The determination of whether an insured is a member of a household is heavily influenced by financial dependency

An arbitrator’s decision holding that an injured victim in an automobile accident should receive statutory benefits from his stepfather’s insurer was upheld on the basis that the victim was principally dependent upon the stepfather for financial support.

Gore Mutual Insurance Company v. Co-Operators General Insurance Company, [2008] O.J. No. 3603, Ontario Superior Court of Justice, P.M. Perell J., September 18, 2008

The Appellant, Gore Mutual Insurance Co., appealed an arbitrator’s decision made pursuant to the Statutory Accident Benefits Schedule, O. Reg. 403/96, s. 2(1), of the Insurance Act, R.S.O. 1990, c. I.8.  The arbitrator held that the appellant was liable to pay statutory accident benefits to Joseph Morgan.  Morgan was catastrophically injured while a passenger in his stepfather’s vehicle, which was insured by the Appellant when that vehicle was struck by a vehicle insured by the Respondent, Co-Operators General Insurance Co.  The key factor in placing liability on the Appellant was the finding of fact that Morgan was principally dependent upon his stepfather for financial support.  The Appellant challenged that finding on the basis that Morgan was employed at the time of the accident.

Justice Perrell upheld the arbitrator’s finding that Morgan had been principally dependent upon his stepfather for financial support, agreeing with the arbitrator’s conclusion that, while employed at the time of the accident, Morgan’s employment earnings did not contribute 50% of his share of household expenses, and that Morgan’s demonstrated earning capacity over the nine months preceding the accident was such that he was unable to provide for himself without the financial assistance of his stepfather

This case was originally summarized by W. Jay Havelaar and originally edited by David W. Pilley.

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