Lafarge Canada v Little Mountain Excavating [2001] BCSC
Facts
- Harbour Insurance, on behalf of Little Mountain requested a quote on liability insurance from AXA (third party insurer)
- Little Mountain had stored equipment at gravel site operated by Lafarge Concrete and destroyed old forest roads
- AXA issued insurance for Little Mountain, on completion of latter’s contract work, Little Mountain would return to normal operations of another nature
- In a logging contractor survey form, Little Mountain answered that there were no “welding regulations and controls” involved
- Two employees of Little Mountain used torches to cut through bolts on a Lafarge Plant, caused a fire damaging the tower
- AXA elected to void the policy claiming that Little Mountain had misrepresented the nature of its business operations when applying for insurance
- Whether Little Mountain made a misrepresentation that would void the policy
Rules
- It is a question of fact in each case, whether, if the matters concealed or misrepresented had been truly disclosed, they would, on a fair consideration of the evidence, have influenced a reasonable insurer to decline the risk or to have stipulated for a higher premium
- The question of materiality is one of fact, onus of establishing materiality is on AXA
- Must be shown that, in treating a fact as material to the risk of the coverage being extended, the insurer was acting as a “reasonable or prudent insurer”
- Relevant time for assessing materiality is the time when application for insurance is completed
- Under the doctrine of good faith, insured must disclose any information material to risk, and it must be full and accurate, irrelevant whether failure to disclose is deliberate or inadvertent
- If facts withheld by insured are facts which ought to have been known by insurer due to deemed familiarity with business of which they are underwriting, then it is not a material fact
- There is a duty on insurer to make further inquiry as to nature of the risk, if facts disclosed by insured are such that would alert a reasonably prudent insurer of need to do so
Analysis
- AXA claimed that they were unaware Little Mountain was involved in cutting or welding, if they had known, would have regarded risk as substantially diff from business described when insurance placed
AXA would’ve declined the risk, or required higher premium
- Little Mountain submitted that torch cutting was necessarily incidental to their everyday activities, obligations of AXA shouldn’t be void on basis Little Mountain failed to disclose info AXA should’ve known
Also Little Mountain’s duty to disclose was limited to past or present facts at time policy was issued and it could not predict future operations
Any ambiguity in wording of policy should be construed contra proferentem
- Court was satisfied that AXA met onus of showing activities not revealed by Little Mountain to AXA were material to the risk
- As underwriter, AXA showed it would not regard use of cutting torch as incidental to operation described by Little Mountain at time of insurance
Use of such equipment would have increased severity of risk, and fact that AXA added a surcharge after learning of Little Mountain’s contract work indicates the position AXA would have took if it was aware of insured’s other activities
- While Little Mountain’s use of “etc” when describing activities might be construed to mean anything that could change future exposure to risk in question, jusdem genersi rule of interpretation satisfied court that “etc” would not lead prudent insurer to assume normal operations of Little Mountain would include activities ultimately undertaken
- Contra proferetem rule didn’t apply since scope of Little Mountain’s activities couldn’t be brought within description listed within policy
- W.r.t. statement of no welding and future unpredictability of activities, Court held that such a statement extends the representation so that there will never be any welding
Conclusion
- Little Mountain made a misrepresentation to AXA, and misrepresentation of work was material, policy void
Metcalfe v Manufacturers Life Insurance Co [2004] BCSC [fraudulent misrepresentation]
Facts
- Metcalfe’s wife (P) brings action for recovery of life insurance on her husband (M) from Manufacturers Life Insurance P
- M was contacted by agent and persuaded to change insurers, was asked a number of questions relating to past drug use which he answered ‘no’, but he had previously used drugs
- Later M died of accidental drug overdose, though appeared that he was drug free before that time
Issues
- Whether P made a fraudulent misrepresentation that contained a material fact in his insurance application
Rules
- The threshold for proof of misrepresentation, as distinct from fraudulent misrep, is not a high one
Insured holds a duty to disclose full and accurate info about everything relevant to proposed insurance
Keeping back of such circumstance that would mislead an underwriter to estimate a risk as if it didn’t exist is fraud
- The classic test to determine if there is a material fact within s.41(1) of Act is whether a statement is capable of affecting the mind of the insurer
- A fraudulent statement occurs where there is a false representation, made knowingly, without belief in its truth, or recklessly, without care whether it is true or false (Derry v Peek), i.e. there must be fraudulent intent (subjective)
Fraud must be proved by the insurer on the balance of probabilities
The seriousness of the conduct alleged is a circumstance to be considered in determining whether the matter has been sufficiently proven
Analysis
- M made a misrepresentation
In absence of explanation, he answered ‘no’ to questions about past drug use, failed to meet a reasonable standard of disclosure
M violated the statutory duty of disclosure under s.41(1) of the Act
- Misrepresentation as to drug use and treatment was material
s.41(1) of Act requires disclosure of only material facts
Drug use of M were neither minor nor remote, the hospitalization that was six years old would have affected mind of insurer in determining level of risk and setting of premium
- As per s.42(2) of Act, misrepresentations or non-disclosure of material fact, except for fraudulent statements, become incontestable two years from date policy was issued
Court held that M did not have fraudulent intent
If M answered agent’s first question about heroin or cocaine sensibly, it could indicate absence of intent to mislead
Court accepted P’s version of facts, finding agent to be unreliable in following standard practice of questioning
Also, fact that P had previous coverage would make it unlikely that they would give up coverage in favour of policy in danger of being declared void
Agent also did not impress the legal significance of false answer and its consequences, therefore more likely that M did not make statement with a fraudulent intent to mislead
Conclusion
- A misrepresentation was made by M but it was not fraudulent, policy stood
Kong v. Manulife: insurance company defended action on two grounds, 1) guy staged his own death, 2) fraudulently represented info. Insured’s wife brought an action to recover proceeds of policy
Stands for
Difficulty in proving fraud
Deals with ambiguity w.r.t. question in application itself. Preceding words can render later words ambiguous