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Insurance Act

R.S.O. 1990, CHAPTER I.8

Consolidation Period: From May 5, 2008 to the e-Laws currency date.

Last amendment: 2007, c. 7, Sched. 18.

SKIP TABLE OF CONTENTS

CONTENTS

Definitions

Definitions

1.  In this Act, except where inconsistent with the definition sections of any Part,

“accountant” means a person who is licensed under the Public Accounting Act, 2004; (“comptable”)

“actuary” means a Fellow of the Canadian Institute of Actuaries; (“actuaire”)

“adjuster” means a person who,

(a) on behalf of an insurer or an insured, for compensation, directly or indirectly solicits the right to negotiate the settlement of or investigate a loss or claim under a contract or a fidelity, surety or guaranty bond issued by an insurer, or investigates, adjusts or settles any such loss or claim, or

(b) holds himself, herself or itself out as an adjuster, investigator, consultant or adviser with respect to the settlement of such losses or claims,

but does not include,

(c) a barrister or solicitor acting in the usual course of the practice of law,

(d) a trustee or agent of the property insured,

(e) a salaried employee of a licensed insurer while acting on behalf of such insurer in the adjustment of losses,

(f) a person who is employed as an appraiser, engineer or other expert solely for the purpose of giving expert advice or evidence, or

(g) a person who acts as an adjuster of marine losses only; (“expert d’assurance”)

“agent” means a person who, for compensation, commission or any other thing of value,

(a) solicits insurance on behalf of an insurer who has appointed the person to act as the agent of such insurer or on behalf of the Facility Association under the Compulsory Automobile Insurance Act, or

(b) solicits insurance on behalf of an insurer or transmits, for a person other than himself, herself or itself, an application for, or a policy of insurance to or from such insurer, or offers or assumes to act in the negotiation of such insurance or in negotiating its continuance or renewal with such insurer,

and who is not a member of the Registered Insurance Brokers of Ontario; (“agent”)

“automobile” includes a trolley bus and a self-propelled vehicle, and the trailers, accessories and equipment of automobiles, but does not include railway rolling stock that runs on rails, watercraft or aircraft; (“automobile”)

“broker” means an insurance broker within the meaning of the Registered Insurance Brokers Act; (“courtier”)

“cash-mutual corporation” means a corporation without share capital that is empowered to undertake insurance on both the cash plan and the mutual plan; (“société mutuelle au comptant”)

“chief agency” means the principal office or place of business in Ontario of any licensed insurer having its head office out of Ontario; (“agence principale”)

“Commission” means the Financial Services Commission of Ontario established under the Financial Services Commission of Ontario Act, 1997; (“Commission”)

“compensation association” means a body corporate or unincorporated association the purpose of which is to provide compensation to claimants and policyholders of insolvent insurers and that has been designated under the regulations as a compensation association; (“association d’indemnisation”)

“contract” means a contract of insurance, and includes a policy, certificate, interim receipt, renewal receipt, or writing evidencing the contract, whether sealed or not, and a binding oral agreement; (“contrat”)

“debt obligation” means a bond, debenture, note or other evidence of indebtedness, whether the debt is secured or unsecured; (“titre de créance”)

“Director” means the director of arbitrations appointed under section 6; (“directeur”)

“due application” includes such information, evidence and material as the Superintendent requires to be furnished and the payment of the fees established by the Minister in respect of any application, certificate or document required or issued by virtue of this Act; (“demande régulière”)

“entity” includes a corporation, trust, partnership, fund, unincorporated association or organization, the Crown, a Crown agency, the government of a foreign country or of a political subdivision of a foreign country and any agency of that government; (“entité”)

“exchange” or “reciprocal insurance exchange” means a group of subscribers exchanging reciprocal contracts of indemnity or insurance with each other through the same attorney; (“bourse” ou “bourse d’assurance réciproque”)

“financial institution” means,

(a) an insurer that is incorporated or organized under the laws of Canada or of any province of Canada,

(b) a bank or authorized foreign bank within the meaning of section 2 of the Bank Act (Canada),

(c) a loan or trust corporation incorporated or organized under the laws of Canada or any province of Canada,

(d) an entity that,

(i) is incorporated or organized under the laws of Canada or of any province of Canada, and

(ii) primarily engages in dealing in securities, including portfolio management and investment counselling,

(e) a credit union or caisse populaire incorporated under the laws of any province of Canada or an association to which the Cooperative Credit Associations Act (Canada) applies,

(f) an entity that is prescribed or is a member of a class that is prescribed; (“institution financière”)

“foreign jurisdiction” means a jurisdiction other than Ontario; (“ressort étranger”)

“fraternal society” means a society, order or association incorporated for the purpose of making with its members only, and not for profit, contracts of life insurance or accident and sickness insurance in accordance with its constitution, by-laws and rules and this Act; (“société fraternelle”)

“governing executive authority” means the executive committee, executive board, management committee, grand executive committee or such other board, committee or body as is charged under the constitution and rules of a fraternal society with its general management between general meetings; (“organe de direction”)

“head office” means the place where the chief executive officer of an insurer transacts business; (“siège social”)

“industrial contract” means a contract of life insurance for an amount not exceeding $2,000, exclusive of any benefit, surplus, profit, dividend or bonus also payable under the contract, and that provides for payment of premiums once every two weeks or at shorter intervals, or, if the premiums are usually collected at the home of the insured, at monthly intervals; (“contrat populaire”)

“insurance” means the undertaking by one person to indemnify another person against loss or liability for loss in respect of a certain risk or peril to which the object of the insurance may be exposed, or to pay a sum of money or other thing of value upon the happening of a certain event, and includes life insurance; (“assurance”)

“insurance fund” or “insurance funds”, as applied to a fraternal society or as applied to a corporation not incorporated exclusively for the transaction of insurance, includes all money, securities for money and assets appropriated by the rules of the society or corporation to the payment of insurance liabilities or appropriated for the management of the insurance branch or department or division of the society, or otherwise legally available for insurance liabilities, but does not include funds of a trade union appropriated to or applicable for the voluntary assistance of wage earners unemployed or upon strike; (“fonds d’assurance”)

“insurance money” means the amount payable by an insurer under a contract, and includes all benefits, surplus, profits, dividends, bonuses, and annuities payable under the contract; (“sommes assurées”)

“insurance on the cash plan” means any insurance that is not mutual insurance; (“assurance au comptant”)

“insurer” means the person who undertakes or agrees or offers to undertake a contract; (“assureur”)

“lodge” includes a primary subordinate division, by whatever name known, of a fraternal society; (“loge”)

“Minister” means the Minister of Finance; (“ministre”)

“motor vehicle liability policy” means a policy or part of a policy evidencing a contract insuring,

(a) the owner or driver of an automobile, or

(b) a person who is not the owner or driver thereof where the automobile is being used or operated by that person’s employee or agent or any other person on that person’s behalf,

against liability arising out of bodily injury to or the death of a person or loss or damage to property caused by an automobile or the use or operation thereof; (“police de responsabilité automobile”)

“mutual benefit society” means a mutual corporation formed for the purpose of providing insurance against sickness, disability or death for its members, or for these and any other purposes necessary or incidental thereto except life insurance, but does not include a pension fund or employees’ mutual benefit society incorporated under or subject to the Corporations Act; (“société de secours mutuel”)

“mutual corporation” means a corporation without share capital that is empowered to undertake mutual insurance exclusively; (“société mutuelle”)

“mutual insurance” means a contract of insurance in which the consideration is not fixed or certain at the time the contract is made and is to be determined at the termination of the contract or at fixed periods during the term of the contract according to the experience of the insurer in respect of all similar contracts, whether or not the maximum amount of such consideration is predetermined; (“assurance mutuelle”)

“non-owner’s policy” means a motor vehicle liability policy insuring a person solely in respect of the use or operation by that person or on that person’s behalf of an automobile that is not owned by that person; (“police de non-propriétaire”)

“officer” includes a trustee, director, manager, treasurer, secretary or member of the board or committee of management of an insurer and a person appointed by the insurer to sue and be sued in its behalf; (“dirigeant”)

“owner’s policy” means a motor vehicle liability policy insuring a person in respect of the ownership, use or operation of an automobile owned by that person and within the description or definition thereof in the policy and, if the contract so provides, in respect of the use or operation of any other automobile; (“police de propriétaire”)

“paid in”, when applied to the capital stock of an insurer or to any shares thereof, means the amount paid to the insurer on its shares, not including the premium, if any, paid thereon, whether such shares are or are not fully paid; (“versé”)

“paid up”, when applied to the capital stock of an insurer or to any shares thereof, means the capital stock or shares on which there remains no liability, actual or contingent, to the issuing insurer; (“libéré”)

“participating share” means a share of a corporation that carries the right to participate in the earnings of the corporation to an unlimited degree and to participate in a distribution of the remaining property of the corporation on dissolution; (“action participante”)

“policy” means the instrument evidencing a contract; (“police”)

“premium” means the single or periodical payment under a contract for insurance, and includes dues, assessments, administration fees paid for the administration or servicing of such contract, and other considerations; (“prime”)

“premium note” means an instrument given as consideration for insurance whereby the maker undertakes to pay such sum or sums as may be legally demanded by the insurer, but the aggregate of which sums does not exceed an amount specified in the instrument; (“billet de souscription”)

“property” includes profits, earnings and other pecuniary interests, and expenditure for rents, interest, taxes and other outgoings and charges and in respect of inability to occupy the insured premises, but only to the extent of express provision in the contract; (“biens”)

“rate”, in relation to automobile insurance, means all amounts payable under contracts of automobile insurance for an identified risk whether expressed in dollar terms or in some other manner and includes commissions, surcharges, fees, discounts, rebates and dividends; (“taux”)

“regulations” means the regulations made under this Act; (“règlements”)

“risk classification system”, in relation to automobile insurance, means the elements used for the purpose of classifying risks in the determination of rates for a coverage or category of automobile insurance, including the variables, criteria, rules and procedures used for that purpose; (“système de classement des risques”)

“salesperson” means a person who is employed by a licensed insurance agent or broker on a stated salary that is not supplemented by commission, bonus or any other remuneration to solicit insurance or transact, for a person other than himself or herself, an application for a policy of insurance, or to act in the negotiation of such insurance or in negotiating its continuance or renewal, or collects and receives premiums on behalf of his or her employer only, but does not include a licensed insurance agent, broker or employee engaged solely in office duties for an agent or broker; (“vendeur”)

“security” means, when used to refer to a form of investment,

(a) a share of any class of shares of a corporation or a debt obligation of a corporation, and includes a warrant of a corporation, but does not include a deposit with a financial institution, any instrument evidencing a deposit with a financial institution or a policy, or

(b) any ownership interest in or debt obligation of an unincorporated entity, but does not include a policy; (“titre”or “valeur mobilière”)

“security interest” means an interest in or charge upon property by way of mortgage, hypothec, pledge or otherwise, to secure the payment of a debt or the performance of another obligation; (“sûreté”)

“spouse” means either of two persons who,

(a) are married to each other,

(b) have together entered into a marriage that is voidable or void, in good faith on the part of the person asserting a right under this Act, or

(c) are not married to each other and live together in a conjugal relationship outside marriage; (“conjoint”)

“Superintendent” means the Superintendent of Financial Services appointed under the Financial Services Commission of Ontario Act, 1997; (“surintendant”)

“Tribunal” means the Financial Services Tribunal established under the Financial Services Commission of Ontario Act, 1997; (“Tribunal”)

“upon proof”, as applied to any matter connected with the licensing of an insurer or other person, means upon proof to the satisfaction of the Superintendent; (“sur preuve”)

“voting share” means a share of a corporation carrying voting rights under all circumstances or by reason of an event that has occurred and is continuing or by reason of a condition that has been fulfilled. (“action avec droit de vote”) R.S.O. 1990, c. I.8, s. 1; 1993, c. 10, s. 2; 1994, c. 11, s. 336; 1996, c. 21, s. 1; 1997, c. 19, s. 10 (1); 1997, c. 28, s. 64; 1999, c. 6, s. 31 (1); 1999, c. 12, Sched. I, s. 4 (1, 2); 2002, c. 18, Sched. H, s. 4 (1-4); 2004, c. 8, s. 46; 2004, c. 31, Sched. 20, s. 1; 2005, c. 5, s. 35 (1, 2); 2006, c. 33, Sched. O, s. 1.

PART I
GENERAL

Organization

2.-5.  Repealed: 1997, c. 28, s. 66.

Insurance Ombudsman

5.1  (1)  The Superintendent shall appoint an employee of the Commission as Insurance Ombudsman. 1996, c. 21, s. 2; 1997, c. 28, s. 67.

Duties

(2)  The Insurance Ombudsman shall inquire into complaints about insurers’ business practices.

Complaints

(3)  A person may submit a written complaint about an insurer’s business practices to the Insurance Ombudsman if the person has submitted the complaint to the insurer and the complaint has not been resolved within a reasonable time.

Response

(4)  The Insurance Ombudsman shall give the insurer an opportunity to respond to any complaint submitted under subsection (3).

Authority of Insurance Ombudsman

(5)  After considering the complaint and any response, the Insurance Ombudsman may attempt to resolve the complaint or may recommend to the Superintendent that the Superintendent inquire into the complaint. 1996, c. 21, s. 2.

Director of arbitrations

6.  (1)  The Lieutenant Governor in Council shall appoint a director of arbitrations who shall carry out the duties and exercise the powers of the Director under this Act. R.S.O. 1990, c. I.8, s. 6 (1); 1996, c. 21, s. 3.

Acting Director

(2)  If the Director is absent or if there is a vacancy in the office of Director, such person as may be designated by the Director shall act as and have all the powers of the Director.

Delegation

(3)  The Director may delegate in writing any of his or her powers or duties to an employee of the Commission, subject to any limitation or condition set out in the delegation.

Idem

(4)  The Director may appoint employees of the Commission or other persons to hold hearings on his or her behalf and to exercise the powers and perform the duties of the Director relating to such hearings. R.S.O. 1990, c. I.8, s. 6 (2-4).

Committees

7.  (1)  The Minister shall appoint one or more committees for the purposes of this Act.

Name

(2)  The Minister shall assign a name to each committee. 1996, c. 21, s. 4.

Duties

(3)  Each committee shall,

(a) perform such functions as are assigned to the committee by the Minister or the Superintendent; and

(b) perform such other functions as are prescribed by the regulations. 1996, c. 21, s. 4; 1997, c. 28, s. 67.

Same

(4)  The Minister shall assign to one of the committees the function of recommending persons to conduct arbitrations under this Act. 1996, c. 21, s. 4.

Arbitrators

8.  (1)  The Superintendent shall establish and maintain a roster of candidates chosen by the Superintendent from the persons recommended to conduct arbitrations under this Act by the committee appointed under section 7. 1996, c. 21, s. 5; 1997, c. 28, s. 67.

Appointment

(2)  The Director shall appoint arbitrators only from the roster of candidates. R.S.O. 1990, c. I.8, s. 8 (2).

Mediators

9.  The Superintendent may appoint employees of the Commission or other persons to act as mediators. R.S.O. 1990, c. I.8, s. 9; 1997, c. 28, s. 67.

10.  Repealed: 1996, c. 21, s. 6.

Evidence of mediation, evaluation, arbitration

11.  (1)-(4)  Repealed: 1997, c. 28, s. 68 (1).

Mediators

(5)  A mediator shall not be required to testify in a civil proceeding or in a proceeding before any tribunal respecting any mediation conducted under this Act or respecting information obtained in the discharge of the mediator’s duties under this Act. 1996, c. 21, s. 7.

Neutral evaluation

(6)  A person who performs an evaluation under section 280.1 shall not be required to testify in a civil proceeding or in a proceeding before any tribunal respecting the evaluation or respecting information obtained in the discharge of the person’s duties under this Act. 1996, c. 21, s. 7.

Arbitrators

(7)  A person who is appointed as an arbitrator for the purposes of an arbitration under this Act shall not be required to testify in a civil proceeding or in a proceeding before any tribunal respecting any arbitration performed under this Act or respecting information obtained in the discharge of the person’s duties under this Act. 1997, c. 28, s. 68 (2).

12.  Repealed: 1997, c. 28, s. 69.

12.1  Repealed: 1997, c. 28, s. 70.

12.2  Repealed: 1997, c. 28, s. 71.

13.  Repealed: 1997, c. 28, s. 72.

14.  Repealed: 1997, c. 28, s. 73.

Assessment of health system costs

14.1  (1)  The Lieutenant Governor in Council may, in accordance with the regulations, assess all insurers that have issued motor vehicle liability policies in Ontario for amounts prescribed by the regulations that are incurred by the Ministry of Health and Long-Term Care under an Act or program administered by that ministry. 1996, c. 21, s. 10; 2006, c. 19, Sched. L, s. 11 (3).

Same

(2)  If an assessment is made under subsection (1), the share of a particular insurer shall be determined in the manner prescribed by regulation. 1996, c. 21, s. 10.

Insurer’s duty to pay

(3)  An insurer shall pay the amount assessed against it. 1996, c. 21, s. 10.

Same

(4)  If an insurer fails to pay an assessment made under subsection (1), the Superintendent may suspend or cancel the insurer’s licence. 1996, c. 21, s. 10; 1997, c. 28, s. 74.

Same

(5)  The Superintendent may revive the licence of an insurer whose licence was suspended or cancelled under subsection (4) if the insurer pays all amounts owing by the insurer under this section. 1996, c. 21, s. 10; 1997, c. 28, s. 74.

Decisions of Superintendent

Orders

15.  (1)  The Superintendent shall determine matters before him or her by order and may make an order subject to such conditions as are set out in the order. R.S.O. 1990, c. I.8, s. 15 (1); 1997, c. 28, s. 75 (2).

Interim orders

(2)  The Superintendent may make interim orders pending the final order in a matter before him or her. R.S.O. 1990, c. I.8, s. 15 (2); 1997, c. 28, s. 75 (2).

Matters before the Superintendent

16.  (1)  The Superintendent is not required to hold a hearing when making a decision but shall allow the parties affected by a matter before him or her to make written submissions.

Variation of decisions

(2)  Subject to subsection (1), the Superintendent may reconsider and vary or revoke a decision or order made by him or her if the Superintendent considers it advisable to do so.

Making of rules

(3)  The Superintendent may make rules for the practice and procedure to be observed in determining matters before him or her.

Superintendent’s powers

(4)  In determining any matter, the Superintendent may,

(a) determine what constitutes adequate public notice;

(b) conduct any inquiry or inspection the Superintendent considers necessary;

(c) consider any relevant information obtained by the Superintendent in addition to information provided by the parties, if he or she first informs the parties of the additional information and gives them an opportunity to explain or refute it. 1997, c. 28, s. 76.

Appeal of Superintendent’s decision

17.  (1)  If an appeal is provided for, a person affected by a decision of the Superintendent may appeal the decision to the Tribunal.

Notice of appeal

(2)  A notice of appeal shall be in writing and shall be served on the Superintendent and filed with the Tribunal within 30 days after the date of the Superintendent’s decision or within such other time period that this Act specifies.

Hearing

(3)  The Tribunal shall hold a hearing of an appeal.

Parties

(4)  The parties to an appeal are the person who requests the appeal, the Superintendent and the other persons whom the Tribunal specifies.

Power of the Tribunal

(5)  Upon hearing an appeal, the Tribunal may, by order, confirm, vary or rescind the decision appealed from or substitute its decision for that of the Superintendent.

Stay of decision

(6)  The filing of a notice of appeal does not stay the decision of the Superintendent but the Tribunal may grant a stay until it disposes of the appeal. 1997, c. 28, s. 76.

18.  Repealed: 1997, c. 28, s. 76.

Reference hearings

19.  (1)  The Lieutenant Governor in Council may require the Tribunal to examine and report on any question related to insurance that, in the opinion of the Lieutenant Governor in Council, requires a public hearing. R.S.O. 1990, c. I.8, s. 19 (1); 1997, c. 28, s. 77.

Parties

(2)  The Tribunal shall determine who may be a party to a reference hearing. R.S.O. 1990, c. I.8, s. 19 (2); 1997, c. 28, s. 77.

Exclusive jurisdiction

20.  (1)  This section applies with respect to proceedings under this Act before the Tribunal, the Superintendent and the Director and before an arbitrator. R.S.O. 1990, c. I.8, s. 20 (1); 1997, c. 28, s. 77.

Idem

(2)  A person referred to in subsection (1) has exclusive jurisdiction to exercise the powers conferred upon him or her under this Act and to determine all questions of fact or law that arise in any proceeding before him or her and, unless an appeal is provided under this Act, his or her decision thereon is final and conclusive for all purposes.

Decisions, etc., not stayed

(3)  An application for judicial review and any appeal from an order of the court on the application does not stay the decision made under this Act.

Court may grant stay

(4)  Despite subsection (3), a judge of the court to which the application is made or a subsequent appeal is taken may grant a stay until the disposition of the judicial review or appeal. R.S.O. 1990, c. I.8, s. 20 (2-4).

Rules

21.  Subject to the regulations made under paragraph 25 of subsection 121 (1), the Director may make rules for the practice and procedure to be observed in mediations under section 280, in performing evaluations under section 280.1, and in proceedings under this Act before the Director or an arbitrator. 1996, c. 21, s. 11.

Proceedings before Director or arbitrator

22.  (1)  For the purpose of exercising the powers and performing their duties under this Act, the Director and every arbitrator has the same power to summon and enforce the attendance of witnesses and compel them to give evidence on oath or otherwise, and to produce documents, records and things, as is vested in the Superior Court of Justice for the trial of civil actions. R.S.O. 1990, c. I.8, s. 22 (1); 1997, c. 28, s. 78; 2006, c. 19, Sched. C, s. 1 (1).

Power to require evidence

(2)  A person referred to in subsection (1) may require to be made or may take and receive affidavits or depositions and may examine witnesses upon oath. R.S.O. 1990, c. I.8, s. 22 (2).

