On February 5, Ayla started working at Larson Group Inc. as an administrative assistant. Larson Group offers all employees a group health, dental and…

Group insurance policies contain an "actively at work" provision. This clause stipulates that an employee must be actively performing all regular duties of their job on the day their coverage is scheduled to become effective. Ayla's coverage was scheduled to start on May 5, after the three-month waiting period. However, on that date, she was on sick leave due to her surgery and was not actively at work. Consequently, her coverage did not commence. The effective date of her coverage would have been postponed until the day she returned to active, full-time employment. Since she passed away without ever returning to work, the policy never came into force for her, and no death benefit is payable.

A. The cause of death is not the determining factor; the primary issue is whether the insurance policy was in effect at the time of death.
B. The coverage was scheduled to start on May 5, but it did not become effective because the "actively at work" condition was not met.
D. For basic group life coverage, individual proof of insurability is typically not required for employees who enroll during the initial eligibility period.

1. IFSE Institute, Life License Qualification Program (LLQP) - Life Insurance Module (Common Law), Chapter 12: Group Life and Health Insurance, Section 12.3 "Eligibility and Enrolment," subsection "Actively-at-Work Provision." This section details that if an employee is not actively at work on the day coverage is to take effect, the coverage is deferred until the employee returns to work.

2. W. Jean Dodds, Canadian Life and Health Insurance Law, 2nd ed. (Toronto: LexisNexis Canada, 2011), Chapter 7, Section 7.5 "Eligibility for Coverage." This legal text, often used in academic insurance courses, confirms that active employment is a standard condition precedent for the commencement of group insurance coverage.

3. G.F. Kimball and S.L. Kimball, The Essentials of Group Insurance (Toronto: The Life Underwriters Association of Canada, 2005), pp. 45-46. This text explains that the "actively at work" requirement protects the insurer against adverse selection from individuals who are already ill when coverage is supposed to begin.