Citation: Jangra v. Primmum Insurance Company, 2026 ONLAT 24-010670/AABS

Licence Appeal Tribunal File Number: 24-010670/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:

Gayatri Jangra

Applicant

and

Primmum Insurance Company

Respondent

DECISION

ADJUDICATOR:

Nadia Mauro

APPEARANCES:

For the Applicant:

Thomas Dugas, Counsel

For the Respondent:

Matthew Owen, Counsel

HEARD:

By way of written submissions

OVERVIEW

1Gayatri Jangra, the applicant, sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”) as a result of an accident on March 6, 2022, leading to the fatality of her brother. The applicant was denied benefits by the respondent, Primmum Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

i. Is the applicant entitled to $16,250.00 for death benefits submitted April 24, 2023?

ii. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?

iii. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

3The applicant is not entitled to a death benefit, interest, or an award.

ANALYSIS

Background

4On approximately March 6, 2022, the applicant’s brother, Vinay, died in a motor vehicle accident. At the time of the accident Vinay was 21 years old.

Death Benefits and Dependency

5Section 26(2) of the Schedule states that an insurer shall provide a death benefit payment of $25,000.00 to the insured person’s spouse and $10,000.00 to each of the insured person’s dependents in respect of an insured person who dies as a result of an accident.

6Pursuant to s. 3(7)(b) of the Schedule “a person is a dependant of an individual if the person is principally dependent for financial support or care on the individual or the individual’s spouse.” The leading case on this point is Miller v. Safeco Insurance Co. of America, 1985 CanLII 2022 (ONCA), wherein the Ontario Court of Appeal identified four factors to be considered when determining dependency: the amount of the dependency, the duration of dependency; the financial and other needs of the alleged dependent; and the ability of the alleged dependent to be self-supporting.

7While the issues before me are for a death benefit and an award, the applicant’s case ultimately hinges on whether she is considered a dependent pursuant to s.3(7)(b) of the Schedule.

The applicant was not principally dependent

8The applicant submits that the death of her brother, Vinay, has caused significant emotional and psychological loss, as well as the loss of future financial support she reasonably expected to receive. The applicant further submits that she shared a close sibling bond and a culturally and emotionally significant relationship with her brother.

9While I am sympathetic to the tragic passing of the applicant’s brother, submissions are not evidence. The only evidence that the applicant has provided, other than the accident report and death certificate, are “photographs with various dates”. It is not clear who is in the photos, when the photos were taken, or how they satisfy the legal test of dependency.

10Despite the applicant indicating that “she was not financially dependent on her brother at the time of his death”, the applicant, in her reply submissions, states “she relied on her brother’s contributions and anticipated continuing reliance as she completed her education and entered the workforce.” I find these statements to be contradictory, but even so, the applicant has not provided any evidence to support that she was principally dependent on Vinay. Moreover, the applicant has not provided any evidence of financial transactions that would support she was receiving any payment from the deceased. It is also not clear how much financial assistance the deceased provided to the applicant or how much of the deceased’s financial assistance would contribute to her daily living expenses. The applicant does not make submissions or provide evidence to support the frequency and duration of the financial assistance, nor the amount of financial assistance to establish that she was “principally dependent” financially on Vinay.

11Further, the applicant submits that culturally, the eldest son is typically expected to assume the role of provider and protector for his family, particularly sisters and aging parents. As I have indicated above, submissions are not evidence. The applicant does not direct me to any evidence that she was principally dependent on her brother for physical or emotional care as contemplated by the Schedule. I find that the applicant’s submissions are vague and do not engage with any specific details that would provide clarity on how Vinay provided emotional support, such that she was “principally dependent” on her brother at the time of the accident.

12Based on the evidence before me, I find that the applicant has not demonstrated that she was principally dependent on the insured for financial support or care in accordance with s.3(7)(b). As such, I find that the applicant is not entitled to a death benefit.

Interest

13As there are no overdue benefits, the applicant is not entitled to interest pursuant to s. 51 of the Schedule.

Award

14The applicant sought an award under s. 10 of Reg. 664. Under s. 10, the Tribunal may grant an award of up to 50 per cent of the total benefits payable if it finds that an insurer unreasonably withheld or delayed the payment of benefits.

15As there are no overdue benefits, the applicant is not entitled to an award.

ORDER

16I find that:

i. The applicant is not entitled to a death benefit;

ii. The applicant is not entitled to interest pursuant to s. 51 of the Schedule;

iii. The respondent is not liable to pay an award; and

iv. The application is dismissed.