Employment of stenographer

(3)  The evidence and proceedings in any matter before a person referred to in subsection (1) may be reported by a stenographer who has taken an oath before the person to report the evidence and proceedings faithfully. R.S.O. 1990, c. I.8, s. 22 (3).

Oaths

(4)  A person referred to in subsection (1) may administer and certify an oath required under this Act. R.S.O. 1990, c. I.8, s. 22 (4).

Administration

Records of Superintendent

23.  (1)  The Superintendent shall keep the following books and records:

1. A register of all licences issued under this Act, in which shall appear the name of the insurer, the address of the head office, the address of the principal office in Canada, the name and address of the chief or general agent in Ontario, the number of the licence issued, particulars of the classes of insurance for which the insurer is licensed, and such other information as the Superintendent considers necessary.

2. A record of all securities deposited by each insurer with the Superintendent, naming in detail the several securities, their par value, their date of maturity and value at which they are received as deposit. R.S.O. 1990, c. I.8, s. 23 (1); 1997, c. 28, s. 79.

Inspection

(2)  The books and records required by this section to be kept shall be open to inspection at such times and upon payment of such fees as may be established by the Minister. R.S.O. 1990, c. I.8, s. 23 (2); 1997, c. 19, s. 10 (2); 2004, c. 31, Sched. 20, s. 2.

24.  Repealed: 1999, c. 12, Sched. I, s. 4 (3).

Information about insurers, etc.

Annual publication in The Ontario Gazette, notice of licence

25.  (1)  The Superintendent shall cause to be published in The Ontario Gazette in July of each year a list of the insurers licensed at the date of the list, and shall from time to time cause notice of the licence of an insurer not theretofore licensed and notice of suspension or cancellation or revivor of licence to be given by publication in The Ontario Gazette. R.S.O. 1990, c. I.8, s. 25 (1).

Certificates

(2)  The Superintendent may issue a certificate,

(a) Repealed: 1997, c. 28, s. 81 (2).

(b) stating that a copy of, or extract from, a document or thing in the custody of the Commission is a true copy of, or extract from, the original;

(c) stating the amount payable to the Treasurer of Ontario under subsection 32 (3) or (4);

(d) stating the amount payable for an audit under subsection 101 (4);

(e) stating whether a document was served or delivered under this Act;

(f) stating whether any document required under this Act was filed;

(g) stating whether a document or notification was received or issued by the Superintendent, the Director, an arbitrator or a mediator under this Act.

(h), (i) Repealed: 1997, c. 28, s. 81 (4).

R.S.O. 1990, c. I.8, s. 25 (2); 1997, c. 28, s. 81 (1-4).

(3)  Repealed: 1997, c. 28, s. 81 (5).

Official documents as evidence

26.  (1)  In this section,

“official document” means a certificate, licence, order, decision, direction, inquiry or notice under this Act. R.S.O. 1990, c. I.8, s. 26 (1).

Idem

(2)  An official document that purports to be signed on behalf of the Superintendent shall be received in evidence in any proceeding as proof, in the absence of evidence to the contrary, of the facts stated in the official document without proof of the signature or the position of the person appearing to have signed the official document. R.S.O. 1990, c. I.8, s. 26 (2); 1997, c. 28, s. 82.

True copies as evidence

(3)  A true copy certified by the Superintendent under clause 25 (2) (b) is admissible in evidence to the same extent as and has the same evidentiary value as the document or thing of which it is a copy. R.S.O. 1990, c. I.8, s. 26 (3); 1997, c. 28, s. 82.

Right to a licence

27.  It is the duty of the Superintendent to determine the right of an insurer in Ontario to be licensed under this Act. 1997, c. 28, s. 83.

Decision of Superintendent

28.  (1)  Every decision of the Superintendent upon an application for a licence shall be in writing and notice thereof shall be forthwith given to the insurer. R.S.O. 1990, c. I.8, s. 28 (1).

Certified copy

(2)  The insurer, or any person interested, is entitled, upon payment of the fee established by the Minister, to a certified copy of the decision. R.S.O. 1990, c. I.8, s. 28 (2); 2004, c. 31, Sched. 20, s. 3.

Appeal

(3)  The insurer or any person affected by a decision of the Superintendent made under subsection (1) may appeal the decision to the Tribunal. 1997, c. 28, s. 84.

Inquiries

29.  The Superintendent or a person designated by the Superintendent may direct to an insurer any inquiry related to the contracts, financial affairs or the acts and practices of the insurer, and the insurer shall answer promptly, explicitly and completely. R.S.O. 1990, c. I.8, s. 29; 1997, c. 28, s. 85.

Right of access

30.  The Superintendent or a person designated by the Superintendent may at any reasonable time examine the books, securities, documents and things related to the business of an insurer, agent, adjuster or broker. R.S.O. 1990, c. I.8, s. 30; 1997, c. 28, s. 85.

Duty to furnish information

31.  (1)  Persons who are licensed under this Act, officers and agents of an insurer, the chief agent of an insurer that has its head office outside Ontario and other persons engaged in the business of insurance in Ontario shall on request furnish the Superintendent or a person designated by the Superintendent with full information,

(a) relating to any contract of insurance issued by an insurer;

(b) relating to any settlement or adjustment under a contract of insurance; or

(c) respecting any activities related to the business of insurance. 1993, c. 10, s. 4; 1997, c. 28, s. 85.

Idem

(2)  An insured person shall, on request, furnish the Superintendent or person designated by the Superintendent with full information relating to any contract of insurance issued to the insured person or to any settlement or adjustment affecting the insured person under a contract of insurance. R.S.O. 1990, c. I.8, s. 31 (2); 1997, c. 28, s. 85.

Examination of insurers

32.  (1)  Once each year or more frequently as the Superintendent may consider appropriate for all insurers or for a particular insurer, the Superintendent or a person appointed by the Superintendent,

(a) shall examine an insurer’s statement made under section 102;

(b) may make such inquiries as are necessary to ascertain the insurer’s condition and ability to meet its obligations as and when they become due; and

(c) may make such inquiries as are necessary to ascertain whether the insurer has complied with the requirements of this Act applicable to its transactions. R.S.O. 1990, c. I.8, s. 32 (1).

Exception

(2)  Subsection (1) does not apply so as to require an examination of an insurer,

(a) Repealed: 1999, c. 12, Sched. I, s. 4 (4).

(b) in respect of which the Superintendent adopts an examination by another government. R.S.O. 1990, c. I.8, s. 32 (2); 1999, c. 12, Sched. I, s. 4 (4).

Preparation of abstracts, valuation

(3)  The Superintendent may cause abstracts to be prepared of the books and vouchers and a valuation to be made of the assets and liabilities of an insurer and the insurer shall pay the Official Guardian for the cost of the preparation of the abstracts or the valuation upon receiving a certificate of the Commission stating the amount payable.

Expenses of examination

(4)  Where the office of an insurer at which an examination is made under this section is outside Ontario, the insurer shall pay the Treasurer of Ontario for the cost of the examination upon receiving a certificate of the Commission stating the amount payable. R.S.O. 1990, c. I.8, s. 32 (3, 4).

Service of documents

33.  (1)  Unless otherwise provided in this Act or in the rules made by the Superintendent under subsection 16 (3) or by the Tribunal, service of any document for the purpose of a matter to be determined by the Superintendent or a proceeding before the Tribunal that may result in an order or decision affecting the rights or obligations of a person required to be licensed under this Act may be made,

(a) on any person, by personal service on the person to be served;

(b) on an insurer, by first class registered mail addressed to the insurer or its chief executive officer at the insurer’s head office in Ontario as identified in the records of the Superintendent;

(c) on a person who is not an insurer, by first class registered mail addressed to the person’s last known address;

(d) on any person, by leaving a copy of the document with the solicitor, if any, of the person to be served, or with an employee in the solicitor’s office; or

(e) on any person, by telephone transmission of a facsimile of the document in accordance with subsection (7). R.S.O. 1990, c. I.8, s. 33 (1); 1993, c. 10, s. 5 (1); 1997, c. 28, s. 86; 1999, c. 12, Sched. I, s. 4 (5).

Service at place of residence

(2)  Where an attempt is made to effect personal service at a person’s place of residence and for any reason personal service cannot be effected, the document may be served by,

(a) leaving a copy, in a sealed envelope addressed to the person, at the place of residence with anyone who appears to be an adult member of the same household; and

(b) on the same day or the following day, mailing another copy of the document to the person at the place of residence. R.S.O. 1990, c. I.8, s. 33 (2).

Effective date of service

(3)  Service by first class registered mail under subsection (1) and service at a person’s place of residence under subsection (2) is effective on the seventh day after the document is mailed in accordance with subsection (1) or (2). 1993, c. 10, s. 5 (2).

(4), (5)  Repealed: 1993, c. 10, s. 5 (2).

Acceptance of service by a solicitor

(6)  Service on a solicitor is not effective unless the solicitor endorses on the document or a copy of it an acceptance of service on behalf of his or her client and the date of the acceptance. R.S.O. 1990, c. I.8, s. 33 (6).

Requirements for service by facsimile

(7)  A document that is served by telephone transmission shall include a cover page indicating,

(a) the sender’s name, address and telephone number;

(b) the name of the person to be served;

(c) the date and time of transmission;

(d) the total number of pages transmitted, including the cover page;

(e) the telephone number from which the document is transmitted; and

(f) the name and telephone number of a person to contact in the event of transmission problems. R.S.O. 1990, c. I.8, s. 33 (7).

Deemed service

34.  (1)  Where an attempt is made to effect service under subsection 33 (1) on an insurer or an agent, and for any reason service cannot be effected, the document may be served on the Superintendent and such service shall be deemed to be service on the insurer or agent.

Method of service

(2)  Service may be made on the Superintendent under subsection (1) by first class registered mail addressed to the Superintendent at the Superintendent’s office, or by personal service on the Superintendent.

Superintendent to forward document

(3)  Where a document is served on the Superintendent under subsection (1), the Superintendent shall forthwith mail the document to the insurer or agent at the address for the insurer or agent contained in the records of the Superintendent. R.S.O. 1990, c. I.8, s. 34.

Service of notice or process on chief agent or Superintendent, insurers outside Ontario

35.  (1)  Where the head office of a licensed insurer is situate out of Ontario, notice or process in any action or proceeding in Ontario may be served upon the chief agent of the insurer in Ontario or, where no appointment of a chief agent is then in effect, upon the Superintendent and such service shall be deemed service upon the insurer in the case of a corporation and upon members of the insurer in the case of an unincorporated body or association.

Insurer to file address

(2)  Every licensed insurer shall file in the office of the Superintendent notice of a post office address to which any such notice or process may be forwarded by the Superintendent and shall from time to time notify the Superintendent of any change in the address so filed.

Superintendent to forward notice or process

(3)  The Superintendent shall forthwith after the receipt of any such notice or process forward it to the insurer by registered mail addressed in the manner last notified to him or her for this purpose by the insurer. R.S.O. 1990, c. I.8, s. 35.

Annual report

36.  (1)  The Superintendent shall prepare for the Minister, from the statements filed by the insurers and from any inspection or inquiries made, an annual report, showing particulars of the business of each insurer as ascertained from such statement, inspection and inquiries, and such report shall be printed and published forthwith after completion. R.S.O. 1990, c. I.8, s. 36 (1).

Permissible investments

(2)  In his or her annual report the Superintendent shall allow as assets only such of the investments of the several insurers as are authorized by this Act, or by their Acts or instruments of incorporation, or by the general Acts applicable to such investments. R.S.O. 1990, c. I.8, s. 36 (2).

Superintendent’s corrections of annual statements

(3)  In his or her annual report the Superintendent shall make all necessary corrections in the annual statements made by all licensed insurers as provided in this Act, and the Superintendent is at liberty to increase or diminish the liabilities of such insurers to the true and correct amounts thereof as ascertained by him or her in the examination of their affairs at the head office thereof in Ontario, or otherwise. R.S.O. 1990, c. I.8, s. 36 (3).

Appraisement of real property owned by insurer

(4)  If it appears to the Superintendent, or if he or she has any reason to suppose, from the annual statements prepared and delivered to him or her by all insurers, that the value placed by any insurer, incorporated and licensed in Ontario, upon the real property owned by it or any parcel thereof is too great, the Superintendent may require such insurer to secure an appraisement of such real property by one or more competent valuators or the Superintendent may procure such appraisement at the expense of the insurer, and the appraised value, if it varies materially from the statement or return made by the insurer, may be substituted in the annual report of the Superintendent. R.S.O. 1990, c. I.8, s. 36 (4); 2006, c. 33, Sched. O, s. 2.

Appraisement of real property held as security for loans

(5)  In like manner, if it appears to the Superintendent, or if he or she has any reason to suppose, that the amount secured by mortgage or hypothec upon any parcel of real property, together with the interest due and accrued thereon, is greater than the value of the parcel, or that the parcel is not sufficient for the loan and interest, the Superintendent may procure an appraisement thereof and, if from the appraised value it appears that the parcel is not adequate security for the loan and interest, he or she may write off the loan and interest a sum sufficient to reduce the loan to such an amount as may fairly be realizable from the security, in no case to exceed the appraised value, and the Superintendent may insert the reduced amount in his or her annual report. R.S.O. 1990, c. I.8, s. 36 (5); 2006, c. 33, Sched. O, s. 2.

Appraisement of other investments

(6)  In like manner, if it appears to the Superintendent, or if he or she has any reason to suppose, that the value of any other investment of the funds of the insurer is less than the amount of the value of the investments shown in the books of the insurer, the Superintendent may make or cause to be made an appraisal of the security, and, if from the appraised value it appears that the value of the security as shown on the books of the insurer is greater than its true value as shown by the appraisal, he or she may reduce the book value of the security to such amount as may fairly be realizable from the security, in no case to exceed the appraised value, and the Superintendent may insert the reduced amount in his or her annual report. R.S.O. 1990, c. I.8, s. 36 (6).

37.  Repealed: 1997, c. 28, s. 87.

38.  Repealed: 1997, c. 19, s. 10 (3).

PART II
GENERAL PROVISIONS APPLICABLE TO INSURERS

Application of Part, insurance business in Ontario

39.  (1)  This Part applies to insurance undertaken in Ontario and to all insurers carrying on business in Ontario.

Undertaking insurance

(2)  An insurer undertaking a contract of insurance that under this Act is deemed to be made in Ontario, whether the contract is original or renewed, except the renewal from time to time of life insurance policies, shall be deemed to be undertaking insurance in Ontario within the meaning of this Part.

Carrying on business

(3)  An insurer undertaking insurance in Ontario or that in Ontario sets up or causes to be set up a sign containing the name of an insurer, or that in Ontario maintains or operates, either in its own name or in the name of its agent or other representative, an office for the transaction of the business of insurance either in or out of Ontario, or that in Ontario distributes or publishes or causes to be distributed or published any proposal, circular, card, advertisement, printed form or like document, or that in Ontario makes or causes to be made any written or oral solicitation for insurance, or that in Ontario issues or delivers any policy of insurance or interim receipt or collects or receives or negotiates for or causes to be collected or received or negotiated for any premium for a contract of insurance or inspects any risk or adjusts any loss under a contract of insurance, or that prosecutes or maintains in Ontario an action or proceeding in respect of a contract of insurance, or a club, society or association incorporated or unincorporated that receives, either as trustees or otherwise, contributions or money from its members out of which gratuities or benefits are paid directly or indirectly upon the death of its members, or any of them, shall be deemed to be an insurer carrying on business in Ontario within the meaning of this Act. R.S.O. 1990, c. I.8, s. 39.

Licences

Necessity for licence

40.  (1)  Every insurer undertaking insurance in Ontario or carrying on business in Ontario shall obtain from the Superintendent and hold a licence under this Act. R.S.O. 1990, c. I.8, s. 40 (1); 1997, c. 28, s. 88.

Prohibition re: licence

(2)  No person shall carry on business as an insurer or engage in an act constituting the business of insurance in Ontario without a licence under this Act.

Idem

(3)  No insurer shall carry on business in Ontario as an insurer of a class of insurance that is not authorized by its licence under this Act.

Prohibition against acting on behalf of unlicensed insurer

(4)  No person in Ontario shall do or cause to be done any act or thing mentioned in subsection 39 (3) on behalf of or as agent of an insurer that is not licensed under this Act. R.S.O. 1990, c. I.8, s. 40 (2-4).

Exception

(5)  The following shall not be deemed insurers within the meaning of this Act or required or entitled to be licensed as such:

1. Pension fund societies incorporated under the Corporations Act.

2. Corporations mentioned in paragraphs 3 and 4 of section 343.

3. A trade union in Ontario that under the authority of its incorporating Act or charter has an assurance or benefit fund for the benefit of its own members exclusively.

4. Mutual benefit societies. R.S.O. 1990, c. I.8, s. 40 (5); 1997, c. 19, s. 10 (4).

Unauthorized insurance

(6)  No insurer that is incorporated in Ontario and licensed under this Act shall carry on or solicit business as an insurer in another jurisdiction unless it is authorized to do so under the laws of that jurisdiction. R.S.O. 1990, c. I.8, s. 40 (6).

Prohibited benefits

(7)  No mutual benefit society shall offer or pay a benefit that would have been prohibited under this Act on January 1, 1996. 1997, c. 19, s. 10 (5).

Reinsurance with unlicensed insurer

41.  Subject to the regulations, nothing in this Act prevents a licensed insurer who has lawfully effected a contract of insurance in Ontario from reinsuring the risk or part thereof with an insurer transacting business out of Ontario and not licensed under this Act. R.S.O. 1990, c. I.8, s. 41.

Authorized insurers and insurance

What insurers may be licensed

42.  (1)  Upon due application and upon proof of compliance with this Act, the Superintendent may issue a licence to undertake contracts of insurance and carry on business in Ontario to any insurer coming within one of the following classes:

1. Joint stock insurance companies.

2. Mutual insurance corporations.

3. Cash-mutual insurance corporations.

4. Fraternal societies.

5. Repealed: 1997, c. 19, s. 10 (6).

6. Companies duly incorporated to undertake insurance contracts and not within classes 1 to 5.

7. Reciprocal insurance exchanges.

8. Underwriters or syndicates of underwriters operating on the plan known as Lloyds.

9. Repealed: 1997, c. 19, s. 10 (6).

R.S.O. 1990, c. I.8, s. 42 (1); 1997, c. 19, s. 10 (6); 1997, c. 28, s. 88; 1999, c. 12, Sched. I, s. 4 (6).

Authorized insurance

(2)  A licence issued under this Act authorizes the insurer named therein to exercise in Ontario all rights and powers reasonably incidental to the carrying on of the business of insurance named therein that are not inconsistent with this Act or with its Act or instrument of incorporation or organization. R.S.O. 1990, c. I.8, s. 42 (2).

Classes of insurance and licence conditions

43.  (1)  The Superintendent may by order determine and define classes of insurance for the purposes of this Act and of licences granted to insurers under this Act. 1997, c. 28, c. 89 (1).

Note: Despite the re-enactment of subsection 43 (1) by the Statutes of Ontario, 1997, chapter 28, subsection 89 (1), regulations made under subsection 43 (1) of this Act, as it read immediately before July 1, 1998, continue until the Superintendent makes an order under subsection 43 (1), as re-enacted by the Statutes of Ontario, 1997, chapter 28, subsection 89 (1), that is inconsistent with those regulations. See: 1997, c. 28, s. 89 (2).

Not a regulation

(1.1)  An order made by the Superintendent under subsection (1) is not a regulation within the meaning of Part III (Regulations) of the Legislation Act, 2006. 1997, c. 28, c. 89 (1); 2006, c. 21, Sched. F, s. 136 (1).

Publication of list

(1.2)  The Superintendent shall publish in The Ontario Gazette in July of each year a list of the classes of insurance authorized under subsection (1) and shall publish in The Ontario Gazette notice of all additions to or deletions from the list as soon as practicable after making them. 1997, c. 28, c. 89 (1).

Licence to carry on insurance business

(2)  Subject to the provisions of the Parts of this Act that particularly relate to the classes of insurers mentioned in section 42, a licence may be granted to an insurer to carry on any one or more of the classes of insurance defined under subsection (1). R.S.O. 1990, c. I.8, s. 43 (2); 2002, c. 18, Sched. H, s. 4 (5).

Determination of classes of insurance by Superintendent

(3)  For the purposes of this Act, the Superintendent may determine the class or classes of insurance into which the circumstances or conditions in any case may bring any insurance granted or that may be granted in respect thereto, and the policy form for the class of insurance to be used thereunder. R.S.O. 1990, c. I.8, s. 43 (3).

Conditions

(4)  A licence may be issued subject to such limitations and conditions as may be prescribed by regulation. R.S.O. 1990, c. I.8, s. 43 (4).

Membership in compensation association

44.  (1)  Where a compensation association has been designated by the regulations as a compensation association for a class of insurers, every insurer in that class shall be deemed to be a member of the compensation association and shall be bound by the by-laws and memorandum of operation of the compensation association. 2002, c. 18, Sched. H, s. 4 (6).

Assessments and levies

(2)  A member of a compensation association shall pay to the compensation association all assessments and levies made against the member by the compensation association, and, where the member fails to pay the assessment or levy within thirty days of the day the notice of the assessment or levy is mailed to the member,

(a) the compensation association may claim the amount of the assessment or levy, with interest, as a debt due from the member or if the insurer has ceased to be a member, from the former member; and

(b) the licence of the member to carry on insurance may be cancelled. R.S.O. 1990, c. I.8, s. 44 (2).

Non-application

(3)  Subsections (1) and (2) do not apply to,

(a) a mutual insurance corporation that is a member of the Fire Mutuals Guarantee Fund or such other insurers designated under the regulations as being adequately covered by some other plan of compensation;

(b) an insurer whose business is limited to that of reinsurance;

(c) an insurer named in an agreement entered into under section 120 as an insurer to whom subsections (1) and (2) do not apply;

(d) a reciprocal insurance exchange; or

(e) a class of insurer designated by the regulations. R.S.O. 1990, c. I.8, s. 44 (3); 1997, c. 19, s. 10 (8); 1999, c. 12, Sched. I, s. 4 (8).

