valid and valid?

Ontario, Canada


The following excerpt is from S.S. v Economical Mutual Insurance Company, 2019 CanLII 83592 (ON LAT):

Having reviewed the letter, I cannot find that the adjudicator made a significant legal error in concluding that the letter constituted a valid refusal. Further the adjudicator clearly considered and applied the Smith v. Co-operators principles. At paragraph 15 of his decision he wrote: In my opinion and based on Smith v. Co-operators regardless of whether the sections were incorrect, there is no ambiguity with respect to whether or not the benefit is being denied. It is clear that the benefit is being terminated and the letter goes on to outline the dispute resolution process and the time limits that govern that process. As a result, my finding is that the denial letter complies with Smith v. Co-operators and it is a valid denial which starts the limitation clock. Did the subsequent payment of benefits negate the earlier denial and extend the limitation period?

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