British columbia health insurance act

3 This Part has effect, despite any law or contract to the contrary, except that

(a) if any section or statutory condition contained in Part 3, 4, 5, 6 or 7 is applicable and deals with a subject matter that is the same as or similar to any subject matter dealt with by this Part, this Part does not apply, and

(b) sections 6 to 14, 17 and 25 do not apply in the case of a contract to which the Insurance (Marine) Act applies.

Section 004 — Contract not avoided by default of insurer under Act

4 A contract is not rendered void or voidable as against the insured or a beneficiary by reason of any failure on the part of the insurer to comply with any of this Act.

Section 005 — Contracts deemed to be made in British Columbia

5 A contract is deemed to have been made in British Columbia and must be construed accordingly if it

(a) insures a person domiciled or resident in British Columbia at the date of it, or

(b) has as its subject matter property or an interest in property located in British Columbia.

Section 006 — Gaming or wagering contracts avoided

6 (1) A contract by way of gaming or wagering is void.

(2) A contract is deemed to be a gaming or wagering contract if the insured has no interest in the subject matter of the contract.

Section 007 — Indemnity recoverable

7 (1) A greater sum must not be recovered or received from the insurer under a contract than the amount or value of the interest of the insured in the subject matter of the contract.

(2) In the case of a contract of life insurance, the measure of the interest insured is the sum set by the contract.

Section 008 — Contents of policy

8 (1) A policy must 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 of the happening of which the liability is to accrue, the date on which the insurance takes effect and the date it terminates, or the method by which the latter is set or to be set.

(2) This section does not apply to contracts of guarantee insurance.

Section 009 — Appraisals

9 (1) This section applies to a contract that

(a) provides insurance against loss or damage

(i) by fire, lightning or explosion, or

(ii) from any of the other perils referred to in section 120,

(b) provides insurance against loss of rents or profits or loss from business interruption, resulting from a peril referred to in paragraph (a), or

(c) contains a condition, statutory or otherwise, that requires that a disagreement in respect of specified matters be determined by appraisal.

(2) An insurer must give notice to an insured of the availability of the appraisal process established by this Act within 21 days after the insurer becomes aware that,

(a) in respect of a contract referred to in subsection (1) (a) or (b), there is a disagreement between the insurer and the insured as to the value of the property insured, the value of the property saved or the amount of the loss, or

(b) in respect of a contract referred to in subsection (1) (c), there is a disagreement between the insurer and the insured as to a matter for which an appraisal is required in the contract.

(3) The value or amount in dispute in a disagreement referred to in subsection (2) (a) or the matter in respect of which there is a disagreement referred to in subsection (2) (b) must, unless the insurer and the insured are able to resolve their disagreement, be determined by an appraisal under this section.

(4) An appraisal under this section must not be conducted until

(a) the insured has delivered to the insurer a proof of loss, and

(b) one of the parties to the disagreement has delivered to the other a written demand for an appraisal.

(5) An appraisal must be conducted under this section

(a) before any recovery is made under the contract,

(b) independently of any other question, and

(c) whether or not the right to recover on the contract is disputed.

(6) For an appraisal under this section, the insured and the insurer must each appoint an appraiser, and the 2 appraisers appointed must appoint an umpire.

(7) The appraisers must determine the matters in disagreement and, if they fail to agree, they must submit their differences to the umpire, and the finding in writing of any 2 determines the matters.

(8) Each party to the appraisal must pay the appraiser appointed by that party and must bear equally the expense of the appraisal and the umpire.

(a) a party fails to appoint an appraiser within 7 clear days after being served with written notice to do so,

(b) the appraisers fail to agree on an umpire within 15 days after their appointment, or

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

the Supreme Court may appoint an appraiser or umpire, as the case may be, on the application of the insured or of the insurer.

Section 010 — Court may relieve against forfeiture

10 If 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, or if there has been a termination of the policy by a notice that was not received by the insured owing to the insured's absence from the address to which the notice was addressed, and the court deems it inequitable that the insurance should be forfeited or avoided on that ground or terminated, the court may, on terms it deems just, relieve against the forfeiture or avoidance or, if the application for relief is made within 90 days of the date of the mailing of the notice of termination, against the termination.

Section 011 — Waiver of term or condition

11 (1) A term or condition of a contract is not 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.

(2) Neither the insurer nor the insured are 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.

Section 012 — Effect of terms of contract not set out in policy

12 (1) A term or condition of a contract which is not set out in full in the policy or in a document in writing attached to it, when issued, is not valid or admissible in evidence to the prejudice of the insured or a beneficiary.

(2) This section does not apply to an alteration of the contract agreed on in writing between the insurer and the insured after the issue of the policy.

Section 013 — Misrepresentation and nondisclosure

13 (1) A contract is not rendered void or voidable by reason of any misrepresentation, or any failure to disclose on the part of the insured in the application or proposal for the insurance or otherwise, unless the misrepresentation or failure to disclose is material to the contract.

(2) The question of materiality is one of fact.

Section 014 — Effect of delivery of policy or premium receipt

14 If a policy or a receipt for the premium under a contract is delivered to the insured by the insurer or its agent, the insurer is bound by the contract, even though

(a) the delivery may have been made by the agent without authority, or

(b) the premium may not in fact have been paid.