Conditions of automobile insurance licence

45.  (1)  A licence to carry on automobile insurance in Ontario is subject to the following conditions:

1. In any action in Ontario against the licensed insurer or its insured arising out of an automobile accident in Ontario, the insurer shall appear and shall not set up any defence to a claim under a contract made outside Ontario, including any defence as to the limit or limits of liability under the contract, that might not be set up if the contract were evidenced by a motor vehicle liability policy issued in Ontario and such contract made outside Ontario shall be deemed to include the statutory accident benefits referred to in subsection 268 (1).

2. In any action in another province or territory of Canada, a jurisdiction in the United States of America or a jurisdiction designated in the Statutory Accident Benefits Schedule against the licensed insurer, or its insured, arising out of an automobile accident in that jurisdiction, the insurer shall appear and shall not set up any defence to a claim under a contract evidenced by a motor vehicle liability policy issued in Ontario, including any defence as to the limit or limits of liability under the contract, that might not be set up if the contract were evidenced by a motor vehicle liability policy issued in that jurisdiction. R.S.O. 1990, c. I.8, s. 45 (1); 1993, c. 10, s. 6; 1996, c. 21, s. 12.

Penalty for breach

(2)  A licence may be cancelled when the holder commits a breach of condition as set out in subsection (1). R.S.O. 1990, c. I.8, s. 45 (2).

Scope of life insurance licence

46.  Every insurer licensed for the transaction of life insurance may, under the authority of its licence, unless the licence expressly provides otherwise,

(a) Repealed: 2002, c. 18, Sched. H, s. 4 (7).

(b) transact annuities of all kinds and insurance providing for the establishment of accumulation or endowment funds. R.S.O. 1990, c. I.8, s. 46; 2002, c. 18, Sched. H, s. 4 (7).

47.  Repealed: 2002, c. 18, Sched. H, s. 4 (8).

Capital requirements, etc.

Capital requirements for joint stock Co. — life insurance

48.  (1)  A licence shall not be granted to a joint stock insurance company not licensed before the 1st day of January, 1971 unless the company furnishes to the Superintendent satisfactory evidence that if the company is applying for a licence to transact the business of life insurance, the company has paid up capital and surplus of not less than $2,000,000, or such greater amount as the Superintendent in the circumstances may require, of which at least $1,000,000 is paid up capital and at least $500,000 is unimpaired surplus. R.S.O. 1990, c. I.8, s. 48 (1); 1997, c. 28, s. 90.

Capital requirements for joint stock Co. — insurance other than life

(2)  A licence shall not be granted to a joint stock insurance company unless the company furnishes to the Superintendent satisfactory evidence that if the company is applying for a licence to transact any insurance other than life insurance, the company has, in aggregate, a paid up capital and unimpaired surplus of not less than $3,000,000 or such greater amount as the Superintendent in the circumstances may require. R.S.O. 1990, c. I.8, s. 48 (2); 1997, c. 28, s. 90.

Capital requirements for other insurers — insurance other than life

(3)  A licence shall not be granted to a mutual insurance corporation, a cash-mutual insurance corporation, an insurance company mentioned in paragraph 6 of subsection 42 (1), or to an underwriter or syndicate of underwriters operating on the plan known as Lloyds, except upon proof that the net surplus of assets over all liabilities exceeds the amount fixed by subsection (2) for the paid in capital stock of joint stock insurance companies, and that such net surplus of assets over all liabilities together with the contingent liability of members, if any, exceeds the amount fixed by subsection (2) for the paid up capital and surplus of joint stock insurance companies for the respective classes of insurance mentioned therein. R.S.O. 1990, c. I.8, s. 48 (3).

Exemption orders

(4)  On the report of the Superintendent, the Lieutenant Governor in Council may by order exempt an insurer from the minimum capital requirements set out in subsection (2) or (3), as the case may be, if the insurer is offering its services only within Ontario or if the insurer is offering a specialized or limited service that in the opinion of the Lieutenant Governor in Council does not require the support of higher capital requirements. R.S.O. 1990, c. I.8, s. 48 (4).

Idem

(5)  An exemption under subsection (4) may be made subject to such conditions as the Lieutenant Governor in Council may impose. R.S.O. 1990, c. I.8, s. 48 (5).

Capital requirements for other insurers — life insurance

(6)  A licence shall not be granted to a mutual insurance corporation, a cash-mutual insurance corporation, an insurance company mentioned in paragraph 6 of subsection 42 (1), a reciprocal insurance exchange, or to an underwriter or syndicate of underwriters operating on the plan known as Lloyds, not licensed on the 30th day of June, 1971, except upon proof that the net surplus of assets over all liabilities exceeds the amount fixed by subsection (1) for the paid in capital stock of joint stock insurance companies, and that such net surplus of assets over all liabilities together with the contingent liability of members, if any, exceeds the amount fixed by subsection (1) for the paid up capital and surplus of joint stock insurance companies for the respective classes of insurance mentioned therein. R.S.O. 1990, c. I.8, s. 48 (6); 1999, c. 12, Sched. I, s. 4 (9).

Application of subs. (3)

(7)  Subsection (3) does not apply to a mutual insurance corporation incorporated under the laws of Ontario that is a member of the Fire Mutuals Guarantee Fund. 1999, c. 12, Sched. I, s. 4 (10).

Restriction, premium note plan

(7.1)  No mutual insurance corporation that is incorporated in Ontario to undertake contracts on a premium note plan may be licensed under this Act unless it is a member of the Fire Mutuals Guarantee Fund. 1999, c. 12, Sched. I, s. 4 (10).

Application of other Parts

(8)  A licence shall not be granted to an insurer except upon proof that it has complied with the provisions of this Act and the regulations applicable to it. R.S.O. 1990, c. I.8, s. 48 (8).

Licence for both fire and life

(9)  A licence shall not be granted to an insurer for the transaction of both property and life insurance unless it maintains separate and distinct accounts, funds and securities in respect of its business of life insurance, and those funds and securities are available only for the protection of the holders of its policies of life insurance and are not liable for the payment of claims arising from any other class of insurance that it undertakes, and it complies with such other requirements as the Superintendent may impose for the purposes of this subsection. R.S.O. 1990, c. I.8, s. 48 (9); 2002, c. 18, Sched. H, s. 4 (9).

Evidence by insurer when head office is outside Ontario

(10)  Where the head office of an applicant for a licence under this Act is situate out of Ontario, a licence shall not be granted except upon proof of its ability to provide for the payment at maturity of all its contracts, but the Superintendent may accept as sufficient the fact that it is licensed by any other government in Canada. R.S.O. 1990, c. I.8, s. 48 (10).

Licence of extra-provincial corporation

(11)  A licence shall not be granted to a corporation that is incorporated under the law of a province other than Ontario unless its head office and chief place of business is situate in that province. R.S.O. 1990, c. I.8, s. 48 (11).

Information preliminary to licence

49.  The Superintendent may require such notice of the application for a licence to be given by publication in The Ontario Gazette and elsewhere as he or she considers necessary. R.S.O. 1990, c. I.8, s. 49.

Documentary, etc., requirements

Documents to be filed by applicants for licence

50.  (1)  Before the issue of a licence to an insurer, such insurer shall file in the office of the Superintendent the following documents:

1. A certified copy of its Act or other instrument of incorporation or association and of its constitution and by-laws and regulations verified in a manner satisfactory to the Superintendent.

2. A certified copy of its last balance sheet and auditor’s report thereon.

3. If the head office of the insurer is out of Ontario, notice of the place where the chief office of the insurer in Ontario is to be situate.

4. If the head office of the insurer is out of Ontario, a power of attorney from the insurer to an agent resident in Ontario.

5. Copies of all policy forms and forms of application for insurance proposed to be used by the insurer in Ontario.

6. Any evidence or documents required by other Parts of this Act.

Evidence

(2)  The applicant for a licence shall furnish such evidence as the Superintendent considers necessary that the requirements of this Act have been complied with and that the applicant is entitled to the licence applied for.

Paying cost of examination

(3)  When the Superintendent considers it necessary to conduct an examination of the affairs of an applicant for a licence, the applicant shall pay the costs of the examination upon receiving a statement thereof certified by the Superintendent. R.S.O. 1990, c. I.8, s. 50.

Filing of changes in by-laws, etc.

51.  Every licensed insurer shall file in the office of the Superintendent certified copies of every amendment, revision or consolidation of its Act or other instrument of incorporation or association and of its constitution, by-laws and regulations verified in a manner satisfactory to the Superintendent within thirty days after the passing or adoption of the amendment, revision or consolidation. R.S.O. 1990, c. I.8, s. 51.

Corporate requirements

Statement of expenses of organization

52.  (1)  Upon application being made for a licence under this Act by an insurer incorporated after the 1st day of January, 1925 under any general or special Act of Ontario, there shall be submitted to the Superintendent a sworn statement setting forth the several sums of money paid in connection with the incorporation and organization of the insurer, and such statement shall, in addition, include a list of all unpaid liabilities, if any, in connection with or arising out of the incorporation and organization.

To what limited

(2)  Until the licence is granted, no payments on account of expenses of incorporation and organization shall be made out of the money paid in by shareholders, except reasonable sums for the payment of clerical assistance, legal services, office rental, advertising, stationery, postage and expense of travel, if any. R.S.O. 1990, c. I.8, s. 52 (1, 2).

Conditions precedent to issue of licence

(3)  The Superintendent shall not issue the licence until he or she is satisfied that all the requirements of this Act and of the Corporations Act as to the subscriptions for shares in the capital of the insurer, the payment of money by shareholders on account of their subscriptions, the election of directors and other preliminaries have been complied with, and unless he or she is satisfied that the expenses of incorporation and organization, including any commission payable in connection with subscriptions for shares in the capital of the insurer, are reasonable. R.S.O. 1990, c. I.8, s. 52 (3); 1997, c. 28, s. 90.

Right to licence and insurer’s name

Right to licence

53.  (1)  An insurer that has applied for a licence and has complied with this Act and the Corporations Act is entitled to the licence. R.S.O. 1990, c. I.8, s. 53 (1).

Name of insurer

(2)  The Superintendent may refuse to licence an insurer where the name of the insurer is,

(a) the same as or similar to the name of another insurer and the assumption or use of the name in Ontario would be likely to deceive or mislead the public; or

(b) if the name of the insurer is objectionable on any public grounds. R.S.O. 1990, c. I.8, s. 53 (2); 1997, c. 28, s. 90.

Power of attorney of chief agent, insurers outside Ontario

54.  (1)  Every licensed insurer that has its head office outside Ontario shall file with the Superintendent an executed copy of a power of attorney from the insurer to a chief agent resident in Ontario.

Execution of power of attorney

(2)  The power of attorney shall be under the seal of the insurer, and shall be signed by the president and secretary or other proper officers of the insurer in the presence of a witness who shall make oath as to its due execution.

Authentication

(3)  The official positions held by the officers signing the power of attorney shall be verified by an oath of a person cognizant of the fact.

Contents of power of attorney

(4)  The power of attorney shall declare at what place in Ontario the chief agency of the corporation is and shall expressly authorize the chief agent to receive service of process in all actions and proceedings against the insurer in Ontario for any liability incurred by the insurer therein, and also to receive from the Superintendent all notices that the law requires to be given, or that it is thought advisable to give, and shall declare that service of process for or in respect of such liability on the chief agent is legal and binding on the insurer.

Authority conferred

(5)  The power of attorney may confer upon the chief agent any further or other powers that the insurer considers advisable.

Effect of copy as evidence

(6)  The production of a copy of the power of attorney certified by the Superintendent is sufficient evidence for all purposes of the power and authority of the person therein named to act on behalf of the insurer in the manner and for the purposes set forth in the certified copy.

Changes in chief agent

(7)  Where the insurer changes its chief agent in Ontario, it shall, within seven days of the appointment, file with the Superintendent a similar power of attorney, stating the change and containing a similar declaration as to service of process and notices.

Service of process thereafter

(8)  After the power of attorney is filed, any process in any action or proceeding against the insurer for liability incurred in Ontario may be validly served on the insurer upon its chief agent, but nothing in this section renders invalid service in any other mode in which the corporation may be lawfully served. R.S.O. 1990, c. I.8, s. 54.

Form, term, conditions of licence

Form

55.  (1)  Subject to section 382, the licence shall be in such form or forms for the different classes of insurers as may be from time to time determined by the Superintendent, and shall specify the business to be carried on by the insurer. R.S.O. 1990, c. I.8, s. 55 (1); 1997, c. 28, s. 90.

Conditions

(2)  The Superintendent may, at any time and in respect of any licence of an insurer,

(a) set a term for the licence;

(b) impose any conditions or limitations that the Superintendent considers appropriate relating to the carrying on of the insurer’s business; or

(c) vary, amend or revoke any condition or limitation to which the licence is subject.

Notice

(3)  The Superintendent shall not exercise any power under subsection (2) until he or she has given the insurer notice of intention to exercise the power and has afforded the insurer a reasonable opportunity to make written submissions.

Application

(4)  Subsections (2) and (3) apply in respect of licences in force on the date this section comes into force and in respect of licenses issued after the date this section comes into force.

Appeal to Tribunal

(5)  The insurer may appeal the decision of the Superintendent to the Tribunal. 1997, c. 28, s. 91 (1).

Failure to pay claim, licence cancellation, etc.

56.  (1)  Where written notice has been served on the Superintendent and upon proof of an undisputed claim arising from loss insured against in Ontario remaining unpaid for the space of sixty days after being due or of a disputed claim after final judgment in the regular course of law and tender of a legal, valid discharge being unpaid, the Superintendent may suspend or cancel the licence. R.S.O. 1990, c. I.8, s. 56 (1); 1997, c. 28, s. 92.

Revival of licence

(2)  The licence may be revived and the insurer may again transact business if, within six months after notice to the Superintendent of the failure of the insurer to pay an undisputed claim or the amount of a final judgment as provided in this section, such undisputed claim or final judgment upon or against the insurer in Ontario is paid and satisfied. R.S.O. 1990, c. I.8, s. 56 (2).

57.  Repealed: 1997, c. 19, s. 10 (10).

Disciplinary action against insurers

Superintendent’s report

58.  (1)  Upon examination, from annual statements, or upon any other evidence, the Superintendent shall make a report if he or she,

(a) finds, with respect to an insurer incorporated or organized under the laws of Ontario, that the assets of the insurer are insufficient to justify its continuance in business or to provide for its obligations;

(b) is of the opinion that there exists a state of affairs that is or may be prejudicial to the interests of persons who have contracts of insurance with an insurer licensed in Ontario;

(c) finds that an insurer licensed in Ontario has failed to comply with any provision of law or with its Act or instrument of incorporation or association; or

(d) becomes aware that the licence of an insurer licensed in Ontario has been suspended or cancelled by any government in Canada.

Notice to insurer

(2)  The Superintendent may give notice in writing, which shall include a copy of the report made under subsection (1), to the insurer stating that the Superintendent intends,

(a) to suspend or cancel the insurer’s licence; or

(b) to take possession and control of the assets of the insurer if incorporated or organized under the laws of Ontario.

Request for hearing

(3)  Within 15 days after receiving the notice, the insurer may request in writing that the Tribunal hold a hearing before the Superintendent takes any action described in the notice.

Hearing

(4)  If, within the time period allowed, the insurer requests a hearing, the Tribunal shall hold a hearing.

No request for hearing

(5)  If, within the time period allowed, the insurer does not request a hearing, the Superintendent may, by order,

(a) suspend or cancel the licence of the insurer; or

(b) take possession and control of the assets of the insurer if incorporated or organized under the laws of Ontario.

Interim order

(6)  If the Superintendent is of the opinion that the interests of the public may be adversely affected by any delay in making an order mentioned in subsection (5), the Superintendent may make an interim order before the expiry of the time period for the insurer to request a hearing or, if the Tribunal holds a hearing, before the final determination of the hearing.

Interim order in force

(7)  Unless the Superintendent revokes an interim order,

(a) the interim order remains in force indefinitely if, within the time allowed, the insurer does not request a hearing;

(b) the interim order remains in force until the final determination of the hearing if, within the time period allowed, the insurer requests a hearing.

Powers of Tribunal

(8)  At a hearing, if the Tribunal finds that one or more of the circumstances described in clauses (1) (a), (b), (c) and (d) exist, it may,

(a) suspend or cancel the licence of the insurer; or

(b) order the Superintendent to take possession and control of the assets of the insurer if incorporated or organized under the laws of Ontario.

Copy of order to insurer

(9)  If the Tribunal makes an order described in clause (8) (b), the Superintendent shall deliver a copy of the order to an officer of the insurer. 1997, c. 28, s. 94.

59.  Repealed: 1997, c. 28, s. 94.

60.  Repealed: 1997, c. 19, s. 10 (11).

61.  Repealed: 1997, c. 28, s. 95.

Superintendent takes control

Power of Superintendent upon taking control

62.  (1)  If the Superintendent has taken possession and control of the assets of the insurer, he or she shall thereafter conduct its business and take such steps as in his or her opinion should be taken toward its rehabilitation, and for such purposes the Superintendent has all the powers of the board of directors of the insurer, and, without limiting the generality of the foregoing, the Superintendent may,

(a) exclude the directors, officers, employees and agents of the insurer from the premises, property and business of the insurer; and

(b) carry on, manage and conduct the operations of the insurer and in the name of the insurer preserve, maintain, realize, dispose of and add to the property of the insurer, receive the incomes and revenues of the insurer and exercise all the powers of the insurer. R.S.O. 1990, c. I.8, s. 62 (1); 1993, c. 10, s. 9; 1997, c. 28, s. 96 (1).

Application to court

(2)  While the Superintendent has possession and control of the assets of an insurer under this section, the Superintendent may apply to the court for an order for the winding up of the insurer under Part VI of the Corporations Act. R.S.O. 1990, c. I.8, s. 62 (2); 1997, c. 28, s. 96 (2).

Appointment of managers

(3)  Where the Superintendent is in possession and control of the assets of an insurer and is conducting its business, he or she may appoint one or more persons to manage and operate the business of the insurer and,

(a) each person so appointed is a representative of the Superintendent; and

(b) the remuneration of any such person, other than an employee of the office of the Superintendent, shall be fixed by the Superintendent. R.S.O. 1990, c. I.8, s. 62 (3); 1997, c. 28, s. 96 (3).

Relinquishing control

(4)  Whenever the Superintendent believes that an insurer whose assets are in the possession and control of the Superintendent meets all the requirements of this Act and that it is otherwise proper for the insurer to resume possession and control of its assets and the conduct of its business, the Superintendent may relinquish to the insurer the possession and control of its assets, and after that time the powers of the Superintendent under this section cease.

Rehabilitation efforts futile

(5)  If the Superintendent considers that further efforts to rehabilitate an insurer whose assets are in the possession and control of the Superintendent would be futile, the Superintendent may relinquish to the insurer the possession and control of its assets, and after that time the powers of the Superintendent under this section cease. 1997, c. 28, s. 96 (4).

Expenses of proceedings

(6)  The expenses of the Superintendent incurred in rehabilitation proceedings under this section and section 58 shall be paid by all insurers licensed under this Act to carry on business of the same class or classes as the insurer who is the subject of the proceedings, and the share of each shall be the proportion of the expenses that the net premium income received from the insurer’s policyholders in Ontario in its last preceding fiscal year bears to the total net premium income received from the policyholders in Ontario by all insurers of that class in their respective last preceding fiscal years. R.S.O. 1990, c. I.8, s. 62 (6); 1997, c. 28, s. 96 (5).

Advisory committee

(7)  The insurers required to bear the said expenses of the Superintendent may appoint a committee of not more than six members to advise the Superintendent in respect of all matters pertinent to the rehabilitation of the insurer whose assets are in the possession and control of the Superintendent. R.S.O. 1990, c. I.8, s. 62 (7).

Appeal against Tribunal order to take control

63.  (1)  Despite section 62, an insurer may appeal to the Divisional Court from any order made by the Tribunal under clause 58 (8) (b) within thirty days after the delivery of a copy of the order to an officer of the insurer. 1993, c. 10, s. 10 (1); 1997, c. 28, s. 97 (1).

Stay

(2)  An order of the Tribunal under clause 58 (8) (b) shall take effect immediately, but where there is an appeal, a judge of the Divisional Court may grant a stay until any appeal is disposed of. R.S.O. 1990, c. I.8, s. 63 (2); 1993, c. 10, s. 10 (2); 1997, c. 28, s. 97 (2).

Documents to be filed

(3)  The Tribunal shall file with the Divisional Court,

(a) the decision of the Tribunal;

(b) the report of the Superintendent;

(c) the record of the hearing; and

(d) all written submissions by the appellant to the Tribunal. 1997, c. 28, s. 97 (3).

(4)  Repealed: 1993, c. 10, s. 10 (3).

Order

(5)  Where an appeal is taken under this section, the court may by order direct the Superintendent to take such action as the court considers proper or refrain from taking any action specified in the order and the Superintendent shall act accordingly. R.S.O. 1990, c. I.8, s. 63 (5).

Further decision

(6)  Despite the determination of the appeal under this section, the Superintendent and the Tribunal have power to make any further reports and orders on new material or where there is a material change in the circumstances, and any such further order is subject to appeal under this section. 1993, c. 10, s. 10 (4); 1997, c. 28, s. 97 (4).

Revival of licence

64.  Where the licence of an insurer is suspended or cancelled under this Act, it may be revived if the insurer makes good the deposit, or the deficiency, as the case may be, to the satisfaction of the Superintendent. R.S.O. 1990, c. I.8, s. 64; 1997, c. 28, s. 98.

Notice of suspension or cancellation

65.  If a licence of an insurer is suspended or cancelled, notice of such suspension or cancellation shall be published in The Ontario Gazette and elsewhere as the Superintendent directs, and thereafter any person transacting business on behalf of the insurer except for winding-up purposes is guilty of an offence. 1997, c. 28, s. 99.

