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In Certas Home and Auto Insurance Company v. Okenge, the Ontario Divisional Court upheld a LAT decision finding that a 19 year old university basketball player injured in a motor vehicle accident while living in Nebraska was principally dependent on his older sister living in Ottawa and, as such, qualified as an “insured person” under her Ontario automobile policy.
The claimant moved from Uganda to Ottawa at age 14 to attend a basketball academy on a scholarship. He lived with his older sister for three months before being billeted with a local family while attending the program. He later attended high school in Oklahoma while living with another billeted family and eventually attended university in Nebraska. Since moving to North America, he listed his permanent address as his sister’s residence. He would return to her residence when not in school such as for holidays and during the COVID-19 pandemic.
The accident occurred while the claimant was attending university in Nebraska at age 19. He applied for statutory accident benefits under his sister’s policy. The insurer denied coverage on the basis that the claimant had been living independently and was not principally dependent on his sister at the time of the accident. The LAT disagreed and found the claimant qualified as an insured person under the policy issued by the insurer to the sister.
The Divisional Court upheld the LAT’s decision on appeal and judicial review. The Court affirmed that dependency under the SABS is a contextual, fact-specific analysis. Even though the claimant lived away from his sister for many years while attending school, the evidence demonstrated the claimant was principally dependent on her for care. The LAT noted evidence that included the claimant regularly FaceTiming his older sister, he never financially supported himself, and he relied on his sister like a parent given the absence of his actual parents.
Further, the Court rejected the insurer’s argument that dependency requires some sort of physical or mental vulnerabilities. The analysis requires review of the entire fact situation on a case-by-case basis. In this situation, the LAT reviewed the claimant’s physical, emotional and social needs as factors in reaching the conclusion that the claimant was dependent on his older sister for care.
Take Away
This case is a reminder that dependency under the SABS is highly contextual and extends beyond traditional indicators like co-residency, financial reliance, or day-to-day caregiving. Even when an injured person lives away from home for extended periods of time, he may still qualify as an insured person under a family member’s policy where evidence establishes dependency. The Court accepted a parental relationship existed where there was evidence of ongoing emotional guidance, stability, and support such that it constituted a relationship that was principally dependent for care.
Notably, this was a benefits entitlement dispute rather than a priority dispute between insurers. The claimant would only qualify for statutory accident benefits if he established that he was an “insured person” under his sister’s policy by virtue of dependency. One wonders whether the evidence may have played out differently in a priority context where responsibility would have rested with one of the competing insurers rather than whether any entitlement to benefits existed at all.
Further, this case highlights the importance of conducting thorough investigations into a claimant’s relationships, living arrangements, access to support, and level of independence when evaluating approval of claims. Early investigation is encouraged using means such as statutory declarations and/or examinations under oath to address dependency.
Certas Home and Auto Insurance Company v. Okenge, 2026 ONSC 1189 (CanLII)
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