Ineligible benefit claim not fraud, just a mistake: Arbitrator

Employee was unaware his wife couldn't claim coverage for safety glasses
|Canadian Employment Law Today|Last Updated: 12/10/2014

An Ontario company did not have just cause to discipline a worker it suspended for using benefits coverage for his spouse, an arbitrator has ruled.

The worker was a dye-setter for Tenneco Canada, a manufacturer of exhaust systems for the automotive emissions control industry based in Cambridge, Ont. As part of the collective agreement between Tenneco and the union, employees and their families were entitled to a vision care plan that covered prescription glasses and laser surgery. Employees were also entitled to coverage for prescription safety glasses, but this benefit was employees-only and not for their families.

In late 2013, the worker was on medical leave recovering from surgery when his wife asked if she could make a claim on his vision care plan for prescription safety glasses. The worker called the human resources department to verify if this was allowed, but he was unable to reach anyone. He contacted the union and asked about getting the form for prescription safety glasses, but he failed to mention they were for his wife.