Withdrawal from Automobile Insurance

Withdrawal procedure

65.1  (1)  For the purpose of this section, an insurer is withdrawing from the business of automobile insurance if the insurer does anything that results or is likely to result in a significant reduction in the amount of gross premiums written by the insurer for automobile insurance in any part of Ontario, including any of the following things that have or are likely to have that result:

1. Refusing to process applications for automobile insurance.

2. Declining to issue, terminating or refusing to renew contracts of automobile insurance.

3. Refusing to provide or continue coverages or endorsements in respect of contracts of automobile insurance.

4. Taking actions that directly or indirectly result in termination of contracts between the insurer and the agents and brokers who solicit or negotiate contracts of automobile insurance on behalf of the insurer.

5. Reducing the ability of the agents or brokers to solicit or negotiate contracts of automobile insurance on behalf of the insurer.

6. Reducing the insurer’s ability to act as a servicing carrier or ceasing to act as a servicing carrier under the Plan of Operation of the Facility Association.

7. Taking actions that directly or indirectly result in the termination of any contract between the insurer and the Facility Association.

8. Engaging in any activity or failure to act that is prescribed by the regulations.

Withdrawal from automobile insurance

(2)  An insurer shall not withdraw from the business of automobile insurance except in accordance with this section. 1993, c. 10, s. 11.

Procedure for withdrawal

(3)  An insurer that intends to withdraw from the business of automobile insurance shall file with the Superintendent a notice in the form provided by the Superintendent. 1993, c. 10, s. 11; 1997, c. 28, s. 100.

Time for notice

(4)  The notice shall specify the date that the insurer intends to begin to withdraw from the business of automobile insurance and shall be filed at least 180 days before that date. 1993, c. 10, s. 11.

Additional information

(5)  The Superintendent may require the insurer to provide such information, material and evidence as the Superintendent considers necessary in addition to the information, material and evidence required to be provided in the notice. 1993, c. 10, s. 11; 1997, c. 28, s. 100.

Authority to withdraw

(6)  The insurer may withdraw from the business of automobile insurance on or after the date specified in the notice under subsection (4). 1993, c. 10, s. 11.

Superintendent’s powers

(7)  Despite subsection (6), the Superintendent may,

(a) authorize the insurer to withdraw from the business of automobile insurance before the date specified in the notice under subsection (4); or

(b) prohibit the insurer from withdrawing from the business of automobile insurance until a date specified by the Superintendent that is not later than ninety days after the date specified in the notice under subsection (4). 1993, c. 10, s. 11; 1997, c. 28, s. 100.

Application of regulations under subs. 121 (1), par. 16

(8)  The Superintendent may order that the regulations made under paragraph 16 of subsection 121 (1) do not apply to a class of contracts, coverages or endorsements specified by the Superintendent to which an insurer is a party. 1993, c. 10, s. 11; 1997, c. 28, s. 100.

Deposits

Deposits

66.  (1)  At any time, the Superintendent may require an insurer to deposit, in any amount the Superintendent considers necessary, securities acceptable to the Superintendent and on such conditions as the Superintendent considers proper.

When to be made

(2)  The securities shall be deposited with the Superintendent within 30 days of the date that the requirement is made or within such longer period of time as is agreed to by the Superintendent. 1997, c. 19, s. 10 (14).

Appeal

(2.1)  An insurer may appeal to the Tribunal the decision of the Superintendent to require a deposit. 1997, c. 28, s. 101 (2).

Withdrawal of deposit

(3)  No part of a deposit shall be withdrawn without the approval of the Superintendent. 1997, c. 19, s. 10 (14).

Failure to comply

(4)  The Superintendent may suspend the licence of an insurer that fails to deposit securities in the amount and within the time required by,

(a) the Superintendent under subsection (1) if the insurer has not appealed the Superintendent’s decision; or

(b) the Tribunal under subsection (2.1) if the insurer has appealed the Superintendent’s decision. 1997, c. 28, s. 101 (3).

Vesting

(5)  Securities deposited with the Superintendent are vested in the Superintendent without any formal transfer.

Interest

(6)  The insurer is entitled to the interest and dividends paid on securities while the securities are on deposit with the Superintendent, if the insurer is in compliance with this Act.

Substitution

(7)  The Superintendent may permit an insurer to substitute other securities for those deposited by the insurer.

Reciprocal deposits

(8)  If an insurer incorporated under the laws of Ontario or a reciprocal insurance exchange provided for in Part XIII wants to be licensed by another province that requires a deposit, the Superintendent may hold securities as a deposit on a reciprocal basis for the other province.

Purpose of deposits

(9)  The Superintendent shall hold and administer a deposit as security for the Ontario contracts of the insurer and for any contracts in a reciprocating province.

Order to fix amount

(10)  If a reciprocating province requires that the amount of a deposit be in a fixed amount, the Lieutenant Governor in Council may, by order, fix the required amount of the deposit and list the reciprocating provinces with respect to the deposit.

Claims

(11)  If an insurer that has deposited securities with the Superintendent under this section ceases to carry on the business of insurance in Ontario or if its licence is suspended or cancelled under this Act, the Superintendent shall notify each reciprocating province of the cessation, suspension or cancellation.The notice shall state that the reciprocating province is entitled to submit to the Superintendent an accounting of all claims and liabilities outstanding in the reciprocating province in respect of the insurer before the deposit is released to the insurer.

Out-of-province insurer

(12)  If the Superintendent is notified that an insurer that has deposited securities with the Superintendent has ceased to transact business in a reciprocating province or that the insurer’s licence to transact the business of insurance has been suspended or cancelled in that province, the Superintendent may, at the request of the reciprocating province, take any action that the Superintendent could take if the insurer ceased to carry on the business of insurance in Ontario or could take if the licence of the insurer were suspended or cancelled in Ontario.

Notice to insured

(13)  If the Superintendent receives notice that an order has been made in another province for the administration of a deposit of an insurer in respect of which Ontario is a reciprocating province and that a date has been fixed by the trustee in the other province for the termination of the administration of the deposit, the Superintendent shall give notice of the termination date to persons insured under Ontario policies issued by the insurer.

Application to court

(14)  The Superintendent may, at any time, make application to a court of competent jurisdiction for directions regarding the administration of securities deposited by an insurer under this section. 1997, c. 19, s. 10 (14).

67.-99.  Repealed: 1997, c. 19, s. 10 (14).

Records and Returns

Report on share transfers

100.  No transfers of shares of an insurer shall be entered in the book or books maintained for that purpose until thirty days after notice thereof has been deposited with the Superintendent if,

(a) the transfer relates to 10 per cent or more of the issued shares of the insurer for the time being enjoying voting rights; or

(b) the directors have reason to believe that the transfer would result in a majority of the issued shares of the insurer for the time being enjoying voting rights being beneficially owned by any one person. R.S.O. 1990, c. I.8, s. 100; 1997, c. 28, s. 102.

Returns

101.  (1)  When required by the Superintendent, licensed insurers shall prepare and file with the Superintendent or with an agency designated by the Superintendent a return respecting the experience of the insurer’s business in a form approved by the Superintendent containing such information as the Superintendent may require. R.S.O. 1990, c. I.8, s. 101 (1); 1997, c. 28, s. 102.

Compilation of data

(2)  The Superintendent may require any agency so designated to compile the data so filed in such form as he or she may approve, and the expense of making the compilation shall be apportioned among the insurers whose data is compiled by such agency by the Superintendent, who shall certify in writing the amount due from each insurer, and it is payable by the insurer to such agency forthwith. R.S.O. 1990, c. I.8, s. 101 (2).

Audit and direction

(3)  If it appears to the Superintendent that the insurer’s records of premium income and claims paid are not kept in such a manner as to show correctly the experience of the insurer for the purposes of the return, the Superintendent may nominate an accountant to proceed under his or her direction to audit the books and records of the insurer and to give such instructions as will enable the officers of the insurer to keep the records correctly after the audit. R.S.O. 1990, c. I.8, s. 101 (3); 1997, c. 28, s. 102.

Expenses of audit

(4)  The insurer shall pay the accountant for an audit under subsection (3) forthwith upon receiving a certificate of the Superintendent stating the amount payable. R.S.O. 1990, c. I.8, s. 101 (4); 1997, c. 28, s. 102.

Debt to the Crown

(5)  Any amount payable to an accountant under subsection (3) that is not paid within thirty days from the date on which the insurer receives the Superintendent’s certificate becomes a debt owing to the Crown. R.S.O. 1990, c. I.8, s. 101 (5); 1997, c. 28, s. 102.

Information on claims

101.1  Every insurer shall provide the Superintendent or an agency designated by the Superintendent with information prescribed by the regulations about applications for insurance and claims made to the insurer at such times and subject to such conditions as are prescribed by the regulations. 1996, c. 21, s. 13; 1997, c. 28, s. 102.

Business statements and capital or asset requirements

Annual and interim statements

102.  (1)  Subject to section 370, every licensed insurer shall,

(a) prepare annually and deliver to the Superintendent or his or her designate, on or before the prescribed date for the prescribed category of insurer, a statement of the condition of affairs of the insurer for the year that ended, at the election of the company in its by-laws, on the 31st day of October or the 31st day of December next preceding the delivery of the statement; and

(b) prepare and deliver to the Superintendent or his or her designate when required by the Superintendent, for the prescribed category of insurer, an interim statement for the period specified by the Superintendent containing such information as the Superintendent considers necessary to assess the insurer’s condition of affairs. R.S.O. 1990, c. I.8, s. 102 (1); 1994, c. 11, s. 337; 1997, c. 19, s. 10 (15, 16); 2004, c. 31, Sched. 20, s. 4.

Contents of annual statement

(2)  A statement of the condition of affairs of an insurer under clause (1) (a) shall be in a form approved by the Superintendent, and shall set out,

(a) the assets, liabilities, revenues and expenses of the insurer for the year;

(b) particulars of the business done by the insurer in Ontario during the year; and

(c) such other information as the Superintendent considers necessary to assess an insurer’s condition of affairs. R.S.O. 1990, c. I.8, s. 102 (2).

Auditor’s report

(3)  A statement of the condition of affairs of an insurer under clause (1) (a) shall be accompanied by a report of an auditor prepared in the manner required by the Superintendent. R.S.O. 1990, c. I.8, s. 102 (3).

Modified statement

(4)  The Superintendent may, in writing, direct an insurer to prepare and file a modified statement respecting the business of the insurer in Ontario only, in lieu of filing the annual statement that the insurer is required to file under clause (1) (a). 1997, c. 28, s. 103.

Who may verify statement

(5)  In the case of a corporation, such statement shall be verified by the president, vice-president or managing director, or other director appointed for the purpose by the board of directors, and by the secretary or manager of the corporation. R.S.O. 1990, c. I.8, s. 102 (5).

Indirect collection of personal information

(6)  The Superintendent is authorized to obtain from insurers personal information about identifiable individuals where the collection of the information is required to monitor the condition of affairs of the insurer and the information is collected on a statement made under subsection (1). R.S.O. 1990, c. I.8, s. 102 (6).

(7)  Repealed: 2002, c. 18, Sched. H, s. 4 (10).

Required level of capital or assets

(8)  Every insurer licensed under this Act shall maintain capital or assets (in compliance with such requirements as may be prescribed by regulation governing the level of capital or assets to be maintained) in an amount that bears not less than a reasonable relationship to the outstanding liabilities, premiums and loss experience of the insurer. 1999, c. 12, Sched. I, s. 4 (11).

Same

(8.1)  The amount required by subsection (8) shall be calculated in accordance with such requirements as may be prescribed by regulation, and the calculation shall exclude any investments of the insurer that are not authorized by this Act or that were not authorized by law at the time they were acquired. 1999, c. 12, Sched. I, s. 4 (11).

Exception

(9)  Subsection (8) does not apply to a mutual insurance corporation that is a member of the Fire Mutuals Guarantee Fund or to an insurer licensed to transact only,

(a) the business of life insurance;

(b) the business of accident and sickness insurance; or

(c) the business of life insurance and the business of accident and sickness insurance. 2002, c. 18, Sched. H, s. 4 (11).

Contributions to the Fire Mutuals Guarantee Fund

(10)  The contribution by a member of the Fire Mutuals Guarantee Fund to the Fund shall be treated as if it were an asset of the member for the purposes of the statements required under this section and shall be subject to examination by the Superintendent in the same manner as the other assets and property of a licensed insurer. 2006, c. 33, Sched. O, s. 3.

Life insurance policies

(11)  No insurer incorporated and licensed under the laws of Ontario to transact life insurance shall issue a policy that does not appear to be self-supporting upon reasonable assumptions as to interest, mortality and expenses. 1997, c. 19, s. 10 (17).

Exemption from filing requirements

(12)  The Superintendent may, in writing, exempt completely or in part any insurer or any category of insurer from any or all of the filing requirements imposed under this section for the period of time specified in the exemption. 1997, c. 19, s. 10 (17).

Notice of returns

103.  Notice of the requirements for returns under section 101 or 102 is sufficient if it is sent by first class ordinary mail addressed to the insurer at the insurer’s address for service of notice or process as identified in the records of the Superintendent. R.S.O. 1990, c. I.8, s. 103.

Preparation of financial statements

104.  The financial statements required under this Act shall be prepared in accordance with this Act and the regulations. R.S.O. 1990, c. I.8, s. 104.

Published statements

105.  A statement purporting to show the financial condition of an insurer differing from the financial condition shown by the statement filed with the Superintendent, or a balance sheet or other statement in form differing from the form approved by the Superintendent, shall not be published or circulated, and every insurer publishing such a statement is guilty of an offence. R.S.O. 1990, c. I.8, s. 105; 2004, c. 31, Sched. 20, s. 5.

Statements that financial standing guaranteed by government prohibited

106.  Every person who represents orally or in writing that the issue of a licence to an insurer or the printing or publication of an annual statement in the report of the Superintendent or in any other publication of the Superintendent or any other circumstance of the supervision or regulation of the business of the insurer by law or the Superintendent is a warranty or guarantee of the financial standing of the insurer or of its ability to provide for the payment of its contracts at maturity is guilty of an offence. R.S.O. 1990, c. I.8, s. 106.

Real Property

Powers of insurer to hold real property

107.  An insurer incorporated and licensed under the laws of Ontario may hold, manage and otherwise deal with real property, subject to any restrictions on doing so under Parts XVII and XVII.1 or the regulations. 2006, c. 33, Sched. O, s. 4.

108.  Repealed: 1997, c. 19, s. 10 (21).

Life Insurance

Variable life insurance contracts based on segregated funds

109.  (1)  Any insurer incorporated and licensed under the laws of Ontario to transact the business of life insurance may,

(a) issue policies for which the reserves vary in amount with the market value of a specified group of assets; and

(b) retain for investment,

(i) policy dividends,

(ii) policy proceeds that become payable on surrender or maturity of the policy not less than five years from the date of its issue if the policyholder so directs, and

(iii) policy proceeds that become payable on the death of the policyholder if the policyholder or beneficiary so directs,

on the basis that the liability of the insurer in respect thereof varies in amount with the market value of a specified group of assets,

and the insurer shall maintain in respect of such policies, dividends and proceeds, as the case may be, one or more separate and distinct funds with separate assets for each such fund. R.S.O. 1990, c. I.8, s. 109 (1).

How fund created

(2)  For the purpose of creating a separate and distinct fund under subsection (1), an insurer may, if duly authorized by by-law,

(a) make a transfer from the shareholders’ fund but the amounts so transferred shall not exceed the surplus in the shareholders’ fund; and

(b) make a transfer of assets from one or more life insurance funds, but,

(i) the maximum amount that may be transferred from any life insurance fund is the amount by which 25 per cent of the surplus in that fund exceeds the aggregate of all prior transfers from that fund to all such separate and distinct funds under this subsection and clause (3) (b) less the aggregate of all prior transfers to that fund pursuant to clause (5) (a), and

(ii) the maximum amount that may be transferred from all life insurance funds is the amount by which 10 per cent of the surplus in those funds or $2,000,000, whichever is the lesser, exceeds the aggregate of all prior transfers from those funds to all such separate and distinct funds pursuant to this subsection and clause (3) (b) less the aggregate of all prior transfers to all life insurance funds pursuant to clause (5) (a). R.S.O. 1990, c. I.8, s. 109 (2).

Transfers to fund

(3)  For the purpose of maintaining a separate and distinct fund under subsection (1), an insurer may from time to time make transfers from a life insurance fund,

(a) to the extent that the assets of the separate and distinct fund are not sufficient to provide for any benefits guaranteed under the terms of the policies for which the separate fund is held; or

(b) in any case other than that mentioned in clause (a), if the insurer provides evidence satisfactory to the Superintendent that such transfers are necessary for the proper administration of the policies or deposits for which the separate fund is held. R.S.O. 1990, c. I.8, s. 109 (3).

Surplus

(4)  Where for the purposes of subsection (2) the surplus in any fund is required to be determined, the surplus shall be taken as shown in the most recent annual statement filed with the Superintendent. R.S.O. 1990, c. I.8, s. 109 (4).

Segregation of assets for policies

(5)  Where a separate and distinct fund is maintained under subsection (1), the assets of such fund shall, subject to subsection (3), be available only to meet the liabilities arising under the policies or deposits in respect of which such fund is maintained, except that,

(a) any amount representing the value of a transfer, or any part thereof, to such separate and distinct fund under subsection (2) or clause (3) (b), may, with the approval of the Superintendent, be transferred back to the fund or funds from which such transfer was made, and, where there is more than one such fund, the amount transferred back to each shall be that proportion of the whole amount that the amount transferred from that fund to the separate and distinct fund was to the total amount so transferred from all the funds; and

(b) any assets, other than assets in respect of a transfer to the separate and distinct fund under subsection (2) or clause (3) (b), remaining in the separate and distinct fund after the discharge of all the insurer’s liabilities in respect of the policies or deposits for which the fund is maintained, may be transferred to such other fund as the directors may determine. R.S.O. 1990, c. I.8, s. 109 (5).

Value of transfers

(6)  For the purposes of clause (2) (b), the value of any assets transferred to or from a separate and distinct fund shall be taken as the value thereof at the time of transfer to that fund and, for all other purposes, the value from time to time of any assets that have been transferred to a separate and distinct fund maintained under subsection (1) shall be the market value of such assets. R.S.O. 1990, c. I.8, s. 109 (6).

(7)  Repealed: 2006, c. 33, Sched. O, s. 5.

Variable life insurance contracts, forms and information folders

110.  (1)  In this section,

“variable insurance contract” means an annuity or life insurance contract for which the reserves or a part thereof vary in amount with the market value of a specified group of assets held in a separate and distinct fund and includes a provision in a life insurance contract under which policy dividends or policy proceeds may be retained for investment in such a fund.

Prohibition

(2)  No insurer shall issue a variable insurance contract or offer to enter into a variable insurance contract that under this Act would be deemed to be made in Ontario until there has been filed with the Superintendent a specimen form of such variable insurance contract, an information folder pertaining thereto and such other material as may be required under the regulations and a receipt therefor has been obtained from the Superintendent.

Form of contract

(3)  The forms of variable insurance contracts and information folders with respect thereto shall comply with the requirements of Part V of this Act and the regulations.

Form of information folder

(4)  The information folder shall provide brief and plain disclosure of all material facts relating to the variable insurance contract and shall contain a certificate to that effect signed by the chief executive officer and the chief financial officer of the insurer or such other persons as the regulations may prescribe.

Delivery of information folder

(5)  No application for a variable insurance contract shall be accepted by an insurer until the insurer has delivered to the applicant therefor a copy of the latest information folder relating thereto that is on file with the Superintendent.

New information folders

(6)  So long as an insurer continues to issue a variable insurance contract in respect of which it has filed an information folder, it shall,

(a) forthwith after the occurrence of any material change in the contract or in any other facts set out in the latest information folder so filed; and

(b) within thirteen months after the date of filing of the latest information folder so filed, or such other period of time as may be provided by the regulations,

file with the Superintendent a new information folder in respect thereof. R.S.O. 1990, c. I.8, s. 110 (1-6).

Prohibition order

(7)  Where it appears to the Superintendent that,

(a) an information folder or any other document filed with the Superintendent by an insurer with respect to a variable insurance contract,

(i) fails to comply in any substantial respect with the requirements of this Act or the regulations,

(ii) contains any promise, estimate, illustration or forecast that is misleading, false or deceptive, or

(iii) conceals or omits to state any material fact necessary in order to make any statement contained therein not misleading in the light of the circumstances in which it was made; or

(b) the financial condition of the insurer or its method of operation in connection with the issuance of its variable insurance contracts will not afford sufficient protection to prospective purchasers of such variable insurance contracts in Ontario,

the Superintendent may prohibit the insurer from continuing to issue such variable insurance contracts in Ontario. R.S.O. 1990, c. I.8, s. 110 (7); 1997, c. 28, s. 105 (1).

Appeal

(7.1)  The insurer may appeal the decision of the Superintendent under subsection (7) to the Tribunal. 1997, c. 28, s. 105 (2).

Regulations

(8)  The Lieutenant Governor in Council may make regulations,

(a) prescribing the form and content of variable insurance contracts;

(b) prescribing the form, content, time of filing and delivery of information folders and the persons to whom information folders shall be delivered;

(c) for the furnishing of information by an insurer or an agent thereof to prospective purchasers of variable insurance contracts;

(d) prescribing the documents, reports, statements, agreements and other information required to be filed, furnished or delivered under this section, and the form and content thereof. R.S.O. 1990, c. I.8, s. 110 (8).

Life insurers to separate business accounts

111.  Every insurer licensed to transact life insurance shall keep separate and distinct accounts of participating and non-participating business. R.S.O. 1990, c. I.8, s. 111.

Life insurance, distribution of parts of profits to participating policyholders

112.  (1)  The directors of an insurer incorporated and licensed under the laws of Ontario to transact the business of life insurance as a joint stock insurance company may from time to time set apart such portion of the net profits as they consider safe and proper for distribution as dividends or bonuses to shareholders and holders of participating policies, ascertaining the part thereof that has been derived from participating policies and distinguishing that part from the profits derived from other sources.

