N.J. v. Aviva Insurance Canada (17-002841)

The claimant’s mother died in an accident. The claimant sought payment of death benefits. The insurer denied the benefits, arguing that the claimant was not a dependent of her mother. Adjudicator Watt agreed with the insurer. He noted that while the claimant lived with her mother and did not pay rent, the claimant had earned in excess of $40,000 per year and was employed part-time as a nurse. While the claimant had a close relationship with her mother, she was not principally dependent for financial support. She could not prove that she relied on her mother for 50 percent plus one of her financial needs, nor was her income under the Low Income Cut Off for her geographic region.

G.K. v. Security National Insurance Company (16-001904)

The insurer sought reconsideration of the Tribunal’s decision that the claimant was a resident of Ontario at the time of the accident, and therefore an “insured person.” Executive Chair Lamoureux rejected the reconsideration. She held that the Tribunal was asked to make a determination that largely turned on the facts of the case, and that the Tribunal had not erred in finding that the claimant resided in Ontario. She also held that section 3 of the SABS was the pertinent section to consider, and that section 59 was only relevant to determining whether an insured could elect benefits in another jurisdiction. Finally, Executive Chair Lamoureux noted that the insurer was essentially asking for reconsideration on the Tribunal’s findings of fact, which was not an appropriate request.

G.K. v. Security National Insurance Company (16-001904)

The insurer sought reconsideration of the Tribunal’s decision that the claimant was a resident of Ontario at the time of the accident, and therefore an “insured person.” Executive Chair Lamoureux rejected the reconsideration. She held that the Tribunal was asked to make a determination that largely turned on the facts of the case, and that the Tribunal had not erred in finding that the claimant resided in Ontario. She also held that section 3 of the SABS was the pertinent section to consider, and that section 59 was only relevant to determining whether an insured could elect benefits in another jurisdiction. Finally, Executive Chair Lamoureux noted that the insurer was essentially asking for reconsideration on the Tribunal’s findings of fact, which was not an appropriate request.