Neutral Citation: 1994 ONICDRG 51
File No. A-002988
ONTARIO INSURANCE COMMISSION
BETWEEN:
MARGARET McGUIRE (DECEASED)
Applicant
and
ZURICH INSURANCE COMPANY
Insurer
File No. A-002989
BETWEEN:
MARGARET McGUIRE (DECEASED)
Applicant
and
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Insurer
DECISION
Issues:
Ms. Margaret McGuire was a pedestrian who was fatally injured on September 7, 1991, by an automobile insured through State Farm Mutual Automobile Insurance Company ("State Farm"). Mr. James Weedon, who claims that he was Ms. McGuire's common law spouse at the time of the accident, had automobile insurance with Zurich Insurance Company ("Zurich"). He claims entitlement to the $25,000 death benefit provided under section 11(1) of the Statutory Accident Benefits Schedule - Accidents before January 1, 19941.
Holly Caitlin McGuire-Weedon and Caitlin Erin McGuire-Weedon are the natural children of James Weedon and the deceased. They claim that Mr. Weedon was not their mother's common law spouse on the accident date, and that they are entitled to the $25,000 death benefit under section 11(1) of the Schedule. The parties were unable to resolve the dispute through mediation and Mr. Weedon and the children applied for arbitration under the Insurance Act, R.S.O. 1990, c. I.8.
The issue in this hearing is:
- Was James Weedon the spouse of Margaret McGuire at the time of the accident?
Result:
- James Weedon was not the spouse of Margaret McGuire at the time of the accident. Hearing:
The hearing was held in North York, Ontario, on June 6, 1994, before me, Fred Sampliner, arbitrator.
Present at the Hearing:
Zurich's Representative:
Mark Sones Regional Manager
State Farm's Representatives:
Eric Zeldin Barrister and Solicitor
Carl Von Holstein
Claims Superintendant
The parties filed an Agreed Statement Of Facts and referred to the following authorities:
McIntyre (Litigation Guardian of) v. West Wawanosh Mutual Insurance Company, (1994) O.J. No. 652, Action No. 1359/92
Vincenzo Scavuzzo and Canadian Home Assurance Company, March 18, 1992, OIC File No. A-000626
Insurance Act (1980), Schedule C, Accident Benefits Section, Subsection 2, Part I B(2), as found in Part B of the Standard Auto Policy
Ontario Regulation 776/93, Statutory Accident Benefits Schedule-Accidents On Or After January 1, 1994, Part I 1
Ontario Regulation 672, R.R.O. 1990, Statutory Accident Benefits Schedule-Accidents Before January 1, 1994, Part III 11(1)
Evidence and Analysis:
A $25,000 death benefit is provided to the spouse of an insured person who dies as a result of an automobile accident, under section 11 of the No-Fault Benefits Schedule in effect at the time of this accident:
DEATH BENEFITS
11.(1) If, as a result of an accident, an insured person dies within the benefit period set out in sub-section (3), the insurer will pay with respect to the insured person, if Optional Benefit 1 has not been purchased.
(a) $25,000 to his or her spouse, if the deceased is survived by a spouse who was his or her spouse at the time of the accident;
(b) $25,000 to his or her dependants, if the deceased is survived by any dependant who was a dependant at the time of the accident and is not survived by a spouse who is entitled to a benefit under this section.
The parties agree that James Weedon and Margaret McGuire were not married or living together at the time of the accident. However, Mr. Weedon and Ms. McGuire had continuously lived together in a common law relationship from 1983 until about January 6, 1990, during which time two children were born to the couple. Holly Caitlin McGuire-Weedon was born on September 23, 1986, and Caitlin Erin McGuire-Weedon was born on February 23, 1988. Mr. Weedon and Ms. McGuire separated on or about January 6, 1990, and did not resume living together again after that date.
The dtermination of whether Mr. Weedon and Ms. McGuire were spouses at the time of the accident involves the interpretation of the term "spouse" which is defined under section 224 of the Insurance Act:
"spouse"