Idem

(2)  Despite anything to the contrary in any letters patent of incorporation or contract, the holders of participating policies are entitled to share in that portion of the profits that has been distinguished as having been derived from participating policies (including a share of the profits arising from the sale of securities in the proportion of the mean participating fund to the mean total funds) to the extent of at least 90 per cent thereof in any year.

Interest on unimpaired paid up capital stock

(3)  In fixing or arriving at the amount of divisible profits, there may be included interest on the amount of the unimpaired paid up capital stock and on any other sum or sums from time to time standing to the credit of the shareholders after deducting any amounts expended in the establishment, prosecution or extension of the company’s business or applied to making good any impairment of capital, and such interest may be allowed or credited to the shareholders at the average net rate of interest earned in the preceding year or other period under consideration upon the mean total funds of the company, but the shareholders are to be charged with a fair proportion of all losses incurred upon investments or other losses of a similar character in the proportion of the mean shareholders’ funds to the mean total funds.

Rights of participating policyholders

(4)  This section does not interfere with the rights of the participating policyholders of an insurer referred to in subsection (1) to share in the profits realized from the non-participating branch of its business in any case to which the policyholders are so entitled. R.S.O. 1990, c. I.8, s. 112.

Insurance with Unlicensed Insurers

Insurance with unlicensed insurers

113.  Despite anything in this Act, any person may insure property situated in Ontario against fire with an unlicensed insurer, and any property insured or to be insured under this section may be inspected and any loss incurred in respect thereof adjusted, if such insurance is effected outside Ontario and without any solicitation whatsoever directly or indirectly on the part of the insurer. R.S.O. 1990, c. I.8, s. 113.

114.  Repealed: 1999, c. 12, Sched. I, s. 4 (13).

General

Trafficking in life insurance policies prohibited

115.  Any person, other than an insurer or its duly authorized agent, who advertises or holds himself, herself or itself out as a purchaser of life insurance policies or of benefits thereunder, or who trafficks or trades in life insurance policies for the purpose of procuring the sale, surrender, transfer, assignment, pledge or hypothecation thereof to himself, herself or itself or any other person, is guilty of an offence. R.S.O. 1990, c. I.8, s. 115.

Note: On a day to be named by proclamation of the Lieutenant Governor, section 115 is repealed by the Statutes of Ontario, 2000, chapter 26, Schedule G, subsection 1 (1) and the following substituted:

Trafficking in life insurance policies prohibited

115.  Any person who advertises or holds himself, herself or itself out as a purchaser of life insurance policies or of benefits thereunder, or who trafficks or trades in life insurance policies for the purpose of procuring the sale, surrender, transfer, assignment, pledge or hypothecation thereof to himself, herself or itself or any other person, is guilty of an offence.

See: 2000, c. 26, Sched. G, ss. 1 (1), 2.

Privileged information

116.  Any information, document, record, statement or thing made or disclosed to the Commission concerning a person licensed or applying for licence under this Act is absolutely privileged and shall not be used as evidence in any action or proceeding in any court brought by or on behalf of such person. R.S.O. 1990, c. I.8, s. 116.

Form of insurance policy

117.  (1)  The Superintendent may require an insurer to file with him or her a copy of any form of policy or of the form of application for any policy issued or used by the insurer. R.S.O. 1990, c. I.8, s. 117 (1).

Prohibition of certain policies

(2)  If an insurer issues a policy or uses an application that, in the opinion of the Superintendent, is unfair, fraudulent, or not in the public interest, the Superintendent may prohibit the insurer from issuing or using the form of policy or application.

Appeal

(2.1)  The insurer may appeal the decision of the Superintendent under subsection (2) to the Tribunal. 1997, c. 28, s. 106.

Offence

(3)  An insurer that, after being so prohibited, issues any such policy or uses any such application is guilty of an offence. R.S.O. 1990, c. I.8, s. 117 (3).

Violation of law, effect of, on claim for indemnity

118.  Unless the contract otherwise provides, a contravention of any criminal or other law in force in Ontario or elsewhere does not, by that fact alone, render unenforceable a claim for indemnity under a contract of insurance except where the contravention is committed by the insured, or by another person with the consent of the insured, with intent to bring about loss or damage, but in the case of a contract of life insurance this section applies only to insurance undertaken as part of the contract whereby the insurer undertakes to pay insurance money or to provide other benefits in the event that the person whose life is insured becomes disabled as a result of bodily injury or disease. R.S.O. 1990, c. I.8, s. 118; 2002, c. 18, Sched. H, s. 4 (13).

Reporting on applications to register

119.  An insurer incorporated under the laws of Ontario shall notify the Superintendent fourteen days in advance of making application for registration under Part IX of the Canadian and British Insurance Companies Act (Canada) or any similar enactment or regulation of the Government of Canada. R.S.O. 1990, c. I.8, s. 119.

Agreements with Compensation Association

Authority of Minister

120.  The Minister, with the approval of the Lieutenant Governor in Council, may enter into agreements with a compensation association related to the conduct of a plan to compensate policyholders and eligible claimants of insolvent insurers. R.S.O. 1990, c. I.8, s. 120.

Fees and Regulations

Regulations

121.  (1)  The Lieutenant Governor in Council may make regulations,

1. prescribing limitations and conditions for the purpose of subsection 43 (4);

2. prescribing entities or classes of entities for the purposes of clause (f) of the definition of “financial institution” in section 1;

2.1 Repealed: 1997, c. 28, s. 107 (1).

3. designating one or more bodies corporate or associations as compensation associations and designating any such body corporate or association as a compensation association for one or more classes of insurers specified by the regulations;

4. Repealed: 2002, c. 18, Sched. H, s. 4 (14).

5. designating insurers for the purposes of clause 44 (3) (a) and designating classes of insurers for the purposes of clause 44 (3) (e);

6. prescribing ratios, percentages, amounts and calculations for the purposes of subsection 102 (8) and any such regulation may prescribe different ratios, percentages, amounts and calculations for one or more classes of insurance and for insurers whose business is limited to that of reinsurance;

7. exempting any insurer or class of insurers from any regulation made under paragraph 6 subject to such terms and conditions as may be set out in the regulations;

7.0.1 prescribing restrictions on insurers holding, managing or otherwise dealing with real property;

7.1 prescribing an activity or failure to act for the purpose of paragraph 8 of subsection 65.1 (1);

8. prescribing terms, conditions and limitations with respect to the reinsurance of risk;

9. establishing benefits for the purposes of Part VI that must be provided under contracts evidenced by motor vehicle liability policies and establishing terms, conditions, provisions, exclusions and limits related to such benefits;

10. requiring insurers to offer optional benefits in excess of the benefits that must be provided under paragraph 9 prescribing the circumstances in which the optional benefits are to be offered and establishing terms, conditions, provisions, exclusions and limits related to such benefits;

10.1 prescribing coverages and endorsements in respect of contracts of automobile insurance that insurers or a class of insurers are required to offer, deeming the benefits provided by the coverages and endorsements not to be statutory accident benefits for the purpose of Part VI, and prescribing the circumstances in which the coverages and endorsements shall be offered;

10.2 prescribing rules for interpreting the regulations made under paragraphs 9 and 10 or any provision of those regulations;

10.3 prescribing functions to be performed by a committee appointed under section 7;

10.4 governing the procedure for determining who is liable to pay statutory accident benefits under section 268, including requiring insurers to resolve disputes about liability through an arbitration process established by the regulations and requiring the interim payment of benefits pending the determination of liability;

11. prescribing categories of insurers for the purpose of subsection 101 (1), requiring insurers to file a return under that subsection by category and prescribing the information that insurers may solicit from insured persons for purposes of such returns;

11.1 prescribing the information to be provided under section 101.1 and any conditions that apply to the provision of the information;

12. prescribing categories of insurers for the purpose of subsection 102 (1);

13. prescribing dates for the purpose of clause 102 (1) (a);

14. governing the preparation of financial statements required under this Act or the regulations;

14.0.1 governing the investment and valuation of the assets of the Fire Mutuals Guarantee Fund;

14.1 for the purposes of Part VI or any provision of Part VI,

i. defining “automobile”,

ii. prescribing any vehicle or class of vehicles to be automobiles subject to any terms and conditions prescribed in the regulations,

iii. prescribing any vehicle or class of vehicles not to be automobiles, subject to any terms and conditions prescribed in the regulations;

15. prescribing the information to be given to applicants or to insured persons under subsection 229 (1) and the circumstances in which it is to be given;

15.0.1 governing the inspection of automobiles for the purpose of section 232.1;

15.1 for the purpose of section 234, prescribing statutory conditions and the types of contracts of automobile insurance to which the statutory conditions apply;

16. establishing requirements that must be met, in circumstances specified by the regulations, before an insurer declines to issue, terminates or refuses to renew a contract of automobile insurance or refuses to provide or continue any coverage or endorsement in respect of a contract of automobile insurance;

17. prescribing grounds for which an insurer cannot, in circumstances specified by the regulations, decline to issue, terminate or refuse to renew a contract of automobile insurance or refuse to provide or continue any coverage or endorsement in respect of a contract of automobile insurance;

18. prescribing coverages and endorsements for the purposes of section 237;

19. governing the payment of premiums for automobile insurance in instalments and setting maximum rates of interest in relation to instalment payments;

19.1 prescribing types of contracts and circumstances in which section 236 does not apply;

20. exempting any insurer, and exempting any insurer in respect of certain types of contracts of automobile insurance, from section 236;

20.1 prescribing information to be provided under clause 258.3 (1) (c) and the time period within which the information must be provided for the purpose of that clause;

20.2 prescribing procedures and time limits applicable to mediations required by section 258.6;

20.3 prescribing circumstances in which a contract or part of a contract providing insurance against loss of or damage to an automobile and the loss of use thereof must contain a clause described in subsection 261 (1.1);

20.4 prescribing a minimum or maximum sum to be deducted under a clause described in clause 261 (1) (b) or subsection 261 (1.1);

21. prescribing rules for determining the degree of fault in various situations for loss or damage arising directly or indirectly from the use or operation of an automobile;

22. providing for and governing indemnification and subrogation where section 263 applies;

22.1 prescribing classes of contracts for the purpose of subsection 263 (5.1);

22.2 prescribing circumstances in which a contract belonging to a class prescribed under paragraph 22.1 must contain a provision described in subsection 263 (5.2.1);

22.3 prescribing the minimum or maximum amount of a reduction required by a provision described in clause 263 (5.1) (b) or subsection 263 (5.2.1);

23. prescribing any activity or failure to act that constitutes an unfair or deceptive act or practice under the definition of “unfair or deceptive acts or practices” in section 438, and prescribing requirements that, if not complied with, constitute an unfair or deceptive act or practice;

23.1 defining serious impairment of an important physical, mental or psychological function for the purpose of section 267.1 and defining permanent serious impairment of an important physical, mental or psychological function for the purpose of section 267.5;

23.2 respecting the evidence that must be adduced to prove that a person has sustained serious impairment of an important physical, mental or psychological function for the purposes of section 267.1 or permanent serious impairment of an important physical, mental or psychological function for the purposes of section 267.5;

23.3 prescribing the method for determining net income loss and net loss of earning capacity for the purpose of paragraphs 2 and 3 of subsection 267.5 (1);

23.4 defining catastrophic impairment for the purpose of subsection 267.5 (4);

23.5 prescribing amounts for the purpose of sub-subparagraph B of subparagraph i of paragraph 3 of subsection 267.5 (7) and sub-subparagraph B of subparagraph ii of paragraph 3 of subsection 267.5 (7);

23.6 prescribing circumstances in which the court shall order that an award for damages be paid periodically under section 267.10;

23.6.1 for the purpose of this Act or any provision of this Act, deeming payments for income loss or loss of earning capacity under an income continuation benefit plan to include payments prescribed by the regulations;

23.6.2 prescribing types of amounts and the manner of determining any type of amount for the purposes of clause 267.12 (2) (c);

23.6.3 prescribing types of amounts and the manner of determining any type of amount for the purposes of clause 267.12 (3) (c);

23.6.4 prescribing, for the purposes of subsection 267.12 (4),

i. circumstances in which subsection 267.12 (1) does not apply,

ii. persons or classes of persons to whom subsection 267.12 (1) does not apply,

iii. motor vehicles or classes of motor vehicles to which subsection 267.12 (1) does not apply,

iv. terms, conditions, provisions, exclusions and limits for the purposes of determining if subsection 267.12 (1) applies in particular circumstances or to a prescribed person, prescribed class of persons, prescribed motor vehicle or prescribed class of motor vehicles;

23.6.5 defining the terms “taxicab”, “livery vehicle” and “limousine for hire” for the purposes of clause 267.12 (4) (c);

23.7 prescribing the information to be provided under section 273.1 and the conditions governing the provision of the information;

24. prescribing classes of persons, classes of automobiles and terms, conditions, provisions, exclusions and limits for the purposes of subsection 275 (1);

25. prescribing rules of procedure and setting time limits in respect of mediation, arbitration, appeal and variation proceedings under sections 280 to 284 and in respect of evaluations under section 280.1;

25.1 governing agreements to settle claims and disputes in respect of statutory accident benefits under Part VI;

25.2 governing the assignment of statutory accident benefits under Part VI, including the application of sections 279 to 287 to persons to whom the benefits are assigned;

26. prescribing expenses that may be awarded to insured persons and insurers under subsections 282 (11) and (11.1), prescribing criteria governing the awarding of the expenses, and setting maximum amounts that may be awarded for the expenses;

26.1 prescribing such matters as are required or permitted to be prescribed under sections 380.1 to 386 with respect to reciprocal insurance exchanges;

27. permitting the Director to vary or revoke orders and prescribing rules of procedure and setting conditions and setting time-limits in respect thereof and permitting the Director to proceed by way of a hearing or by way of written submissions;

28. extending the provisions of this Act or any of them to a system or class of insurance not particularly mentioned in this Act;

28.1 exempting a person or class of persons from section 393 and sections 397 to 401, or from any provision of those sections, subject to such terms and conditions, including any limitations or restrictions, as may be specified in the regulations;

28.2 governing the sale and marketing of prescribed classes of insurance to members of a group, including prescribing and regulating qualifications for membership in groups;

28.3 for the purposes of section 284.1, specifying terms and conditions governing the representation of a party to a proceeding under sections 279 to 284;

28.4 prescribing persons or classes of persons for the purposes of subsection 398 (3) and prescribing terms and conditions governing persons engaged in an activity set out in subsection 398 (1);

29. governing group insurance contracts or schemes, or any class thereof including prescribing and regulating their terms and conditions, qualifications for membership in groups and regulating the marketing of group insurance contracts or schemes;

30.-32. Repealed: 2006, c. 33, Sched. O, s. 6 (5).

33. governing the advertising of insurance contracts or any class thereof including prescribing and regulating the form and content of advertisements and requiring their filing;

33.1 governing the collection, use and disclosure of personal information by insurers or a class of insurers and, for that purpose, defining personal information;

34. prescribing types of contracts of automobile insurance and types of endorsements to contracts of automobile insurance in respect of which sections 410 to 417 apply;

34.1 prescribing percentages, criteria and elements of risk classification systems for the purposes of subsection 411 (1);

34.2 prescribing circumstances in which the Tribunal is required to hold a hearing on an application under section 410 to which section 411 does not apply;

35. prescribing coverages and categories of automobile insurance that may be provided by insurers and prescribing coverages and categories of automobile insurance that insurers are prohibited from providing;

36. prescribing a risk classification system or elements of a risk classification system that must be used by insurers or a class of insurers in classifying risks for a coverage or category of automobile insurance;

36.1 prescribing elements of a risk classification system that insurers or a class of insurers are prohibited from using in classifying risks for a coverage or category of automobile insurance;

36.2 prescribing, for the purpose of section 413.1, maximum monetary amounts and percentages by which the rate for a class of risks in respect of a coverage or category of automobile insurance may increase or decrease as a result of the application of a regulation made under paragraph 36 or 36.1;

37. Repealed: 1997, c. 28, s. 107 (3).

37.0.1 prescribing amounts incurred by the Ministry of Health and Long-Term Care that may be subject to an assessment under section 14.1 and governing assessments under that section;

37.1 respecting the relations between insurers, agents or brokers and,

i. entities that undertake the business of financial services,

ii. financial services intermediaries, and

iii. customers of persons and entities referred to in subparagraphs i and ii;

37.2 respecting networking arrangements between insurers and other persons providing products or services to the insurer or its customers;

37.3 prohibiting or restricting networking arrangements;

37.4 governing the conduct of insurers, agents and brokers in networking arrangements;

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection (1) is amended by the Statutes of Ontario, 2000, chapter 26, Schedule G, subsection 1 (2) by adding the following paragraph:

37.5 governing viatical settlements, including, without limiting the generality of the foregoing, defining “viatical settlement”, requiring a licence to carry on business in viatical settlements and governing those licences, governing the marketing and entering into of viatical settlements, requiring persons who solicit business for or otherwise assist persons who carry on business in viatical settlements to be licensed and governing those licences, governing the terms and conditions of viatical settlements, requiring the approval of a person or body specified by the regulations for any thing related to viatical settlements, declaring a viatical settlement to be void or voidable in circumstances prescribed by the regulations, and making any provision of this Act or the Financial Services Commission of Ontario Act, 1997 that applies to insurers applicable, with such modifications as may be specified by the regulations, to persons who carry on business in viatical settlements;

See: 2000, c. 26, Sched. G, ss. 1 (2), 2.

Note: On a day to be named by proclamation of the Lieutenant Governor, subsection (1) is amended by the Statutes of Ontario, 2000, chapter 26, Schedule G, subsection 1 (2) by adding the following paragraph:

37.6 exempting any person from section 115, subject to such terms and conditions as may be set out in the regulations;

See: 2000, c. 26, Sched. G, ss. 1 (2), 2.

38. generally for the better administration of this Act. R.S.O. 1990, c. I.8, s. 121 (1); 1993, c. 10, s. 12 (1-13); 1994, c. 11, s. 338; 1996, c. 21, s. 14 (1-8); 1997, c. 19, s. 10 (22-24); 1997, c. 28, s. 107 (1-3); 1999, c. 12, Sched. I, s. 4 (14, 15); 2002, c. 18, Sched. H, s. 4 (14); 2002, c. 22, s. 114; 2004, c. 31, Sched. 20, s. 6; 2005, c. 31, Sched. 12, s. 1; 2006, c. 19, Sched. L, s. 11 (3); 2006, c. 33, Sched. O, s. 6 (1-5).

Effective date of regulations

(2)  A regulation made under paragraph 6 of subsection (1) does not come into force until the day thirty days after it is filed with the Registrar of Regulations or such later day as may be set out in the regulation. R.S.O. 1990, c. I.8, s. 121 (2).

General or particular

(2.1)  A regulation made under subsection (1) may be general or particular. 1996, c. 21, s. 14 (9).

Adoption by reference

(2.2)  A regulation made under subsection (1) may adopt by reference, in whole or in part, with such changes as the Lieutenant Governor in Council considers necessary, any code, standard or guideline, as it reads at the time the regulation is made or as amended from time to time, whether before or after the regulation is made. 1996, c. 21, s. 14 (9).

(3)  Repealed: 1996, c. 21, s. 14 (10).

Same

(4)  The regulations made under paragraphs 9 and 10 of subsection (1),

(a) may establish procedures applicable to benefits;

(b) may prescribe the burden of proof and standard of proof applicable in court proceedings related to benefits and in arbitrations under section 282;

(c) may require that a person be examined or assessed,

(i) by an assessment centre designated by a committee appointed under section 7, in accordance with procedures, standards and guidelines established by that committee or by the Minister, or

(ii) by any other person specified by the regulations;

(d), (e) Repealed: 1996, c. 21, s. 14 (12).

Note: Clauses 121 (4) (c), (d) and (e), as they read immediately before November 1, 1996, continue to apply to regulations made under paragraphs 9 and 10 of subsection 121 (1) in respect of benefits arising from the use or operation, after December 31, 1993 and before November 1, 1996, of an automobile. See: 1996, c. 21, s. 14 (14), 52.

(f) may authorize the payment of a benefit directly to a minor for the purpose of subsection 271 (1.4);

(g) may provide for the use of forms prescribed by the regulations or approved by the Superintendent; and

(h) may designate jurisdictions for the purpose of any provision of this or any other Act that refers to jurisdictions designated in the Statutory Accident Benefits Schedule. 1993, c. 10, s. 12 (14); 1996, c. 21, s. 14 (11-14); 1997, c. 28, s. 107 (4).

Regulations, Part II.2

(5)  The Lieutenant Governor in Council may make regulations,

1. prescribing the circumstances in which an individual is affiliated with an insurer for the purposes of Part II.2;

2. governing the establishment and operation of committees of insurers, including setting out requirements respecting the composition, membership, quorum, powers and duties of committees established by the directors of insurers;

3. exempting any insurer or class of insurers from Part II.2 or from any provision of that Part or the regulations made for the purposes of that Part, subject to such conditions as may be set out in the exempting regulations;

4. prescribing anything that is referred to in Part II.2 as being prescribed by the regulations or determined under the regulations. 2006, c. 33, Sched. O, s. 6 (6).

