Laforme v. Wabisa Mutual Fire Insurance Co.,  O.J. No. 2025 Ontario Superior Court of Justice
In the action, Wabisa had filed a counterclaim seeking repayment of all benefits paid out in error. The court granted judgment to Wabisa on the counterclaim and ordered that Laforme repay to Wabisa all benefits paid out in error.
An issue arose as to whether Laforme was entitled to have benefits paid out under the S.A.B.S. by the Motor Vehicle Accident Claims Fund. The claim for such benefits was required to adhere to the time limits imposed by the S.A.B.S. Laforme did not adhere to such time limits. However, the court granted relief from forfeiture to Laforme and made a declaration that Laforme was entitled to all statutory benefits payable from the Motor Vehicle Accident Claims Fund from the date of the accident forward.
On April 16, 1992, the 18-year-old Laforme was the driver of an uninsured motor vehicle owned by his then girlfriend. The motor vehicle left the roadway and ended up on its roof and Laforme sustained serious cervical spinal cord injuries resulting in quadriplegia. Laforme had previously been an insured person under a policy of automobile insurance issued by Wabisa in respect of a motor vehicle owned by Laforme’s father. In August 1991, Laforme’s father and Laforme both signed an O.E.F.28A endorsement with a view to discontinuing coverage for Laforme under that policy. In January 1993, Wabisa was notified that a claim for statutory accident benefits was being made on Laforme’s behalf against his father’s insurance policy. An adjuster acting as agent for Wabisa took a statement from Laforme on January 12, 1993. This statement indicated that Laforme was principally dependent for financial support on his father. As a result, Wabisa advanced payments for medical/rehabilitation benefits to Laforme and subsequently paid attendant care benefits for Laforme to his girlfriend (now wife) at a rate of $3,000.00 per month. In 1997, Wabisa received information which led it to conclude that Laforme was not principally dependent for financial support on his father and mother at the time of the accident. Wabisa continued to pay benefits on the strength of a specific undertaking from the Motor Vehicle Accident Claims Fund that the Fund would reimburse Wabisa in the event that the court found that Wabisa was not liable to pay those benefits.
The court reviewed the wording of the Statutory Accident Benefits Schedule – Accidents Before January 1, 1994, O.Reg. 672/90 (“S.A.B.S.”) to determine whether Laforme was an “insured person” under the policy of insurance issued by Wabisa to his father. The definition of an “insured person” in the S.A.B.S. included “the named insured, his or her spouse and any dependent of either of them while the occupant of any other automobile …”. Section 3(2) of the S.A.B.S. provided that “a person is a dependent of another person if the person is principally dependent for financial support on the other person or the other person’s spouse”. The court heard oral testimony from Laforme, his father and Laforme’s wife and determined that at the time of the accident Laforme had been living primarily with his wife and their child. The court also found that Laforme had been working for significant periods of time from which he derived income. Laforme’s father indicated that he did give small amounts of money to his son but agreed that Laforme was not financially dependent upon him at the time of the accident. As a result of this finding, the court held that Wabisa was not liable for payment of any statutory accident benefits.
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