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Legal Expense Insurance quick reference guide

What does it cover?

Example

What’s not covered

Employment disputes

Disputes with an insured person’s employer relating to employment contracts and severance or a provincial human rights tribunal.

Dr. Smith’s spouse has been dismissed from her job. They commence a wrongful dismissal action alleging discrimination based on her hearing disability. The policy will provide legal representation to pursue the action.

  • Claims relating to disciplinary hearings or internal grievances

  • Any claim relating solely to death, illness or bodily injury

  • Any claim where the insured person is the employer

Contract disputes (non-auto, limited to small claims court)

Disputes arising from the insured person buying or selling goods or obtaining services.

Dr. Chen booked a family vacation and paid additional fees for access to a private pool. However, upon arrival, the room was not as advertised and there was no pool. The policy will provide legal representation to pursue the travel agent who misrepresented the vacation package.

  • Any claim relating to an insured person’s profession, trade, occupation, employment or any other business venture

  • Any claim related to a dispute arising from any loan, mortgage, investment, borrowing or other financial product

  • Any claim relating to the terms of a lease or land or building or a licence or tenancy of land or buildings

  • Any claim that arises out of contracts for legal services

  • Any claim that arises within the first 90 days of policy inception

Contract disputes (auto)

Disputes relating to the purchase, sale, lease, rental and service of a vehicle. The minimum amount in dispute for a contract claim is $500.

Dr. Jones leases a vehicle. At the end of the term, she returns the car to the dealership, which is now charging her for damage they claim extends beyond normal wear and tear. Legal costs will be covered to pursue legal action against the dealership.

  • Any claim that arises within the first 90 days of policy inception

Fault determination ruling and total loss valuation disputes

Disputes against an insured person’s own automobile insurer regarding fault determination and total loss valuation.

Dr. Phillips is in an accident and his car was written off. His auto insurer valued the car at a lower amount than anticipated based on recent bodywork completed on the car. Legal costs arising from the dispute with the auto insurer will be covered.

  • Any losses, costs, damages or benefits other than legal costs

  • Any dispute with an automobile insurer before the insurer has provided the insured person with its position on the matter in writing

  • Any dispute between an insured person and any other person (including that other person’s insurer) in respect of that other person’s liability or fault for any injury, death or damage

Obtaining statutory accident benefits from your automobile insurer

Presenting and obtaining payment of a claim to the insured person’s own automobile insurer for no-fault accident benefits under the no-fault accident benefits coverage provided to the insured person.

Dr. Moore was in a car accident and required physiotherapy. ARAG will assist her in completing the necessary documents to obtain the physiotherapy.

  • Any losses, costs, damages or benefits other than legal costs

  • Any claim against an insurer that issued a policy of insurance to an insured person outside Canada

Property protection

Pursuing a claim if a neighbour damages an insured person’s property or interferes with an insured person’s use of their land. The minimum amount in dispute for a physical damage claim is $500.

A neighbour cuts down a common property hedge. ARAG will assist Dr. Roberts in rectifying the situation regarding the shared hedge.

  • The first $500 of any claim for legal nuisance or trespass

Any claim relating to:

  • A contract entered into by the insured person

  • Any building or land other than the insured person’s principal or recreational home

  • Someone legally taking the insured person’s physical property from them

  • Work done by or on behalf of any governmental, quasi-governmental or public or local authority

  • A motor vehicle

  • Mining, subsidence, heave or landslide

  • Defending an insured person’s legal rights other than in defending a counterclaim

Bodily injury (worldwide)

Costs to pursue a claim for damages following an accident that causes the insured person injury or death.

Dr. Carpenter slipped and fell on an unmarked puddle of water at a grocery store, which resulted in injury. ARAG will appoint a lawyer and cover legal costs to take action against the grocery store.

  • A dispute with any provincial worker’s compensation board

  • Psychological injury or mental illness unless the condition arises from a specific or sudden accident

  • Surgical, clinical or medical negligence

  • Death, illness or bodily injury arising from the ownership, use or operation of a motor vehicle

  • Defending an insured person’s legal rights other than in defending a counterclaim

Tax protection (personal and business)

Providing counsel if an insured person has to respond to a tax audit or wants to appeal a Canada Revenue Agency decision with respect to their personal tax returns.

Dr. May received a Notice of Assessment, which she felt was inaccurate. ARAG will cover the legal costs to appeal this assessment.

  • Any claim arising from tax avoidance, dishonesty, alleged gross negligence or criminal offences

Employee legal defence

Defending criminal charges laid against an insured person arising from their work as an employee.

Dr. Hwang is charged criminally while carrying out his duties as an employee. A lawyer will be appointed to defend Dr. Hwang against the charges laid.

  • Any offence arising from the alleged use of alcohol, drugs or racing

  • Any offence arising from the insured person’s prohibited use of electronic/communication devices while driving

  • Any offence arising from parking and obstruction charges

  • Any offence arising from automatic traffic enforcement cameras

Automobile legal defence

Defending highway traffic violations.

Dr. Wallace received a speeding ticket that he would like to challenge in court.

  • Any offences related to the alleged use of alcohol or drugs while using or operating of a motor vehicle, including failure to provide a sample or be tested for the presence of such substances

  • Any offences where the insured allegedly operated a motor vehicle for any type of race or contest, while performing a stunt or on a bet or wager

  • Parking or obstruction offences

  • Any claims or traffic tickets arising from the alleged use of a prohibited electronic device while driving

  • Any automated Traffic Enforcement Camera Offences including but not limited to photo radar and photo red light tickets

Driver’s licence protection

Representation at a driver’s licence suspension hearing.

Dr. Manning’s driver’s licence is suspended. ARAG will assist her in expediting the process of reinstating her driver’s licence.

  • Any offence arising from the alleged use of alcohol, drugs, or racing

  • Any claims or traffic tickets arising from the alleged use of a prohibited electronic device while driving

Major excl​​usions

  • ​Use of ins​ured automobile for any illegal activity

  • A claim arising from an act that is wilfully committed

  • A​ny claim reported more than 120 days after the date of occurrence

Limit of indemnity and deductibles

Indemnity limit:

  • $100,000 per claim and $500,000 per issued per annual period

Deductibles:

  • ​The first $500 of any claim for a legal nuisance or trespass

  • The minimum amount in dispute for a physical damage claim is $500

  • The minimum amount in dispute for a contract claim is $500

  • The maximum amount in dispute for a contract claim is the small claims court limit

Reasonable prospects

For civil cases, “reasonable prospects” means that it is always more likely than not that an insured OMA Insurance member will recover losses or damages, obtain legal remedy or make a successful defence.


​​An insured person is you, or your spouse or civil partner or any son or daughter, normally living with you. Anyone claiming under this policy must have your agreement to claim.

The above scenarios are examples only. Coverage is subject to the terms, conditions and exclusions of the policy.​