Regulations, Part XVII

(6)  The Lieutenant Governor in Council may make regulations,

1. with respect to the definition of “commercial loan” in subsection 432 (1),

i. prescribing an amount for the purposes of subclause (a) (i) of the definition,

ii. prescribing international agencies and other entities for the purposes of subclauses (a) (iii) and (b) (ii) of the definition,

iii. prescribing rules for determining amounts for the purposes of subclause (a) (v) and sub-subclauses (a) (vi) (A), (a) (vii) (A) and (a) (viii) (A) of the definition, and

iv. defining “widely distributed” for the purposes of subclauses (b) (iv) and (c) (i) of the definition;

2. prescribing classes of subsidiaries of insurers for the purposes of the definition of “prescribed subsidiary” in subsection 432 (1);

3. prescribing permitted entities and classes of permitted entities in which an insurer may acquire, hold or increase a substantial investment and prescribing any circumstances or conditions that must be satisfied for an entity to be a permitted entity for the purposes of Part XVII;

4. prescribing interests in real property for the purposes of Part XVII;

5. respecting the investment by insurers in permitted entities, including restrictions and limits on investments in permitted entities and rules relating to the form of the investments in permitted entities;

6. prescribing undertakings and information for the purposes of subsections 435.1 (4) and (5);

7. prescribing circumstances in which an insurer or a member of a class of insurers may acquire, hold or increase a substantial investment in an entity or a class of entities;

8. prescribing conditions for the purposes of clauses 435.3 (1) (c) and (d);

9. prescribing circumstances for the purposes of clause 435.3 (4) (a), 435.4 (4) (a) or 435.6 (4) (a);

10. for the purposes of section 435.5, prescribing rules for determining which investments are specialized financing, prescribing entities as specialized financing entities and governing an insurer’s specialized financing investments, including venture capital investments;

11. prescribing circumstances for the purposes of clause 435.6 (1) (f);

12. prescribing rules for determining the various financial limits referred to in Part XVII;

13. prescribing restrictions or conditions on the making of investments or loans or on acquiring an interest in property for the purposes of section 435.7;

14. prescribing circumstances for the purposes of subsection 435.8 (1);

15. prescribing requirements for the purposes of subsection 435.8 (3);

16. prescribing an amount or rules for determining an amount for the purposes of,

i. subsection 435.9 (1),

ii. subsection 435.9 (2),

iii. section 435.10,

iv. subsection 435.11 (2),

v. subsection 435.12 (2);

17. prescribing rules for determining the value of assets and an insurer’s total assets for the purposes of section 435.14;

18. prescribing rules and circumstances for the purposes of clause 435.14 (3) (c);

19. exempting any insurer or class of insurers from Part XVII or from any provision of that Part or the regulations made for the purposes of that Part, subject to such conditions as may be set out in the exempting regulations;

20. providing that one or more of the financial limits prescribed for the purposes of Part XVII do not apply in respect of an insurer or class of insurers or with respect to an investment or class of investments, or both, and prescribing when the financial limit does not apply and any conditions that must be satisfied for the financial limit not to apply;

21. prescribing criteria that the Superintendent shall consider in determining whether to give an approval for the purposes of any provision in Part XVII that refers to the approval of the Superintendent, other than subsection 435.1 (2);

22. prescribing anything that is referred to in Part XVII as being prescribed by the regulations or determined under the regulations. 2006, c. 33, Sched. O, s. 6 (6).

Regulations, Part XVII.1

(7)  The Lieutenant Governor in Council may make regulations,

1. exempting any insurer or class of insurers from Part XVII.1 or from any provision of Part XVII.1 or the regulations made for the purposes of that Part, subject to such conditions as may be set out in the exempting regulations;

2. prescribing holding companies and circumstances for the purposes of clause 437.13 (2) (c);

3. prescribing circumstances in which an insurer may enter into a transaction with a related party and setting out conditions respecting such transactions;

4. prescribing conditions and circumstances under which a transaction entered into by a subsidiary of an insurer will not be deemed to have been entered into by the insurer;

5. prescribing rules and conditions relating to transactions between insurers and related parties;

6. prescribing, for the purposes of paragraph 1 of subsection 437.18 (1),

i. a nominal amount or rules for determining what constitutes a nominal amount, and

ii. what constitutes a transaction that is immaterial to an insurer or rules for determining what constitutes an immaterial transaction;

7. prescribing conditions for the purposes of subparagraph 4 i and rules for the purposes of subparagraph 4 ii of subsection 437.18 (1);

8. prescribing permitted transactions for the purposes of paragraphs 10 and 16 of subsection 437.18 (1);

9. prescribing transactions between an insurer and a related party that are permitted for the purposes of subsection 437.18 (4) despite the fact that they are not on terms and conditions at least as favourable to the insurer as market terms and conditions;

10. prescribing an amount or rules for determining an amount for the purposes of subsection 437.19 (2);

11. prescribing for the purposes of subsection 437.19 (6),

i. types or classes of transactions,

ii. rules for determining the total value of transactions, and

iii. an amount or rules for determining an amount;

12. prescribing for the purposes of subsection 437.19 (7),

i. types or classes of transactions that require approval of the directors of an insurer,

ii. rules for determining the total value of transactions,

iii. an amount or rules for determining an amount, and

iv. what constitutes approval, including prescribing a minimum percentage of directors who must approve;

13. prescribing criteria that the Superintendent shall consider in determining whether to give an approval for the purposes of any provision in Part XVII.1 that refers to the approval of the Superintendent;

14. prescribing anything that is referred to in Part XVII.1 as being prescribed by the regulations or determined under the regulations. 2006, c. 33, Sched. O, s. 6 (6).

General or particular

(8)  A regulation made under subsection (5), (6) or (7) may be general or particular. 2006, c. 33, Sched. O, s. 6 (6).

Same – classes

(9)  For greater certainty, a regulation made under subsection (5), (6) or (7) with respect to a class of insurers may be made with respect to any class as described in the regulation and is not limited to the classes of insurers set out in subsection 42 (1). 2006, c. 33, Sched. O, s. 6 (6).

Fees

121.1  The Minister may establish fees in relation to any matter under this Act, including any services provided by or through the Ministry of Finance or the Commission. 1997, c. 19, s. 10 (25).

Forms

121.2  (1)  The Superintendent may approve forms for any purpose of this Act and the forms may provide for such information to be furnished as the Superintendent may require. 1997, c. 19, s. 10 (25); 1997, c. 28, c. 108 (2).

Electronic forms

(2)  The Superintendent may approve electronic forms for any purposes under this Act. 1997, c. 19, s. 10 (25); 1997, c. 28, s. 108 (2).

PART II.1
ACTUARY OF THE INSURER

Definition

121.3  In this Part,

“insurer” means an insurer incorporated and licensed under the laws of Ontario. 2002, c. 18, Sched. H, s. 4 (15).

Appointment of actuary

121.4  (1)  The directors of an insurer shall appoint an actuary of the insurer. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  An insurer that is incorporated and licensed on the day this Part comes into force shall appoint an actuary of the insurer forthwith after that day. 2002, c. 18, Sched. H, s. 4 (15).

Notice of appointment

121.5  An insurer shall notify the Superintendent in writing of the appointment forthwith after the appointment of the actuary of the insurer. 2002, c. 18, Sched. H, s. 4 (15).

When officers not to be actuary

121.6  (1)  Neither the chief executive officer, the chief operating officer nor a person performing similar functions for an insurer shall be appointed as or hold the position of actuary of the insurer without the Superintendent’s written authorization. 2002, c. 18, Sched. H, s. 4 (15).

Duration of authorization

(2)  An authorization under subsection (1) expires on the earlier of the day specified in the authorization and the day that is six months after the authorization is issued. 2002, c. 18, Sched. H, s. 4 (15).

Chief financial officer

121.7  (1)  Neither the chief financial officer of an insurer nor a person performing similar functions for an insurer shall be appointed as or hold the position of actuary of the insurer unless,

(a) the Superintendent receives a written statement from the audit committee of the insurer indicating that it is satisfied that the duties of both positions will be adequately performed and that the actuarial duties will be performed in an independent manner; and

(b) the Superintendent authorizes the appointment or the holding of the position with or without conditions. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  The conditions may limit the period of time that the officer or person may be the actuary of the insurer. 2002, c. 18, Sched. H, s. 4 (15).

Revocation of appointment

121.8  (1)  The directors of an insurer may revoke the appointment of the actuary of the insurer. 2002, c. 18, Sched. H, s. 4 (15).

Notice of revocation

(2)  An insurer shall give the Superintendent written notice of the revocation of an appointment forthwith after the revocation. 2002, c. 18, Sched. H, s. 4 (15).

Ceasing to hold office

121.9  (1)  A person shall cease to be the actuary of the insurer when,

(a) the person resigns as actuary of the insurer;

(b) the person ceases to be an actuary; or

(c) the directors of the insurer revoke the appointment. 2002, c. 18, Sched. H, s. 4 (15).

Effective date of resignation

(2)  The resignation of an actuary of the insurer takes effect on the later of the day that the insurer receives written notice of the resignation and the day specified in that notice. 2002, c. 18, Sched. H, s. 4 (15).

Filling vacancy

121.10  If the office of actuary of the insurer becomes vacant, the directors of the insurer shall immediately appoint a new actuary of the insurer and notify the Superintendent of the vacancy and the new appointment. 2002, c. 18, Sched. H, s. 4 (15).

Statement of actuary

121.11  If an actuary of the insurer resigns or his or her appointment is revoked, the actuary shall submit a written statement to the directors of the insurer and the Superintendent stating the circumstances and reasons why the actuary resigned or why, in the actuary’s opinion, the appointment was revoked. 2002, c. 18, Sched. H, s. 4 (15).

Duty of replacement actuary

121.12  If an actuary of the insurer resigns or the appointment of the actuary of the insurer is revoked, no person shall accept an appointment or consent to be appointed as the actuary of the insurer unless,

(a) the person has received the statement referred to in section 121.11; or

(b) the person has asked the former actuary for a copy of that statement and has not received a copy of it within 15 days after asking for it. 2002, c. 18, Sched. H, s. 4 (15).

Actuary’s valuation

121.13  (1)  An actuary of the insurer shall value,

(a) the actuarial and other policy liabilities of the insurer as at the end of a year covered by the annual statement required under subsection 102 (1); and

(b) any other matters the Superintendent directs. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  The actuary’s valuation shall be in accordance with generally accepted actuarial practice with such changes as may be determined by the Superintendent and any additional directions that may be made by the Superintendent. 2002, c. 18, Sched. H, s. 4 (15).

Same

(3)  The insurer shall submit the actuary’s valuation report to the Superintendent with the statements required under subsection 102 (1). 2002, c. 18, Sched. H, s. 4 (15).

Superintendent may appoint actuary

121.14  (1)  The Superintendent may appoint an actuary to,

(a) conduct a review of the valuation of the actuary of the insurer completed under section 121.13; or

(b) conduct an independent valuation of matters referred to in section 121.13. 2002, c. 18, Sched. H, s. 4 (15).

Expenses payable by insurer

(2)  The expenses incurred in carrying out a review or a valuation under subsection (1) are payable by the insurer on being approved in writing by the Superintendent. 2002, c. 18, Sched. H, s. 4 (15).

Right to information

121.15  (1)  The actuary of the insurer may request information, explanations or access to any records of the insurer as are necessary to perform his or her duties. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  The present or former directors, officers, employees or representatives of an insurer shall permit access to records and provide information or explanations requested by the actuary of the insurer, to the extent they are reasonably able to do so. 2002, c. 18, Sched. H, s. 4 (15).

No civil liability

(3)  A person who acts in good faith under subsection (2) shall not be liable in any civil proceeding arising from that action. 2002, c. 18, Sched. H, s. 4 (15).

Actuary’s report

121.16  (1)  An actuary of the insurer shall submit a report in a form approved by the Superintendent to shareholders and policyholders of the insurer on the valuation made under section 121.13 and on any other matter required by the Superintendent, at least 21 days before the date of the annual meeting. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  The report shall include a statement by the actuary of the insurer as to whether, in the actuary’s opinion, the annual statement required under subsection 102 (1) presents fairly the results of the valuation made under section 121.13. 2002, c. 18, Sched. H, s. 4 (15).

Report to directors

121.17  (1)  An actuary of the insurer shall meet with the directors of the insurer or, if the directors so choose, with the audit committee of the insurer at least once during each fiscal year. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  At the meeting referred to in subsection (1), the actuary of the insurer shall report, in accordance with generally accepted actuarial practice and any direction made by the Superintendent, on the financial position of the insurer and, if specified in a direction of the Superintendent, the expected future financial condition of the insurer. 2002, c. 18, Sched. H, s. 4 (15).

Report to officers

121.18  (1)  An actuary of the insurer shall report in writing to the chief executive officer and chief financial officer of the insurer any matters that have come to the actuary’s attention in the course of carrying out the actuary’s duties if, in the actuary’s opinion, they have material adverse effects on the financial condition of the insurer and those matters require rectification. 2002, c. 18, Sched. H, s. 4 (15).

Submission of report

(2)  An actuary of the insurer shall also provide a copy of the report referred to in subsection (1) to the directors of the insurer immediately after making it. 2002, c. 18, Sched. H, s. 4 (15).

Failure to take action

(3)  If, in the opinion of the actuary of the insurer, suitable action is not being taken to rectify the matters referred to in subsection (1), the actuary shall immediately send a copy of the report to the Superintendent and advise the directors of the insurer that he or she has done so. 2002, c. 18, Sched. H, s. 4 (15).

Qualified privilege

121.19  (1)  An oral or written statement or report made under this Act by an actuary or former actuary of the insurer has qualified privilege. 2002, c. 18, Sched. H, s. 4 (15).

Same

(2)  An actuary or former actuary of the insurer who in good faith makes an oral or written statement or report under section 121.11 or 121.18 is not liable in any civil proceeding seeking indemnification for damages attributable to the actuary or former actuary of the insurer having made the statement or report. 2002, c. 18, Sched. H, s. 4 (15).

Non-application of this Part

121.20  This Part does not apply to a mutual insurance corporation that is a member of the Fire Mutuals Guarantee Fund. 2002, c. 18, Sched. H, s. 4 (15).

Non-application of s. 121.17

121.21  Section 121.17 does not apply to reciprocal insurance exchanges. 2002, c. 18, Sched. H, s. 4 (15).

Exemptions

121.22  On written application by an insurer, the Superintendent may in special circumstances approve the exemption of the insurer from section 121.13 or 121.17, or both, on such terms and conditions as may be specified in the approval. 2002, c. 18, Sched. H, s. 4 (15).

PART II.2
DIRECTORS OF AN INSURER

Affiliated individuals

Definitions

121.23  (1)  In this Part,

“insurer” means an insurer that is incorporated and licensed under the laws of Ontario; (“assureur”)

“person” includes an entity; (“personne”)

“reporting issuer” means an insurer that is a reporting issuer under the Securities Act. (“émetteur assujetti”) 2006, c. 33, Sched. O, s. 7.

Affiliated individual

(2)  An individual is affiliated with an insurer for the purposes of this Part in the circumstances prescribed by the regulations. 2006, c. 33, Sched. O, s. 7.

Affiliate

(3)  An entity is an affiliate of an insurer for the purposes of this Part if it is an affiliate of the insurer for the purposes of Part XVII. 2006, c. 33, Sched. O, s. 7.

Superintendent may determine individual is affiliated

(4)  Despite subsection (2), the Superintendent may determine that an individual is affiliated with an insurer for the purposes of this Part if, in the opinion of the Superintendent, the individual has such a significant or sufficient commercial, business or financial relationship with the insurer or an affiliate of the insurer that the relationship can be construed as being material to the individual and can reasonably be expected to affect the exercise of the individual’s best judgment. 2006, c. 33, Sched. O, s. 7.

Appeal

(5)  The individual or the insurer may appeal a decision of the Superintendent to the Tribunal. 2006, c. 33, Sched. O, s. 7.

Duration of determination

(6)  A determination by the Superintendent under subsection (4),

(a) becomes effective on the day of the next annual meeting of the shareholders and policyholders unless a notice in writing by the Superintendent revoking the determination is received by the insurer before that day; and

(b) ceases to be in effect on the day of the next annual meeting of the shareholders and policyholders after a notice in writing by the Superintendent revoking the determination is received by the insurer. 2006, c. 33, Sched. O, s. 7.

Directors’ duties

121.24  (1)  Subject to this Act and the regulations, the directors of an insurer shall,

(a) establish an audit committee;

(b) establish a conduct review committee;

(c) establish such other committees as may be required by the regulations;

(d) establish procedures to resolve conflicts of interest, including procedures for the identification of potential conflict situations, and establish or designate a committee of the directors to monitor the application of the procedures and the results of their application. 2006, c. 33, Sched. O, s. 7.

Committees

(2)  In establishing a committee, the directors shall comply with any requirements prescribed by the regulations relating to the composition, membership, quorum, powers and duties of the committee. 2006, c. 33, Sched. O, s. 7.

Quorum of executive committee

(3)  Despite subsection 70 (3) of the Corporations Act, a quorum of the members of the executive committee must include at least one member of the executive committee who is not affiliated with the insurer. 2006, c. 33, Sched. O, s. 7.

PART III
INSURANCE CONTRACTS IN ONTARIO

Application of Part

122.  Except where otherwise provided and where not inconsistent with other provisions of this Act, this Part applies to every contract of insurance made in Ontario, other than contracts of,

(a) accident and sickness insurance;

(b) life insurance; and

(c) marine insurance. R.S.O. 1990, c. I.8, s. 122; 2002, c. 18, Sched. H, s. 4 (16).

Contracts deemed made in Ontario

123.  Where the subject-matter of a contract of insurance is property in Ontario or an insurable interest of a person resident in Ontario, the contract of insurance, if signed, countersigned, issued or delivered in Ontario or committed to the post office or to any carrier, messenger or agent to be delivered or handed over to the insured or the insured’s assign or agent in Ontario shall be deemed to evidence a contract made therein, and the contract shall be construed according to the law thereof, and all money payable under the contract shall be paid at the office of the chief officer or agent in Ontario of the insurer in lawful money of Canada. R.S.O. 1990, c. I.8, s. 123.

Requirement for all terms to be set out in policy; relevance of proposal, etc.

Terms, etc., of contracts invalid unless set out in full

124.  (1)  All the terms and conditions of the contract of insurance shall be set out in full in the policy or by writing securely attached to it when issued, and, unless so set out, no term of the contract or condition, stipulation, warranty or proviso modifying or impairing its effect is valid or admissible in evidence to the prejudice of the insured or beneficiary. R.S.O. 1990, c. I.8, s. 124 (1).

Exception

(2)  Subsection (1) does not apply to an alteration or modification of the contract agreed upon in writing by the insurer and the insured after the issue of the policy. R.S.O. 1990, c. I.8, s. 124 (2).

Contents of renewal receipt

(3)  Whether the contract does or does not provide for its renewal, but it is renewed by a renewal receipt, it is a sufficient compliance with subsection (1) if the terms and conditions of the contract are set out as provided by that subsection and the renewal receipt refers to the contract by its number or date. R.S.O. 1990, c. I.8, s. 124 (3).

What regard to be given to proposal

(4)  The proposal or application of the insured shall not as against the insured be deemed a part of or be considered with the contract of insurance except in so far as the court determines that it contains a material misrepresentation by which the insurer was induced to enter into the contract. R.S.O. 1990, c. I.8, s. 124 (4).

Contract not to be invalidated by erroneous statement in application unless material

(5)  No contract of insurance shall contain or have endorsed upon it, or be made subject to, any term, condition, stipulation, warranty or proviso providing that such contract shall be avoided by reason of any statement in the application therefor, or inducing the entering into of the contract by the insurer, unless such term, condition, stipulation, warranty or proviso is and is expressed to be limited to cases in which such statement is material to the contract, and no contract shall be avoided by reason of the inaccuracy of any such statement unless it is material to the contract. R.S.O. 1990, c. I.8, s. 124 (5).

Materiality, how decided

(6)  The question of materiality in a contract of insurance is a question of fact for the jury, or for the court if there is no jury, and no admission, term, condition, stipulation, warranty or proviso to the contrary contained in the application or proposal for insurance, or in the instrument of contract, or in any agreement or document relating thereto, has any force or validity. R.S.O. 1990, c. I.8, s. 124 (6).

Application

(7)  This section does not apply to,

(a) contracts of automobile insurance; or

(b) contracts of insurance to which Part IV applies. 2002, c. 18, Sched. H, s. 4 (17).

Copy of proposal to be furnished to insured

125.  An insurer shall upon request furnish to the insured a true copy of the insured’s application or proposal for insurance. R.S.O. 1990, c. I.8, s. 125.

No contract shall be inconsistent with Act

126.  (1)  No insurer shall make a contract of insurance inconsistent with this Act.

Rights of insured

(2)  An act or omission of the insurer resulting in imperfect compliance with any of the provisions of this Act does not render a contract invalid as against the insured. R.S.O. 1990, c. I.8, s. 126.

Contents of policy

127.  (1)  Every policy shall contain the name of the insurer, the name of the insured, the name of the person or persons to whom the insurance money is payable, the amount, or the method of determining the amount, of the premium for the insurance, the subject-matter of the insurance, the indemnity for which the insurer may become liable, the event on the happening of which the liability is to accrue, the date upon which the insurance takes effect and the date it terminates or the method by which the latter is fixed or to be fixed. R.S.O. 1990, c. I.8, s. 127 (1).

Application of section

(2)  This section does not apply to contracts of surety insurance. R.S.O. 1990, c. I.8, s. 127 (2); 2002, c. 18, Sched. H, s. 4 (18).

Contracts providing for appraisals

128.  (1)  This section applies to a contract containing a condition, statutory or otherwise, providing for an appraisal to determine specified matters in the event of a disagreement between the insured and the insurer. R.S.O. 1990, c. I.8, s. 128 (1).

Appraisers, appointment

(2)  The insured and the insurer shall each appoint an appraiser, and the two appraisers so appointed shall appoint an umpire. R.S.O. 1990, c. I.8, s. 128 (2).

Appraisers, duties

(3)  The appraisers shall determine the matters in disagreement and, if they fail to agree, they shall submit their differences to the umpire, and the finding in writing of any two determines the matters. R.S.O. 1990, c. I.8, s. 128 (3).

Costs

(4)  Each party to the appraisal shall pay the appraiser appointed by the party and shall bear equally the expense of the appraisal and the umpire. R.S.O. 1990, c. I.8, s. 128 (4).

Appointment by judge

(5)  Where,

(a) a party fails to appoint an appraiser within seven clear days after being served with written notice to do so;

(b) the appraisers fail to agree upon an umpire within fifteen days after their appointment; or

(c) an appraiser or umpire refuses to act or is incapable of acting or dies,

a judge of the Superior Court of Justice may appoint an appraiser or umpire, as the case may be, upon the application of the insured or of the insurer. R.S.O. 1990, c. I.8, s. 128 (5); 2006, c. 19, Sched. C, s. 1 (1).

