Volume. 8 Issue. 27 – July 24, 2024
This week’s edition considers the definition of “spouse” with respect to claims for death benefits. Specifically at issue, whether common-law spouses are required to reside continuously under the same roof in order to qualify for benefits.
When is a Spouse Not a “Spouse”?
Common – Law Spouse not “Spouse” – The Applicant Thompson’s spouse, Scott, passed away as a result of an automobile accident that occurred on November 25, 2020. In 22-003143 v Intact, Thompson sought $25,000 in death benefits for the death of her spouse, in addition to $10,000 for each of her two daughters given the death of their stepfather. Both parties agreed that the applicable definition of spouse is at section 224(1)(c)(i) of the Insurance Act, namely, that either of two persons who have lived together in a conjugal relationship outside marriage continuously for a period of not less than three years.
Monogamous Relationship Confirmed
Thompson submitted that “she was in a monogamous relationship with Jeff Scott since October 2013 and that they became engaged on November 5, 2017. They entered into the relationship as two mature, financially independent people, each with their own residence. Both Mr. Scott and the applicant have children from other relationships. Each maintained their own household to not disrupt their children’s lives. They owned a rental property together as an investment. The applicant listed Mr. Scott as a beneficiary of the health plan at her work. They went on holidays together and presented themselves as a couple to their family, friends, and the community.”
Further, Thompson contended that she and Scott spent an average of 6 nights per week together. However, the understanding of Intact was that they spent three to five nights per week together. While the parties did not agree on the amount of time the couple spent together, this was determined by the Tribunal not to be a decisive factor in assessing whether they are spouses within the meaning of the Act.
Evolving Concept of Spouse
Thomson argued that the concept of a spouse under the Family Law Act, R.S.O. 1990, c. F.3 (FLA) has evolved over time and that living in the same residence is only one of several factors to consider. She points to Stephen v. Stawecki, “where the Court of Appeal gave weight to the intermingling of a couple’s lives and the permanence of their relationship to conclude that they began living together before they “moved in.” In this case, the applicant and Mr. Scott never “moved in,” but they were in a long term, monogamous relationship and their lives were closely intertwined. She submits that under the FLA she and Mr. Scott were living together in a conjugal relationship, and therefore, are spouses.”
Not Required to Reside in Same Dwelling?
While acknowledging that the case law prior supported a literal definition of spouse under the Act that required persons in a conjugal relationship to live under the same roof, she contended that this approach was changed by the Superior Court in McGratten et al. v. Director Motor Vehicle Accident Claims Fund. That decision confirmed “living together in a conjugal relationship must be interpreted as a unitary concept. Residing in the same dwelling is not a requirement to determine if two persons are living together in a conjugal relationship. I find that the factors that must be considered to meet the requirements of living together in a conjugal relationship are expansive. The court must take a holistic approach and review multiple considerations…”.
Different Definitions of Spouse Insurance Act v. FLA
For their part, Intact submitted that McGratten does not alter the narrow definition of spouse under the Act for accident benefit claims, with a clear distinction made between accident benefits and the life insurance benefits that were sought by the litigants in McGratten. The Tribunal agreed with Intact, noting that the Superior Court has determined that the differing policy objectives of the FLA and the Insurance Act require different meanings for the term spouse. For example, Intact v. Dominion and Wawanesa, stated that: “The Catherwood v. Young Estate decision ‘sets out a detailed discussion of the differences between the family law definition of spouse and the Insurance Act definition of spouse. As a result of reviewing these decisions, it is clear that both the Superior Court and the Court of Appeal have determined that different policy considerations underlie each scheme and that a different reading of the definition is appropriate.”
This was reaffirmed in Royal & Sun Alliance v. Desjardins/Certas, “where the Schedule’s need to provide automatic benefits to spouses at the time of the accident is different from the FLA scheme for court-ordered support where need is established. Again, the courts have determined that these two different objectives require two different interpretations for the meaning of spouse. The Tribunal found that McGratten did not veer from this reasoning, having noted that “there must be a distinction in the Insurance Act to the parts that deal with Automatic Benefits and the parts dealing with Family Protection and Dependency.”
Residence in Same Dwelling Required
McGratten “found that the broader meaning of spouse was warranted because of similar policy objectives in the OPCF 44R endorsement and the FLA. The court did not apply this approach to accident benefits, and in fact, explicitly states that there is a clear distinction between the two types of benefits. Thus, McGratten does not make the broader FLA definition of spouse applicable to death benefits under the Schedule.” Accordingly, “s. 224(1)(c)(i) of the Act requires two people in a conjugal relationship to live together in the same dwelling for no less than three years in order to meet the definition of a spouse.”
No Death Benefits
Therefore, as there was no dispute, but that Thompson and Scott maintained two separate households and never resided in the same dwelling, the Tribunal found “only for the purpose of this assessment, that she is not the spouse of Mr. Scott and is not entitled to a death benefit under the Schedule.” Similarly, her two daughters were not entitled to the dependent death benefit.
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