Citation: Kaur v. Co-operators General Insurance Company, 2026 ONLAT 24-001356/AABS

Licence Appeal Tribunal File Number: 24-001356/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:

Sarbjeet Kaur

Applicant

and

Co-operators General Insurance Company

Respondent

DECISION

ADJUDICATOR:

Kathleen Wells

APPEARANCES:

For the Applicant:

Tina Radimisis, Counsel

For the Respondent:

Daniel M Himelfarb, Counsel

HEARD:

By way of written submissions

OVERVIEW

1Sarbjeet Kaur, the applicant, is the mother of Ravinder Singh (the “insured”), who died as the result of injuries sustained in a motor vehicle accident on November 4, 2021. 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, Co-operators General Insurance Company, and applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

2There is a related file before the Tribunal. The applicant’s father, Prem Singh, is also seeking death, funeral, and medical and rehabilitation benefits in Tribunal file number 24-001353/AABS.

Preliminary Issue:

3The preliminary issue is:

1. Is the applicant a “dependant” as defined in section 3(7)(b) of the Schedule?

Substantive issues:

4The substantive issues in dispute are:

1. Is the applicant entitled to $2,200.00 for psychological assessment proposed by S. Kaur Psychotherapy Professional Corporation, in a treatment plan/OCF-18 (“plan”) submitted on February 18, 2022?
2. Is the applicant entitled to $22,500.00 for death benefits?
3. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
4. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

5I find that:

1. The applicant is not a dependant as defined in section 3(7)(b) of the Schedule and is therefore barred from proceeding with the application for the treatment plan for a psychological assessment and a death benefit.
2. The applicant is not entitled to interest.
3. The applicant is not entitled to an award.
4. The application is dismissed.

PROCEDURAL ISSUE

6In her reply submissions, the applicant requests that the transcripts of his Examination under Oath (“EUO”) be struck from the record because they were submitted 5 months after the due date set out in the Case Conference Report and Order (“CCRO”). The applicant submits that she did not have sufficient time to review the transcripts to provide a reply prior to the hearing.

7The respondent makes no submissions with respect to the exclusion of the EOU transcripts.

8The deadline for document exchange set out in the CCRO was September 26, 2024. The respondent filed the EOU transcripts on March 11, 2025, more than five months after they were due. I have considered the prejudice to both parties, and I agree with the applicant that the late disclosure of the EOU transcripts on March 11, 2025, which was after the applicant’s hearing submissions had been submitted, was prejudicial to the applicant because it did not provide her with an adequate opportunity to review and respond to the transcripts within the 7-day window provided for reply submissions in the CCRO.

9As a result, I will not consider the EOU transcripts.

ANALYSIS

Preliminary Issue

10I find that the applicant is not a dependent as defined under s.3(7)(b) of the Schedule.

11The respondent raised a preliminary issue that the applicant does not meet the definition of “insured person” under section 3(1) of the Schedule, because the applicant does not qualify as a dependant under s.3(7)(b). The applicant submits that she qualifies as a “dependant” under s.3(7)(b).

12Section 3(1) defines an “insured person” as “the named insured, any person specified in the policy as a driver of the insured automobile and, if the named insured is an individual, the spouse of the named insured and a dependant of the named insured or of his or her spouse.”

13Subsection 3(7)(b) provides “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.

Case Law

14The Courts have provided guidance on determining whether an applicant is principally dependent for financial support or care.

15In Miller v. Safeco Insurance Co. of America, 1985 CanLII 2022 (ONCA), the Ontario Court of Appeal set out 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.

16Allstate Insurance Company of Canada v Intact Insurance Company, 2016 ONSC 5443 provides that the assessment of whether someone is dependent is requires a broader consideration of the four factors set out in Miller, while in Economical Insurance Group v. Desjardins Insurance, 2020 ONSC 1363, the Court clarified that this “big picture” approach applies to cases where there is insufficient evidence or clarity that the applicant meets the 51% threshold. The Court further held that if a person cannot be principally dependent on another, if their needs can be met by their own resources.

17In Intact Insurance Company v. Allstate Insurance Company of Canada, 2016 ONCA 609, the Court of Appeal held that in considering whether a person is dependent, the determination of the time period under review should be based a time period that accurately reflects the nature of the relationship at the time of the accident.

Was the applicant principally dependent?

18The respondent argues that the applicant was not principally dependent on the insured for either financial support or care, because she was not dependent on the applicant for 51 % of her financial needs at the time of the accident, or leading up to the accident, and that the applicant did not provide any submissions that she was principally dependent on his son for care.