Relief from forfeiture

129.  Where there has been imperfect compliance with a statutory condition as to the proof of loss to be given by the insured or other matter or thing required to be done or omitted by the insured with respect to the loss and a consequent forfeiture or avoidance of the insurance in whole or in part and the court considers it inequitable that the insurance should be forfeited or avoided on that ground, the court may relieve against the forfeiture or avoidance on such terms as it considers just. R.S.O. 1990, c. I.8, s. 129.

How policy payable

130.  Insurance money is payable in Ontario in lawful money of Canada. R.S.O. 1990, c. I.8, s. 130.

Waiver of term or condition

131.  (1)  No term or condition of a contract shall be deemed to be waived by the insurer in whole or in part unless the waiver is stated in writing and signed by a person authorized for that purpose by the insurer.

Idem

(2)  Neither the insurer nor the insured shall be deemed to have waived any term or condition of a contract by any act relating to the appraisal of the amount of loss or to the delivery and completion of proofs or to the investigation or adjustment of any claim under the contract. R.S.O. 1990, c. I.8, s. 131.

Right of claimant against insurer where execution against insured returned unsatisfied

132.  (1)  Where a person incurs a liability for injury or damage to the person or property of another, and is insured against such liability, and fails to satisfy a judgment awarding damages against the person in respect of the person’s liability, and an execution against the person in respect thereof is returned unsatisfied, the person entitled to the damages may recover by action against the insurer the amount of the judgment up to the face value of the policy, but subject to the same equities as the insurer would have if the judgment had been satisfied.

Exception

(2)  This section does not apply to motor vehicle liability policies. R.S.O. 1990, c. I.8, s. 132.

Court actions for recovery of insurance money, special rules

Consolidation of actions

133.  (1)  Where several actions are brought for the recovery of money payable under a contract or contracts of insurance, the court may consolidate or otherwise deal therewith so that there is but one action for and in respect of all the claims made in such actions.

Where minors are entitled to insurance money

(2)  Where an action is brought to recover the share of one or more minors, all the other minors entitled, or the trustees, executors or guardians entitled to receive payment of the shares of such other minors, shall be made parties to the action, and the rights of all the minors shall be determined in one action.

Apportionment of sums directed to be paid

(3)  In all actions where several persons are interested in the insurance money, the court or judge may apportion among the persons entitled any sum directed to be paid, and may give all necessary directions and relief.

When payee is domiciled or resident abroad

(4)  Where the person entitled to receive money due and payable under a contract of insurance, except insurance of the person, is domiciled or resides in a foreign jurisdiction and payment, valid according to the law of such jurisdiction, is made to such person, such payment is valid and effectual for all purposes. R.S.O. 1990, c. I.8, s. 133.

Non-payment of premium

Effect of delivery of policy

134.  (1)  Where the policy has been delivered, the contract is as binding on the insurer as if the premium had been paid, although it has not in fact been paid, and although delivered by an officer or agent of the insurer who had not authority to deliver it.

Right of insurer in respect of unpaid premium

(2)  The insurer may sue for the unpaid premium and may deduct the amount thereof from the amount for which the insurer is liable under the contract of insurance.

Where note or cheque for premium not honoured

(3)  Where a cheque, bill of exchange or promissory note is given, whether originally or by way of renewal, for the whole or part of any premium and the cheque, bill of exchange or promissory note is not honoured according to its tenor, the insurer may terminate the contract forthwith by giving written notice by registered mail. R.S.O. 1990, c. I.8, s. 134.

Insurer to furnish forms for proof of loss

135.  (1)  An insurer, immediately upon receipt of a request, and in any event not later than sixty days after receipt of notice of loss, shall furnish to the insured or person to whom the insurance money is payable forms upon which to make the proof of loss required under the contract.

Offence

(2)  An insurer who neglects or refuses to comply with subsection (1) is guilty of an offence, and in addition section 136 is not available to the insurer as a defence to an action brought, after such neglect or refusal, for the recovery of money alleged to be payable under the contract of insurance.

Furnishing of forms not an admission

(3)  The furnishing by an insurer of forms to make proof of loss shall not be taken to constitute an admission by the insurer that a valid contract is in force or that the loss in question falls within the insurance provided by the contract. R.S.O. 1990, c. I.8, s. 135.

When action may be brought under contract

136.  No action shall be brought for the recovery of money payable under a contract of insurance until the expiration of sixty days after proof, in accordance with the provisions of the contract,

(a) of the loss; or

(b) of the happening of the event upon which the insurance money is to become payable,

or of such shorter period as is fixed by the contract of insurance. R.S.O. 1990, c. I.8, s. 136.

Insurance as Collateral Security

Mortgagee not to receive commission from insurer

137.  (1)  A mortgagee shall not accept or be entitled to receive either directly or through an agent or employee, and no officer or employee of such mortgagee shall accept or receive, any commission or other remuneration or benefit in consideration of effecting a contract of insurance or renewal thereof under which contract loss, if any, is payable to the mortgagee as mortgagee.

Payment of commission prohibited

(2)  No insurer or agent or broker shall pay, allow or give any commission or other remuneration or benefit to a mortgagee or to any person in the mortgagee’s employ or on the mortgagee’s behalf in consideration of effecting a contract of insurance or renewal thereof under which contract loss, if any, is payable to the mortgagee as mortgagee.

Offence

(3)  Any insurer or other person who contravenes this section is guilty of an offence. R.S.O. 1990, c. I.8, s. 137.

Right to refund of premium on termination of contract

138.  (1)  Where an insured assigns the right to refund of premium that may accrue by reason of the cancellation or termination of a contract of insurance under the terms thereof and notice of the assignment is given by the assignee to the insurer, the insurer shall pay any such refund to the assignee despite any condition in the contract, whether prescribed under this Act or not, requiring the refund to be paid to the insured or to accompany any notice of cancellation or termination to the insured.

Idem

(2)  Where the condition in the contract dealing with cancellation or termination by the insurer provides that the refund shall accompany the notice of cancellation or termination, the insurer shall include in the notice a statement that in lieu of payment of the refund in accordance with the condition the refund is being paid to the assignee under this section. R.S.O. 1990, c. I.8, s. 138.

Contracts of Guarantee Insurance

Contracts of title insurance

139.  (1)  Every contract of title insurance shall be in writing, and, in addition to the other requirements prescribed by this Act, shall expressly limit the liability of the insurer to a sum stated in the contract.

Questions as to validity of title

(2)  If a question arises as to the validity of the title insured, or as to the liability of the insurer, the insurer or the insured or any person entitled to proceed in right of either may by application have such question determined as provided in the Vendors and Purchasers Act in the case of vendors and purchasers. R.S.O. 1990, c. I.8, s. 139.

General

No racial or religious discrimination permissible

140.  Any licensed insurer that discriminates unfairly between risks in Ontario because of the race or religion of the insured is guilty of an offence. R.S.O. 1990, c. I.8, s. 140.

Payment into court

141.  (1)  Where an insurer cannot obtain a sufficient discharge for insurance money for which it admits liability, the insurer may apply to the court without notice for an order for the payment thereof into court, and the court may order the payment into court to be made upon such terms as to costs and otherwise as the court may direct, and may provide to what fund or name the amount shall be credited.

Discharge to insurer

(2)  The receipt of the registrar or other proper officer of the court is sufficient discharge to the insurer for the insurance money so paid into court, and the insurance money shall be dealt with according to the orders of the court. R.S.O. 1990, c. I.8, s. 141.

PART IV
FIRE INSURANCE

Meaning of “agricultural property”, Part IV

142.  In this Part, unless the context otherwise requires,

“agricultural property” includes dwelling-houses, stables, barns, sheds and outbuildings and their contents, wagons, carriages, and other vehicles, saddles and harness, agricultural engines, implements, tools, instruments, appliances and machinery, household goods, wearing apparel, provisions, musical instruments, libraries, livestock, growing crops, and crops severed from the land, fruit and ornamental trees, shrubs and plants, and live or standing timber, being upon farms as farm property, and owned by members of the insurer in which the property is insured. R.S.O. 1990, c. I.8, s. 142.

Application of Part

143.  (1)  This Part applies to insurance against loss of or damage to property arising from the peril of fire in any contract made in Ontario except,

(a) insurance within the class of aircraft insurance;

(a.1) insurance within the class of automobile insurance;

(a.2) insurance within the class of boiler and machinery insurance;

(a.3) insurance (other than marine insurance) against loss of or damage to property,

(i) while in transit or during delay incidental to transit, or

(ii) where, in the opinion of the Superintendent, the risk is substantially a transit risk;

(a.4) insurance within the class of marine insurance;

(a.5) insurance against loss of or damage to plate, sheet or window glass, whether in place or in transit;

(a.6) insurance against loss of or damage to property through the breakage or leakage of sprinkler equipment or other fire protection system, or of pumps, water pipes or plumbing and its fixtures;

(a.7) insurance against loss or damage through theft, wrongful conversion, burglary, house-breaking, robbery or forgery;

(b) where the subject-matter of the insurance is rents, charges or loss of profits;

(c) where the peril of fire is an incidental peril to the coverage provided; or

(d) where the subject-matter of the insurance is property that is insured by an insurer or group of insurers primarily as a nuclear risk under a policy covering against loss of or damage to the property resulting from nuclear reaction or nuclear radiation and from other perils. R.S.O. 1990, c. I.8, s. 143 (1); 2002, c. 18, Sched. H, s. 4 (19).

Automobiles

(2)  Despite subsection (1), this Part applies to insurance of an automobile as provided in subsection 47 (2). R.S.O. 1990, c. I.8, s. 143 (2).

Extent of coverage by contract

144.  (1)  Subject to subsection (4) of this section and to clause 151 (a), in any contract to which this Part applies the contract shall be deemed to cover the insured property,

(a) against fire (whether resulting from explosion or otherwise) not occasioned by or happening through,

(i) in the case of goods, their undergoing any process involving the application of heat,

(ii) riot, civil commotion, war, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection or military power;

(b) against lightning, but excluding destruction or loss to electrical devices or appliances caused by lightning or other electrical currents unless fire originates outside the article itself and only for such destruction or damage as occurs from such fire;

(c) against explosion (not occasioned by or happening through any of the perils specified in subclause (a) (ii)) of natural, coal or manufactured gas in a building not forming part of a gas works, whether fire ensues therefrom or not. R.S.O. 1990, c. I.8, s. 144 (1).

Radioactive contamination

(2)  Unless a contract to which this Part applies otherwise specifically provides, it does not cover the insured property against loss or damage caused by contamination by radio-active material directly or indirectly resulting from fire, lightning or explosion within the meaning of subsection (1). R.S.O. 1990, c. I.8, s. 144 (2).

Coverage where property removed

(3)  Where property insured under a contract covering it at a specified location is necessarily removed to prevent loss or damage or further loss or damage thereto, that part of the insurance under the contract that exceeds the amount of the insurer’s liability for any loss incurred covers, for seven days only or for the unexpired term of the contract if less than seven days, the property removed and any property remaining in the original location in the proportions that the value of the property in each of the respective locations bears to the value of the property in them all. R.S.O. 1990, c. I.8, s. 144 (3).

Extended insurance

(4)  Nothing in subsection (1) precludes an insurer giving more extended insurance against the perils mentioned therein, but in that case this Part does not apply to the extended insurance. R.S.O. 1990, c. I.8, s. 144 (4).

Power to extend meaning of “lightning” in livestock contracts

(5)  An insurer licensed to carry on property insurance may include in its insurance contracts a clause or endorsement providing that, in the case of livestock insured against death or injury caused by fire or lightning, the word “lightning” is deemed to include other electrical currents. R.S.O. 1990, c. I.8, s. 144 (5); 2002, c. 18, Sched. H, s. 4 (20).

Renewal of contract

145.  A contract may be renewed by the delivery of a renewal receipt identifying the policy by number, date or otherwise. R.S.O. 1990, c. I.8, s. 145; 1999, c. 12, Sched. I, s. 4 (16).

Form of contract

146.  After an application for insurance is made, if it is in writing, any policy sent to the insured shall be deemed to be intended to be in accordance with the terms of the application, unless the insurer points out in writing the particulars wherein it differs from the application, in which case the insured may, within two weeks from the receipt of the notification, reject the policy. R.S.O. 1990, c. I.8, s. 146.

Mortgagees and other payees

147.  (1)  Where the loss, if any, under a contract has, with the consent of the insurer, been made payable to a person other than the insured, the insurer shall not cancel or alter the policy to the prejudice of that person without notice to that person. R.S.O. 1990, c. I.8, s. 147 (1).

Form of notice

(2)  Subject to subsection (3), the length of and manner of giving the notice under subsection (1) is the same as notice of cancellation to the insured under the statutory conditions in the contract. R.S.O. 1990, c. I.8, s. 147 (2); 1997, c. 19, s. 10 (26).

Alternate notice

(3)  If the loss under a contract has, with the consent of the insurer, been made payable to a person other than the insured, the insurer and the person may enter into a written agreement to provide for alternate notice. 1997, c. 19, s. 10 (27).

Statutory conditions

148.  (1)  The conditions set forth in this section shall be deemed to be part of every contract in force in Ontario and shall be printed in English or French in every policy with the heading “Statutory Conditions” or “Conditions légales”, as may be appropriate, and no variation or omission of or addition to any statutory condition is binding on the insured.

Definition

(2)  In this section,

“policy” does not include interim receipts or binders.

STATUTORY CONDITIONS

Misrepresentation

1.  If a person applying for insurance falsely describes the property to the prejudice of the insurer, or misrepresents or fraudulently omits to communicate any circumstance that is material to be made known to the insurer in order to enable it to judge of the risk to be undertaken, the contract is void as to any property in relation to which the misrepresentation or omission is material.

Property of Others

2.  Unless otherwise specifically stated in the contract, the insurer is not liable for loss or damage to property owned by any person other than the insured, unless the interest of the insured therein is stated in the contract.

Change of Interest

3.  The insurer is liable for loss or damage occurring after an authorized assignment under the Bankruptcy Act (Canada) or change of title by succession, by operation of law, or by death.

Material Change

4.  Any change material to the risk and within the control and knowledge of the insured avoids the contract as to the part affected thereby, unless the change is promptly notified in writing to the insurer or its local agent, and the insurer when so notified may return the unearned portion, if any, of the premium paid and cancel the contract, or may notify the insured in writing that, if the insured desires the contract to continue in force, the insured must, within fifteen days of the receipt of the notice, pay to the insurer an additional premium, and in default of such payment the contract is no longer in force and the insurer shall return the unearned portion, if any, of the premium paid.

Termination

5.  (1)  This contract may be terminated,

(a) by the insurer giving to the insured fifteen days’ notice of termination by registered mail or five days’ written notice of termination personally delivered;

(b) by the insured at any time on request.

(2)  Where this contract is terminated by the insurer,

(a) the insurer shall refund the excess of premium actually paid by the insured over the proportionate premium for the expired time, but, in no event, shall the proportionate premium for the expired time be deemed to be less than any minimum retained premium specified; and

(b) the refund shall accompany the notice unless the premium is subject to adjustment or determination as to amount, in which case the refund shall be made as soon as practicable.

(3)  Where this contract is terminated by the insured, the insurer shall refund as soon as practicable the excess of premium actually paid by the insured over the short rate premium for the expired time, but in no event shall the short rate premium for the expired time be deemed to be less than any minimum retained premium specified.

(4)  The refund may be made by money, postal or express company money order or cheque payable at par.

(5)  The fifteen days mentioned in clause (1) (a) of this condition commences to run on the day following the receipt of the registered letter at the post office to which it is addressed.

Requirements After Loss

6.  (1)  Upon the occurrence of any loss of or damage to the insured property, the insured shall, if the loss or damage is covered by the contract, in addition to observing the requirements of conditions 9, 10 and 11,

(a) forthwith give notice thereof in writing to the insurer;

(b) deliver as soon as practicable to the insurer a proof of loss verified by a statutory declaration,

(i) giving a complete inventory of the destroyed and damaged property and showing in detail quantities, costs, actual cash value and particulars of amount of loss claimed,

(ii) stating when and how the loss occurred, and if caused by fire or explosion due to ignition, how the fire or explosion originated, so far as the insured knows or believes,

(iii) stating that the loss did not occur through any wilful act or neglect or the procurement, means or connivance of the insured,

(iv) showing the amount of other insurances and the names of other insurers,

(v) showing the interest of the insured and of all others in the property with particulars of all liens, encumbrances and other charges upon the property,

(vi) showing any changes in title, use, occupation, location, possession or exposures of the property since the issue of the contract,

(vii) showing the place where the property insured was at the time of loss;

(c) if required, give a complete inventory of undamaged property and showing in detail quantities, cost, actual cash value;

(d) if required and if practicable, produce books of account, warehouse receipts and stock lists, and furnish invoices and other vouchers verified by statutory declaration, and furnish a copy of the written portion of any other contract.

(2)  The evidence furnished under clauses (1) (c) and (d) of this condition shall not be considered proofs of loss within the meaning of conditions 12 and 13.

Fraud

7.  Any fraud or wilfully false statement in a statutory declaration in relation to any of the above particulars, vitiates the claim of the person making the declaration.

Who may give notice and proof

8.  Notice of loss may be given and proof of loss may be made by the agent of the insured named in the contract in case of absence or inability of the insured to give the notice or make the proof, and absence or inability being satisfactorily accounted for, or in the like case, or if the insured refuses to do so, by a person to whom any part of the insurance money is payable.

Salvage

9.  (1)  The insured, in the event of any loss or damage to any property insured under the contract, shall take all reasonable steps to prevent further damage to such property so damaged and to prevent damage to other property insured hereunder including, if necessary, its removal to prevent damage or further damage thereto.

(2)  The insurer shall contribute proportionately towards any reasonable and proper expenses in connection with steps taken by the insured and required under subcondition (1) of this condition according to the respective interests of the parties.

Entry, Control, Abandonment

10.  After loss or damage to insured property, the insurer has an immediate right of access and entry by accredited agents sufficient to enable them to survey and examine the property, and to make an estimate of the loss or damage, and, after the insured has secured the property, a further right of access and entry sufficient to enable them to make appraisement or particular estimate of the loss or damage, but the insurer is not entitled to the control or possession of the insured property, and without the consent of the insurer there can be no abandonment to it of insured property.

Appraisal

11.  In the event of disagreement as to the value of the property insured, the property saved or the amount of the loss, those questions shall be determined by appraisal as provided under the Insurance Act before there can be any recovery under this contract whether the right to recover on the contract is disputed or not, and independently of all other questions. There shall be no right to an appraisal until a specific demand therefor is made in writing and until after proof of loss has been delivered.

When Loss Payable

12.  The loss is payable within sixty days after completion of the proof of loss, unless the contract provides for a shorter period.

Replacement

13.  (1)  The insurer, instead of making payment, may repair, rebuild, or replace the property damaged or lost, giving written notice of its intention so to do within thirty days after receipt of the proofs of loss.

(2)  In that event the insurer shall commence to so repair, rebuild, or replace the property within forty-five days after receipt of the proofs of loss, and shall thereafter proceed with all due diligence to the completion thereof.

Action

14.  Every action or proceeding against the insurer for the recovery of a claim under or by virtue of this contract is absolutely barred unless commenced within one year next after the loss or damage occurs.

Notice

15.  Any written notice to the insurer may be delivered at, or sent by registered mail to, the chief agency or head office of the insurer in the Province. Written notice may be given to the insured named in the contract by letter personally delivered to the insured or by registered mail addressed to the insured at the insured’s latest post office address as notified to the insurer. In this condition, the expression “registered” means registered in or outside Canada.

R.S.O. 1990, c. I.8, s. 148.

Limitation of liability clause

149.  A contract containing,

(a) a deductible clause;

(b) a co-insurance, average or similar clause; or

(c) a clause limiting recovery by the insured to a specified percentage of the value of any property insured at the time of loss, whether or not that clause is conditional or unconditional,

shall have printed or stamped upon its face in red ink or bold type the words “The policy contains a clause that may limit the amount payable”, or the French equivalent failing which the clause is not binding upon the insured. R.S.O. 1990, c. I.8, s. 149; 1997, c. 19, s. 10 (28).

Rateable contribution

150.  (1)  Where on the happening of any loss or damage to property insured there is in force more than one contract covering the same interest, each of the insurers under the respective contracts is liable to the insured for its rateable proportion of the loss, unless it is otherwise expressly agreed in writing between the insurers.

Effect of policy may not be postponed

(2)  For the purpose of subsection (1), a contract shall be deemed to be in force despite any term thereof that the policy will not cover, come into force, attach or become insurance with respect to the property until after full or partial payment of any loss under any other policy.

Certain restrictions valid

(3)  Nothing in subsection (1) affects the validity of any divisions of the sum insured into separate items, or any limits of insurance on specified property, or any clause referred to in section 149 or any contract condition limiting or prohibiting the having or placing of other insurance.

Ascertainment of rateable proportions

(4)  Nothing in subsection (1) affects the operation of any deductible clause and,

(a) where one contract contains a deductible, the proportion of the insurer under that contract shall be first ascertained without regard to the clause and then the clause shall be applied only to affect the amount of recovery under that contract; and

(b) where more than one contract contains a deductible, the proportions of the insurers under those contracts shall be first ascertained without regard to the deductible clauses and then the highest deductible shall be pro rated among the insurers with deductibles and these pro rated amounts shall affect the amount of recovery under those contracts.

Idem

(5)  Nothing in subsection (4) shall be construed to have the effect of increasing the proportional contribution of an insurer under a contract that is not subject to a deductible clause.

Insurance on identified articles

(6)  Despite subsection (1), insurance on identified articles is a first loss insurance as against all other insurance. R.S.O. 1990, c. I.8, s. 150.

