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J.W.C. v. Certas Direct Insurance Company (17-007593)

  • December 5, 2018

The claimant was involved in an accident in British Columbia. He sought accident benefits through a policy held by his sister, argued that he was financially dependent upon her. Adjudicator Ferguson held that the claimant failed to provide evidence supporting financial dependency. The claimant was married, had a daughter, and worked in various jobs in the two years leading up to the accident. He had no documentary evidence to prove that his sister provided monetary assistance. The claimant was not an insured person and therefore not entitled to accident benefits. The claimant also argued that he should be entitled to elect Ontario accident benefits under section 59. Adjudicator Ferguson held that the claimant did not satisfy criteria 59(1)(b) because he was receiving benefits from ICBC. He therefore could not elect to receive Ontario accident benefits even if he were an insured person. Finally, adjudicator Ferguson held that it was irrelevant to his decision that there was a priority dispute ongoing between the insurer and ICBC.

Full decision here

TGP Analysis

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  • FILED UNDER Insured Person, Out-of-Province Accident
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