A ruling that found the meaning of “spouse” under the Family Law Act (FLA) is not applicable when determining eligibility for accident benefits is ’principled and well-reasoned,’ Ottawa personal injury lawyer Najma Rashid .
“While the definition of spouse in the FLA may be similar to the wording in the Insurance Act, accident benefits are automatic. There’s no socioeconomic reason to apply a broader, family law interpretation of the term,” says Rashid, a partner with Howard Yegendorf & Associates LLP.
In a priority dispute between insurers, the Ontario Superior of Justice overturned an arbitrator’s decision which found the policyholder’s insurer should be paying benefits to his partner, even though the couple had only been cohabitating for a year.
The policyholder’s partner was injured while in the parking lot at her place of work. She sought accident benefits from the appellant through his policy as his spouse.
Under the Insurance Act, common-law couples are considered spouses if they have lived together in a conjugal relationship outside of marriage continuously for a period of three years.
The court heard that the couple were involved in a romantic relationship since 2008 but maintained separate residences and didn’t combine their assets, have joint bank accounts or financially support each other in any consistent way during this period, the decision states.
The arbitrator looked at the nature of their relationship prior to their living together in order to determine the meaning of ‘spouse’ and did so based on FLA interpretations.
“In doing so, the arbitrator relied on a  Supreme Court of Canada’s decision which indicated that the meaning of ‘spouse’ for the purposes of spousal support in the event of marital breakdown requires a more global or ‘unitary’ approach that takes into account a number of features of the couple’s life together and contains appropriate flexibility,” the decision notes.
On review, the judge found that unlike the FLA, the Insurance Act provides automatic benefits to spouses regardless of need and requires a context-specific approach of its own.
“More specifically, the insurance context contains no imperative to deviate from the ordinary understanding of what it means for two persons to ‘live together.’ In the family law sense of the term, where dependency is crucial to the spousal support context, persons can ‘live together’ — i.e. live interdependent lives — but maintain separate physical residences,” the judge wrote.
“In most non-family law contexts, and particularly in the insurance law context of automatic benefits without a broad sociological foundation on which to base those benefits, people who ‘live together’ can be considered spouses, but only if they do so in the normal sense of those words and for the requisite period of time,”
Rashid, who was not involved in the matter and comments generally, says the court made the correct distinction that the insurance context contains no reason to depart from the ordinary understanding of what it means for two people to live together.
“In the family law sense, dependency is crucial to the issue of spousal support so people can live together but maintain separate physical residences. This is not critical in the Statutory Accident Benefits-context,” she says. “The court pretty much stuck to the literal definition of a spouse as set out in the Insurance Act and rightly so.”