Rathie v ING Life

In the matter of Rathie v ING Life, the plaintiff sought to recover benefits under an Accident and Sickness Insurance policy. The dispute centred on the interpretation of the policy terms, particularly whether the policy document constituted the complete contract and the definition of the benefit payable under the contract. The court was also required to determine if the increased Maximum Dollar Benefit in a replacement policy applied to the plaintiff who became disabled prior to the issuance of the replacement policy. Additionally, the court examined whether the defendant insurer accepted cover for increases beyond the underwritten level up to the Dollar Maximum Benefit.

The court examined the arguments regarding whether the policy document, which did not include transfer of acceptance terms, was the complete contract. It concluded that the parties had adopted and acted upon the standard form policy document and that relevant terms and conditions were to be found in correspondence exchanged before the commencement of cover. The court determined that the "benefit" payable under the contract should be read as a formula rather than a fixed dollar amount. Regarding the replacement policy, the court found that the increased Maximum Dollar Benefit did not apply to the plaintiff as he had ceased to be a member of the policy due to his disability before the replacement policy was issued. Finally, the court found that the defendant insurer did not accept cover for increases beyond the underwritten level up to the Dollar Maximum Benefit.

The court dismissed the plaintiff's action and ordered the plaintiff to pay the defendant’s costs of the action on the standard basis. The court also ordered the defendant to pay the plaintiff’s costs of the appearance on 27 April 2004, also on the standard basis. The orders did not affect the costs dealt with by the order of Mullins J dated 19 December 2003.