Section 015 — How premiums may be paid or refunded

15 (1) A premium may be paid by post office order or postal note, or cheque payable at par and certified by a bank, or draft of a bank, or money order of an express company doing business in British Columbia, delivered to, or mailed in a registered letter addressed to, the insurer at its head office in British Columbia or to an agent of the insurer authorized to receive the premium, and payment, delivery or tender of the premium is deemed to have been made at the time of delivery or, in the case of a registered letter, of the registration of the letter at any post office.

(2) When a contract is terminated by an insurer in accordance with its terms and any part of the premium is repayable to the insured, the insurer may repay the sum due in any mode permitted by subsection (1) for the payment of a premium.

Section 016 — Payment of refund to assignee

16 (1) If 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 of it and notice of the assignment is given by the assignee to the insurer, the insurer must pay any 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.

(2) If the condition in the contract dealing with cancellation or termination by the insurer provides that the refund must accompany the notice of cancellation or termination, the insurer must include in the notice a statement that in place of payment of the refund in accordance with the condition the refund is being paid to the assignee under this section.

Section 017 — Effect of unpaid cheque or note for premium

17 (1) If 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 at once by giving written notice by registered mail.

(2) This section does not apply to a mutual company.

Section 018 — Unpaid premium deductible from indemnity

18 (1) An insurer may sue for the unpaid premium, and may deduct the amount of it from the amount for which the insurer is liable under the contract of insurance.

(2) This section does not apply to a mutual company.

Section 019 — Time for payment of claims

19 If a claim is made against an insurer under a contract, the amount for which the insurer is liable must be paid by the insurer to the person entitled to it within 60 days after reasonably sufficient proof of the claim and of the right to receive payment has been furnished to it.

Section 020 — Claims payable in Canadian money and in British Columbia

20 All money payable under a contract by an insurer must be paid in lawful money of Canada and, if the person entitled to it requires, in British Columbia.

Section 021 — Right of entry after loss

21 After any loss or damage to property insured under a contract, the insurer or an accredited agent of the insurer has an immediate right of entry and access sufficient to enable the insurer or agent to survey and examine the property and to make an estimate of the loss or damage.

Section 022 — Limitation of actions

22 (1) Every action on a contract must be commenced within one year after the furnishing of reasonably sufficient proof of a loss or claim under the contract and not after.

(2) An action must not be brought for the recovery of money payable under a contract of insurance until the expiration of 60 days after proof, in accordance with the contract

(a) of the loss, or

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

or of such shorter period as may be set by the contract of insurance.

Section 023 — Payment by insurer into court

23 (1) If an insurer cannot obtain a sufficient discharge for insurance money for which it admits liability, the insurer may apply to the court without notice to any person for an order for the payment of it into court, and the court may order the payment into court to be made on terms as to costs and otherwise the court directs, and may provide to what fund or name the amount must be credited.

(2) The receipt of the registrar or other proper officer of the court is a sufficient discharge to the insurer for the insurance money paid into court, and the insurance money must be dealt with according to the orders of the court.

Section 024 — When third person has right of action against insurer

24 (1) If a judgment has been granted against a person in respect of a liability against which the person is insured and the judgment has not been satisfied, the judgment creditor may recover by action against the insurer the lesser of

(a) the unpaid amount of the judgment, and

(b) the amount that the insurer would have been liable under the policy to pay to the insured had the insured satisfied the judgment.

(2) The claim of a judgment creditor against an insurer under subsection (1) is subject to the same equities as would apply in favour of the insurer had the judgment been satisfied by the insured.

(3) This section does not apply in the case of a contract of automobile insurance.

Section 025 — Insurer to furnish copy of application and form for claim

25 (1) It is the duty of an insurer to furnish the insured or the beneficiary on request

(a) with a true copy of the application or proposal for insurance and the policy, and,

(b) immediately on receipt of the request and in any event not later than 60 days after receipt by it of notice of a loss or claim under the contract, with printed forms on which proof of the loss or claim may be made.

(2) The insurer, by furnishing forms to make proof of loss, must not be taken to have admitted that a valid contract is in force or that the loss in question falls within the insurance provided by the contract.

(3) An insurer who neglects or refuses to comply with subsection (1) commits an offence.

Section 026 — Trafficking

26 Any person other than an insurer or its authorized agent who advertises, or holds himself or herself out, as a purchaser of life insurance policies or of benefits under it, or who traffics or trades in life insurance policies for the purpose of procuring the sale, surrender, transfer, assignment, pledge or hypothecation of them to himself or herself or any person, commits an offence against this Act.

Section 027 — Liability of continuing insurer

27 If under an agreement between an insurer, in this section called the "continuing insurer", and another insurer, in this section called the "retiring insurer", providing for a retiring insurer ceasing to do business in British Columbia and the continuing insurer assuming liability under contracts of insurance issued by the retiring insurer specified in the agreement, and the retiring insurer ceases to carry on business in British Columbia, an insured or other person entitled to rights under those contracts may enforce the rights against the continuing insurer as though those contracts had been issued by the continuing insurer.

Section 028 — Effect on contracts of violation of law

28 Unless the contract otherwise provides, a violation of a criminal or other law in force in British Columbia or elsewhere does not render unenforceable a claim for indemnity under a contract of insurance unless the violation is committed by the insured, or by another person with the consent of the insured, with intent to bring about loss or damage, except that in the case of a contract of life insurance this section applies only to disability insurance undertaken as part of the contract.