Citation and Parties

Citation: Thomas v. Travelers Insurance Company of Canada, 2024 ONLAT 23-000162/AABS

Licence Appeal Tribunal File Number: 23-000162/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

[T.T] (A minor by their litigation guardian, [B.M])

Applicant

and

The Dominion of Canada General Insurance Company

Respondent

Decision

ADJUDICATOR: Rachel Levitsky

APPEARANCES:

For the Applicant: Kaitlyn MacDonell, Counsel

For the Respondent: Krista Groen, Counsel

For the Related Party, Intact Insurance Company: Aida Davari, Counsel, in related Tribunal file numbers 23-000158/AABS and 23-000161/AABS

HEARD: By way of written submissions

OVERVIEW

1Tyrone Thomas (“Tyrone”) passed away as a result of an automobile accident that occurred on May 15, 2018. Tyrone’s daughter, [T.T], the applicant, sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, The Dominion of Canada General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

2There are four separate but related disputes at the Tribunal. The applicant’s sister is also seeking death benefits from the respondent in Tribunal file number 23-000160/AABS. The applicant and her sister are also seeking death benefits from Intact Insurance Company in Tribunal file numbers 23-000161/AABS and 23-000158/AABS, respectively. The Tribunal ordered on August 21, 2023, that the same adjudicator will adjudicate all of the related files.

ISSUES

3The issue in dispute is:

i. Is the applicant entitled to a death benefit pursuant to section 26 of the Schedule, in the amount of $10,000.00 plus interest?

RESULT

4The applicant is not entitled to a death benefit or interest from the respondent.

ANALYSIS

5Section 26 of the Schedule stipulates that an insurer shall pay a death benefit in respect of an insured person who dies as a result of an accident. A benefit of $10,000.00 is payable to each of the insured person’s dependents.

6Section 3(1) of the Schedule defines “insured person” to mean the named insured, any person specified in the policy as a driver of the insured automobile, and the spouse of the named insured and a dependent of the named insured or of his or her spouse.

7A policy of insurance was issued to the applicant’s mother, [B.M] (“[B]”), by the respondent. The applicant admits that [T] was not an insured under the policy of insurance with the respondent. She also admits that [T] and [B] were not spouses at the time of the accident. The applicant does not make any submissions and does not adduce any evidence indicating that [T] was a dependent of [B].

8The onus is on the applicant to prove entitlement to benefits. Aside from a submission that she is entitled to the benefit from either insurer, she has not made an argument as to why the respondent is responsible for paying it. Section 26 is clear that the benefit is only payable in respect of the death of an insured person, and there is no compelling evidence before me that [T] was an insured person under the policy issued by the respondent. I accordingly find that the applicant has not met her onus in proving, on a balance of probabilities, that she is entitled to a death benefit from the respondent.

Interest

9Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. As no benefit is overdue, interest is not payable.

ORDER

10The applicant is not entitled to a death benefit or interest from the respondent.