Dispute erupts over wording of firefighters’ benefit plan

ELORA, Ont (Canadian OH&S News)

A language dispute over the wording of an insurance policy for volunteer firefighters in an Ontario township is now before the courts after a statement of claim was filed on behalf of members of the Elora Firefighters Association.

The statement of claim was filed in the Ontario Superior Court of Justice on January 26. In it, the lawyer representing the plaintiffs, David Rosenfeld of Toronto-based Koskie Minsky LLP, claims that a bylaw of the Corporation of the Township of Centre Wellington requires the township to obtain and maintain $100,000 in basic life insurance coverage for the plaintiffs, with the township paying 100 per cent of premiums. Failing to do so constituted a breach of the terms and conditions of employment, the claim says.

“The firefighters believe they have basic life insurance in place and what they found was when one of their own firefighters, John Alles, passed away, they were told — the widow was told anyway — that he did not have basic life insurance coverage,” Rosenfeld says. “So the firefighters were shocked when they found out they didn’t have this coverage.”

The language issue revolves around the wording of Section 5 of Schedule A to bylaw 2008-045, which states that the “Township shall provide $100,000.00 Life Insurance and 24/7 Accident & Sickness Premium Coverage with the Township paying 100% of the premiums. Details attached as Appendix ‘A.’” (The appendix is not included with the online version of the bylaw).

While Rosenfeld believes that “basic life insurance coverage is different than accident and sickness coverage,” defence lawyer Chris Edwards of Templeman Menninga LLP in Kingston, Ontario argues that “these two coverages were merged into one in 2003. The position as a matter of law is that there is one benefit plan, they’ve applied for that benefit, it was denied by the insurer, not by the municipality or the fire department.”

In 2003, the township negotiated with firefighters the terms and conditions of coverage, including the introduction of the Volunteer Firefighter Insurance Service (VFIS) Benefits Plan, says Edwards, who is expecting to file a statement of defence by February 26. The result was a benefit plan that provided for both health as well as an accident and death benefit insurance, he says. “But the firefighters said they never did that, they never agreed to remove their life insurance coverage,” Rosenfeld counters.

The case came to light after the wife of the deceased firefighter made an unsuccessful application for benefits after his death on July 20, 2011. “We don’t have a copy of the letter denying the benefit, but we understand the denial was on the basis that the late John Alles did not pass away on duty, and he did not pass away as a result of an accident, which is the off-duty coverage,” Edwards says.

Rosenfeld, on the other hand, suggests that Alles, a firefighter for the township and its predecessors for 27 years, was “on-duty” at time. “A call went out that night when he passed away. It seems that he tried to get up and go answer, but then passed away as the result of some heart condition,” Rosenfeld says.

On-duty or off-duty considerations factor in

“So whether that is considered to be on-duty, I would certainly argue that it is, and was that responding to a call, I would certainly say it was,” he says, adding that accident and sickness coverage (which includes a death benefit in case of accident, injury or illness) would depend on whether the worker was on-duty or off-duty, whereas basic life insurance coverage would not rely on these provisions.

In the claim, the plaintiffs — which include Deborah Alles and several volunteer firefighters — are seeking a final mandatory order requiring the township to obtain and maintain the $100,000 basic life insurance coverage, with the township paying 100 per cent of the premiums.

“I can tell you this is a very sympathetic situation, and it’s one that nobody likes,” Edwards concludes. “It is a very unusual circumstance.”