19The applicant argues that she meets the definition of dependent in s. 3(7)(b) because she relied on the insured for financial support and care prior to the accident, and that the Tribunal should consider a “big picture” approach, rather than a strictly mathematical approach to determine whether the applicant was dependent on her son.

20The respondent submits that the appropriate timeframe for consideration of the applicant’s dependence should begin on January 1, 2021, when the insured received his permit to work in Canada.

21The applicant did not identify an appropriate timeframe in the alternative, but cited Scottish & York Insurance Co. Limited v. Drover, 2014 NLCA 31 (“Drover”) wherein the Newfoundland and Labrador Court of Appeal found that the applicant was principally dependent on the insured at the time of the accident, while on a weeks-long vacation for which the insured had paid all of the expenses. I am not bound by Drover because it is from a different jurisdiction, and I find it is differentiated from the present case, because in the present case the applicant has not specified a precise time period wherein he was principally dependent on the insured.

22I am not persuaded that the receipt of his work permit is appropriate to mark the beginning of the timeframe. In my view, the appropriate mark is when the insured started working full-time. After receiving his work permit, the insured was employed part-time, and the applicant submitted that the insured began to assist his parents when he began to work full-time. Neither party has provided a precise date for when the insured secured full time employment, however, the applicant submits that it was at some point after his graduation on December 20, 2020, and submitted a “statement of work” from his employer which was dated February 26, 2021 and included a job description for his employment as a security guard at Indigo. In my view, it is appropriate to consider the time period between February 26, 2021 and November 4, 2021, to examine the nature of the financial relationship between the applicant and the insured.

Was the applicant principally dependent financially?

23I find that the evidence does not establish that the applicant was principally dependent on the insured for financial support. The applicant submits that her annual household income in 2021 was $13,765.46 (or $1,1.47.12 per month), which was comprised of her income of $5,797.96 and her husband’s income of $7,967.50. The applicant further submits that their monthly household expenses, including groceries, utilities, housing, and car expenses, totalled $717.77, indicating that the applicant and her husband had a monthly surplus of $429.35.

24The applicant submits that the insured sent money to them in three money transfers in 2021: $999.00 on August 12, 2021, $969.00 on August 13, 2021, and $168.00 on October 17, 2021. She argues that the total money transfers of $1,959.00 in August 2021 represented 2.3 months of their household expenses, and that they were therefore dependent on the insured for over 100% of their expenses. The respondent counters that the transfers on August 12, 2021 and August 13, 2021 were not made to the applicant, or her husband, directly, and that there is no evidence that the funds were deposited in the applicant’s bank account. The evidence reveals that the applicant made the transfer of $168.00 directly to the applicant’s husband on October 17, 2021.

25The applicant argues that the transfers were made to a friend, and that the applicant received the funds. However, even if I were to accept this argument, I find that the applicant has not established that she was principally dependent, because neither the $1,968.00 for the August transfers, nor the $2,136.00 in total transfers in 2001, represent 51% or more of the applicant’s household expenses for the eight full months between March 2021 and November 2021, or $2,928.50. Further, the applicant did not direct me to any evidence that the applicant’s reported household income did not exceed her reported monthly household expenses before any contribution from the insured throughout the time period in question.

26As I have found that the applicant was not principally dependent financially, it is not necessary for me to consider whether the applicant was self-supporting.

Was the applicant principally dependent for care?

27The applicant further submits that the insured was her eldest son, and as such, in their culture, he had a special duty of care and financial responsibility to his parents. The applicant submits that the insured maintained a close and loving relationship with his parents, and was frequently in contact with them through telephone and Zoom calls after he moved to Canada from India in 2018.

28While I accept that the insured made frequent calls to his parents, which were an emotional support to the applicant, I agree with the respondent that the applicant has not made any submissions or directed me to any evidence that she was principally dependent on her son for physical or emotional care as contemplated by the Schedule.

29Based on the evidence before me, I cannot find that the applicant was principally dependent on the insured for financial support or care in accordance with s.3(7)(b).

30As a result, the applicant is barred from proceeding with her application for the treatment plan for a psychological assessment and the death benefit.

Interest

31Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. As no payments are owing, no interest is due.

Award

32The 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.

33As the applicant made no submissions with respect to an award, and as no benefits were unreasonably withheld or delayed, I find that the applicant is not entitled to an award.

ORDER

34I find that:

1. The applicant is barred from proceeding with her application for the treatment plan for a psychological assessment.
2. The applicant is barred from proceeding with her application for a death benefit.
3. As no payments are owing, no interest is due.
4. The applicant is not entitled to an award.
5. The application is dismissed.