Special stipulations

151.  Where a contract,

(a) excludes any loss that would otherwise fall within the coverage prescribed by section 144; or

(b) contains any stipulation, condition or warranty that is or may be material to the risk including, but not restricted to, a provision in respect to the use, condition, location or maintenance of the insured property,

the exclusion, stipulation, condition or warranty is not binding upon the insured, if it is held to be unjust or unreasonable by the court before which a question relating thereto is tried. R.S.O. 1990, c. I.8, s. 151.

Subrogation

152.  (1)  The insurer, upon making a payment or assuming liability therefor under a contract to which this Part applies, is subrogated to all rights of recovery of the insured against any person, and may bring action in the name of the insured to enforce such rights. R.S.O. 1990, c. I.8, s. 152 (1); 2002, c. 18, Sched. H, s. 4 (21).

Where amount recovered is not sufficient to indemnify

(2)  Where the net amount recovered, after deducting the costs of recovery, is not sufficient to provide a complete indemnity for the loss or damage suffered, that amount shall be divided between the insurer and the insured in the proportions in which the loss or damage has been borne by them respectively. R.S.O. 1990, c. I.8, s. 152 (2).

Fire Mutuals Guarantee Fund

General reinsurance agreement

153.  An insurer that is a member of the Fire Mutuals Guarantee Fund shall enter into and remain a party to a general reinsurance agreement with a mutual insurance corporation incorporated under subsection 148 (3) of the Corporations Act. 1999, c. 12, Sched. I, s. 4 (17).

154.-168.  Repealed: 1999, c. 12, Sched. I, s. 4 (17).

Fire Mutuals Guarantee Fund

169.  (1)  The agreement establishing the Fire Mutuals Guarantee Fund is continued and may be amended with the approval of the Superintendent. 1999, c. 12, Sched. I, s. 4 (18).

Members

(2)  The following persons may be members of the Fund, with the approval of the Superintendent:

1. Mutual insurance corporations including those that are incorporated under subsection 148 (3) of the Corporations Act.

2. Joint stock insurance companies, all the shares of which are owned by one or more mutual insurance corporations that are members of the Fund. 1999, c. 12, Sched. I, s. 4 (18).

Purposes

(3)  The Fund has the following purposes, and such additional purposes as may be set out in the agreement:

1. To pay the insurance claims and repay the unearned premiums of policyholders who are members of the Fund, if a member is unable to meet its obligations.

2. To pay the insurance claims of third parties against policyholders who are members of the Fund, if a member is unable to meet its obligations. 1999, c. 12, Sched. I, s. 4 (18).

Same

(3.1)  With the approval of the Superintendent, the assets of the Fund may be used for the purposes of the Fund. 1999, c. 12, Sched. I, s. 4 (18).

Powers

(3.2)  If the Fund is authorized to do so by the agreement, the Fund may,

(a) assess its members in respect of any payments that the Fund has authorized in respect of a member who is unable to meet its obligations; and

(b) until the assessments are paid, borrow money or establish lines of credit for the purposes of making payments in respect of the member who is unable to meet its obligations. 1999, c. 12, Sched. I, s. 4 (18).

Administration

(3.3)  The assets of the Fund shall be held in trust by a trust corporation registered under the Loan and Trust Corporations Act. 1999, c. 12, Sched. I, s. 4 (18).

Assets of Fund

(4)  The assets of the Fund shall,

(a) be maintained at no less than a book value of $1,000,000 including the value of any assessments made to restore the book value of $1,000,000, or such further amount as may be specified from time to time by the Superintendent;

(b) be maintained or increased by assessments on parties to the agreement on the basis set out in the agreement referred to in subsection (1);

(c) Repealed: 2006, c. 33, Sched. O, s. 8 (1).

(d) be invested and valued in accordance with the regulations. R.S.O. 1990, c. I.8, s. 169 (4); 1999, c. 12, Sched. I, s. 4 (19); 2006, c. 33, Sched. O, s. 8.

Relief from assessment

(5)  No assessment referred to in clause (3.2) (a) or (4) (b) shall be paid by an insurer if its effect would be to reduce the surplus of that insurer below the minimum amount specified by the Superintendent, and such a waiver of an assessment shall not be cause for the insurer’s expulsion from the Fund. R.S.O. 1990, c. I.8, s. 169 (5); 1999, c. 12, Sched. I, s. 4 (20).

Interest of Superintendent in Fund

(6)  The Superintendent shall be deemed to have an interest in the Fund as representative of all persons who may be claimants against insurers that are parties to the agreement and the trustees shall from time to time furnish the Superintendent with such information and accounts with respect to the Fund as the Superintendent may require. R.S.O. 1990, c. I.8, s. 169 (6).

Cessation of membership

(7)  The Superintendent may permit an insurer to cease to be a member of the Fund and may impose such terms and conditions respecting the cessation as the Superintendent considers appropriate. 1999, c. 12, Sched. I, s. 4 (21).

Withdrawal of approval

(7.1)  The Superintendent may withdraw his or her approval under subsection (2) when an insurer is in default of payment of its assessment under the agreement. 1999, c. 12, Sched. I, s. 4 (21).

Ceasing to issue contracts on premium note plan

(8)  An insurer who becomes a member of the Fund shall cease to undertake contracts of insurance or to renew existing contracts of insurance on the premium note plan. 1999, c. 12, Sched. I, s. 4 (21).

Application of Act

(9)  All parties to the agreement and their officers and directors shall be deemed to be persons engaged in the business of insurance for the purposes of this Act and the regulations and any contravention of the trust agreement constitutes an offence. R.S.O. 1990, c. I.8, s. 169 (9).

Passing of accounts

(10)  An account filed with the Superintendent under subsection (6), except so far as mistake or fraud is shown, is binding and conclusive upon all interested persons as to all matters shown in the account and the trustees’ administration thereof, unless the Superintendent, within six months of the date upon which the account is filed with him or her, requires in writing that such account be filed and passed before a judge of the Superior Court of Justice. R.S.O. 1990, c. I.8, s. 169 (10); 2006, c. 19, Sched. C, s. 1 (1).

Idem

(11)  The provisions of the Estates Act and the rules made thereunder and of the Trustee Act with respect to the passing of accounts of the trustees apply, with necessary modifications, to the passing of accounts under subsection (10). R.S.O. 1990, c. I.8, s. 169 (11).

170.  Repealed: 1999, c. 12, Sched. I, s. 4 (22).

PART V
LIFE INSURANCE

Definitions

Definitions, Part V

171.  (1)  In this Part,

“application” means an application for insurance or for the reinstatement of insurance; (“proposition”)

“beneficiary” means a person, other than the insured or the insured’s personal representative, to whom or for whose benefit insurance money is made payable in a contract or by a declaration; (“bénéficiaire”)

“contract” means a contract of life insurance; (“contrat”)

“court” means the Superior Court of Justice or a judge thereof; (“tribunal”)

“creditor’s group insurance” means insurance effected by a creditor in respect of the lives of the creditor’s debtors whereby the lives of the debtors are insured severally under a single contract; (“assurance collective de créancier”)

“declaration” means an instrument signed by the insured,

(a) with respect to which an endorsement is made on the policy,

(b) that identifies the contract, or

(c) that describes the insurance or insurance fund or a part thereof,

in which the insured designates, or alters or revokes the designation of, the insured’s personal representative or a beneficiary as one to whom or for whose benefit insurance money is to be payable; (“déclaration”)

“family insurance” means insurance whereby the lives of the insured and one or more persons related to the insured by blood, marriage or adoption are insured under a single contract between an insurer and the insured; (“assurance familiale”)

“group insurance” means insurance, other than creditor’s group insurance and family insurance, whereby the lives of a number of persons are insured severally under a single contract between an insurer and an employer or other person; (“assurance collective”)

“group life insured” means a person whose life is insured by a contract of group insurance but does not include a person whose life is insured under the contract as a person dependent upon, or related to, him or her; (“personne assurée par une assurance-vie collective”)

“instrument” includes a will; (“acte”)

“insurance” means life insurance; (“assurance”)

“insured”,

(a) in the case of group insurance, means, in the provisions of this Part relating to the designation of beneficiaries and the rights and status of beneficiaries, the group life insured, and

(b) in all other cases, means the person who makes a contract with an insurer; (“assuré”)

“will” includes a codicil. (“testament”) R.S.O. 1990, c. I.8, s. 171; 2006, c. 19, Sched. C, s. 1 (1).

Annuity deemed life insurance

(2)  For the purposes of this Part, an undertaking entered into by an insurer to provide an annuity, or what would be an annuity except that the periodic payments may be unequal in amount, shall be deemed to be and always to have been life insurance whether the annuity is for,

(a) a term certain; or

(b) a term dependent solely or partly on the happening of an event not related to a human life. 2002, c. 18, Sched. H, s. 4 (22).

Application of Part

Application of Part

172.  (1)  Despite any agreement, condition or stipulation to the contrary, this Part applies to a contract made in Ontario on or after the 1st day of July, 1962, and, subject to subsections (2) and (3), applies to a contract made in Ontario before that day.

Beneficiary for value

(2)  The rights and interests of a beneficiary for value under a contract that was in force immediately before the 1st day of July, 1962 are those provided in Part V of The Insurance Act, being chapter 190 of the Revised Statutes of Ontario, 1960, as it existed immediately before that day.

Preferred beneficiary

(3)  Where the person who would have been entitled to the payment of insurance money, if the money had become payable immediately before the 1st day of July, 1962, was a preferred beneficiary within the meaning of Part V of The Insurance Act, being chapter 190 of the Revised Statutes of Ontario, 1960, as it existed immediately before that day, the insured may not, except in accordance with that Part,

(a) alter or revoke the designation of a beneficiary; or

(b) assign, exercise rights under or in respect of, surrender or otherwise deal with the contract,

but this subsection does not apply after a time at which the insurance money, if it were then payable, would be payable wholly to a person other than a preferred beneficiary within the meaning of that Part. R.S.O. 1990, c. I.8, s. 172.

Group insurance

173.  In the case of a contract of group insurance made with an insurer authorized to transact insurance in Ontario at the time the contract was made, this Part applies in determining,

(a) the rights and status of beneficiaries if the group life insured was resident in Ontario at the time he or she became insured; and

(b) the rights and obligations of the group life insured if he or she was resident in Ontario at the time he or she became insured. R.S.O. 1990, c. I.8, s. 173.

Issuance of Policy and Contents Thereof

Insurer to issue policy

174.  (1)  An insurer entering into a contract shall issue a policy.

Documents forming contract

(2)  Subject to subsection (3), the provisions in,

(a) the application;

(b) the policy;

(c) any document attached to the policy when issued; and

(d) any amendment to the contract agreed upon in writing after the policy is issued,

constitute the entire contract.

Contract of fraternal society

(3)  In the case of a contract made by a fraternal society, the policy, the Act or instrument of incorporation of the society, its constitution, by-laws and rules, and the amendments made from time to time to any of them, the application for the contract and the medical statement of the applicant constitute the entire contract.

Copy of application

(4)  An insurer shall, upon request, furnish to the insured or to a claimant under the contract a copy of the application. R.S.O. 1990, c. I.8, s. 174.

Contents of policy

175.  (1)  This section does not apply to,

(a) a contract of group insurance;

(b) a contract of creditor’s group insurance; or

(c) a contract made by a fraternal society.

Same

(2)  An insurer shall set forth the following particulars in the policy:

1. The name or a sufficient description of the insured and of the person whose life is insured.

2. The amount, or the method of determining the amount, of the insurance money payable, and the conditions under which it becomes payable.

3. The amount, or the method of determining the amount, of the premium and the period of grace, if any, within which it may be paid.

4. Whether the contract provides for participation in a distribution of surplus or profits that may be declared by the insurer.

5. The conditions upon which the contract may be reinstated if it lapses.

6. The options, if any,

(a) of surrendering the contract for cash;

(b) of obtaining a loan or an advance payment of the insurance money; and

(c) of obtaining paid-up or extended insurance. R.S.O. 1990, c. I.8, s. 175.

Contents of group policy

176.  In the case of a contract of group insurance or of creditor’s group insurance, an insurer shall set forth the following particulars in the policy:

1. The name or a sufficient description of the insured.

2. The method of determining the persons whose lives are insured.

3. The amount, or the method of determining the amount, of the insurance money payable, and the conditions under which it becomes payable.

4. The period of grace, if any, within which the premium may be paid.

5. Whether the contract provides for participation in a distribution of surplus or profits that may be declared by the insurer. R.S.O. 1990, c. I.8, s. 176.

Contents of group certificate

177.  In the case of a contract of group insurance, an insurer shall issue, for delivery by the insured to each group life insured, a certificate or other document in which are set forth the following particulars:

1. The name of the insurer and an identification of the contract.

2. The amount, or the method of determining the amount, of insurance on the group life insured and on any person whose life is insured under the contract as a person dependent upon, or related to, him or her.

3. The circumstances in which the insurance terminates and the rights, if any, upon such termination, of the group life insured or of any person whose life is insured under the contract as a person dependent upon, or related to, him or her. R.S.O. 1990, c. I.8, s. 177.

Conditions Governing Formation of Contract

Insurable interest required

178.  (1)  Subject to subsection (2), where at the time a contract would otherwise take effect the insured has no insurable interest, the contract is void.

Exceptions

(2)  A contract is not void for lack of insurable interest,

(a) if it is a contract of group insurance; or

(b) if the person whose life is insured has consented in writing to the insurance being placed on his or her life.

Consent of minor

(3)  Where the person whose life is insured is under the age of sixteen years, consent to insurance being placed on the person’s life may be given by one of his or her parents or by a person standing in the role of parent to him or her. R.S.O. 1990, c. I.8, s. 178.

Insurable interest, defined

179.  Without restricting the meaning of the expression “insurable interest”, a person has an insurable interest in the person’s own life and in the life of,

(a) the person’s child or grandchild;

(b) the person’s spouse;

(c) any person upon whom the person is wholly or in part dependent, for, or from whom the person is receiving, support or education;

(d) an employee of the person; and

(e) any person in the duration of whose life the person has a pecuniary interest. R.S.O. 1990, c. I.8, s. 179; 1999, c. 6, s. 31 (2); 2005, c. 5, s. 35 (3).

Contract taking effect

180.  (1)  Subject to any provision to the contrary in the application or the policy, a contract does not take effect unless,

(a) the policy is delivered to an insured, the insured’s assign or agent, or to a beneficiary;

(b) payment of the first premium is made to the insurer or its authorized agent; and

(c) no change has taken place in the insurability of the life to be insured between the time the application was completed and the time the policy was delivered.

Delivery to agent

(2)  Where a policy is issued on the terms applied for and is delivered to an agent of the insurer for unconditional delivery to a person referred to in clause (1) (a), it shall be deemed, but not to the prejudice of the insured, to have been delivered to the insured. R.S.O. 1990, c. I.8, s. 180.

Default in paying premium

181.  (1)  Where a cheque or other bill of exchange, or a promissory note or other written promise to pay, is given for the whole or part of a premium and payment is not made according to its tenor, the premium or part thereof shall be deemed not to have been paid.

Payment by registered letter

(2)  Where a remittance for or on account of a premium is sent in a registered letter to an insurer and is received by it, the remittance shall be deemed to have been received at the time of the registration of the letter. R.S.O. 1990, c. I.8, s. 181.

Payment of premium

Who may pay premium

182.  (1)  Except in the case of group insurance, an assignee of a contract, a beneficiary or a person acting on behalf of one of them or of the insured may pay any premium that the insured is entitled to pay.

Period of grace

(2)  Where a premium, other than the initial premium, is not paid at the time it is due, the premium may be paid within a period of grace of,

(a) thirty days or, in the case of an industrial contract, twenty-eight days from and excluding the day on which the premium is due; or

(b) the number of days, if any, specified in the contract for payment of an overdue premium,

whichever is the longer period.

Contract in force during grace period

(3)  Where the happening of the event upon which the insurance money becomes payable occurs during the period of grace and before the overdue premium is paid, the contract shall be deemed to be in effect as if the premium had been paid at the time it was due, but the amount of the premium, together with interest at the rate specified in the contract, but not exceeding 6 per cent per year, and the balance, if any, of the current year’s premium, may be deducted from the insurance money. R.S.O. 1990, c. I.8, s. 182.

Duty to disclose

183.  (1)  An applicant for insurance and a person whose life is to be insured shall each disclose to the insurer in the application, on a medical examination, if any, and in any written statements or answers furnished as evidence of insurability, every fact within the person’s knowledge that is material to the insurance and is not so disclosed by the other.

Failure to disclose

(2)  Subject to section 184, a failure to disclose, or a misrepresentation of, such a fact renders the contract voidable by the insurer. R.S.O. 1990, c. I.8, s. 183.

Exceptions

184.  (1)  This section does not apply to,

(a) a misstatement of age; or

(b) insurance undertaken by an insurer as part of a contract of life insurance whereby the insurer undertakes to pay insurance money or to provide other benefits in the event that the person whose life is insured becomes disabled as a result of bodily injury or disease. 2002, c. 18, Sched. H, s. 4 (23).

Incontestability, general

(2)  Subject to subsection (3), where a contract has been in effect for two years during the lifetime of the person whose life is insured, a failure to disclose or a misrepresentation of a fact required to be disclosed by section 183 does not, in the absence of fraud, render the contract voidable. R.S.O. 1990, c. I.8, s. 184 (2).

Incontestability in group insurance

(3)  In the case of a contract of group insurance, a failure to disclose or a misrepresentation of such a fact in respect of a person whose life is insured under the contract does not render the contract voidable, but, if evidence of insurability is specifically requested by the insurer, the insurance in respect of that person is voidable by the insurer unless it has been in effect for two years during the lifetime of that person, in which event it is not, in the absence of fraud, voidable. R.S.O. 1990, c. I.8, s. 184 (3).

Non-disclosure by insurer

185.  Where an insurer fails to disclose or misrepresents a fact material to the insurance, the contract is voidable by the insured, but, in the absence of fraud, the contract is not by reason of such failure or misrepresentation voidable after the contract has been in effect for two years. R.S.O. 1990, c. I.8, s. 185.

Insurable age

186.  (1)  This section does not apply to a contract of group insurance or of creditor’s group insurance.

Misstatement of age

(2)  Subject to subsection (3), where the age of a person whose life is insured is misstated to the insurer, the insurance money provided by the contract shall be increased or decreased to the amount that would have been provided for the same premium at the correct age.

Limitation of insurable age

(3)  Where a contract limits the insurable age and the correct age of the person whose life is insured at the date of the application exceeds the age so limited, the contract is, during the lifetime of that person but not later than five years from the date the contract takes effect, voidable by the insurer within sixty days after it discovers the error. R.S.O. 1990, c. I.8, s. 186.

Misstatement of age in group insurance

187.  In the case of a contract of group insurance or of creditor’s group insurance, a misstatement to the insurer of the age of a person whose life is insured does not of itself render the contract voidable, and the provisions, if any, of the contract with respect to age or misstatement of age apply. R.S.O. 1990, c. I.8, s. 187.

Effect of suicide

188.  (1)  Where a contract contains an undertaking, express or implied, that insurance money will be paid if a person whose life is insured commits suicide, the undertaking is lawful and enforceable.

Suicide and reinstatement

(2)  Where a contract provides that in case a person whose life is insured commits suicide within a certain period of time the contract is void or the amount payable under it is reduced, if the contract lapses and is subsequently reinstated on one or more occasions, the period of time commences to run from the date of the latest reinstatement. R.S.O. 1990, c. I.8, s. 188.

Reinstatement

189.  (1)  This section does not apply to a contract of group insurance or to a contract made by a fraternal society.

Reinstatement following up to 2 years lapse

(2)  Where a contract lapses and the insured within two years applies for reinstatement of the contract, if within that time the insured,

(a) pays the overdue premiums and other indebtedness under the contract to the insurer, together with interest at the rate specified in the contract, but not exceeding 6 per cent per year, compounded annually; and

(b) produces,

(i) evidence satisfactory to the insurer of the good health, and

(ii) other evidence satisfactory to the insurer of the insurability,

of the person whose life was insured,

the insurer shall reinstate the contract.

Exceptions

(3)  Subsection (2) does not apply where the cash surrender value has been paid or an option of taking paid-up or extended insurance has been exercised.

Application of other sections

(4)  Sections 183 and 184 apply with necessary modifications to reinstatement of a contract. R.S.O. 1990, c. I.8, s. 189.

Designation of Beneficiaries

Designation of beneficiary

190.  (1)  An insured may in a contract or by a declaration designate the insured’s personal representative or a beneficiary to receive insurance money.

Change in designation

(2)  Subject to section 191, the insured may from time to time alter or revoke the designation by a declaration.

Meaning of “heirs”, etc.

(3)  A designation in favour of the “heirs”, “next of kin” or “estate” of the insured, or the use of words of like import in a designation, shall be deemed to be a designation of the personal representative of the insured. R.S.O. 1990, c. I.8, s. 190.

Designation of beneficiary irrevocably

191.  (1)  An insured may in a contract, or by a declaration other than a declaration that is part of a will, filed with the insurer at its head or principal office in Canada during the lifetime of the person whose life is insured, designate a beneficiary irrevocably, and in that event the insured, while the beneficiary is living, may not alter or revoke the designation without the consent of the beneficiary and the insurance money is not subject to the control of the insured or of the insured’s creditors and does not form part of the insured’s estate.

Attempted designation

(2)  Where the insured purports to designate a beneficiary irrevocably in a will or in a declaration that is not filed as provided in subsection (1), the designation has the same effect as if the insured had not purported to make it irrevocable. R.S.O. 1990, c. I.8, s. 191.

Designation in will, etc.

Designation in invalid will

192.  (1)  A designation in an instrument purporting to be a will is not ineffective by reason only of the fact that the instrument is invalid as a will or that the designation is invalid as a bequest under the will.

Priorities

(2)  Despite the Succession Law Reform Act, a designation in a will is of no effect against a designation made later than the making of the will.

Revocation

(3)  Where a designation is contained in a will, if subsequently the will is revoked by operation of law or otherwise, the designation is thereby revoked.

Idem