An Ontario tribunal denied a $35,000 death benefit claim, finding that living rent-free with a parent does not prove financial dependency.
The decision, released on April 20, 2026, by the Licence Appeal Tribunal in Gelua v. Northbridge General Insurance Company (Case No. 24-015482/AABS), turned on whether an adult son qualified as "principally dependent" on his deceased mother - a threshold question with real implications for how insurers evaluate death benefit claims under the Statutory Accident Benefits Schedule.
Norma Gelua was struck by a school bus while crossing an intersection on March 7, 2024, and died from her injuries two days later. She was nearly 88 years old. Her son, Joseph Gelua, 65 at the time, applied for a $35,000 death benefit. A Death and Funeral Benefits Application was submitted on June 25, 2024. Northbridge General Insurance Company denied the claim on September 23, 2024, saying the applicant was not principally dependent on his mother for financial support.
At his Examination Under Oath, Gelua testified he had lived in his mother's Marmora, Ontario home for several years, rent-free and expense-free. His mother, he said, paid for everything - mortgage, property tax, hydro, internet, cable, and the bulk of the groceries. His own income, per his 2023 Notice of Assessment, was $17,953 a year, or about $1,496.08 a month.
Adjudicator Melanie Malach was not persuaded. She applied all three recognized approaches to dependency analysis - mathematical, statistical, and big picture - and the claim failed each one.
On the math, the Tribunal found Gelua had not shown what his actual financial needs were or what his mother specifically paid on his behalf. Even accepting his estimated rental cost of $1,500 a month, 51 percent of that comes to $765 - well within his monthly income. The Tribunal also noted that the majority of the expenses in his bank records were for fast food, calling it a spending choice rather than a necessity of life.
On the statistics, the Tribunal looked at Statistics Canada's Low-Income Cut-Off for a one-person household in Marmora: $18,938 net annually in 2023, or roughly $19,307.93 adjusted for inflation in 2024. Gelua's income was enough to cover more than half.
On the big picture, the Tribunal acknowledged he may have benefitted from his mother's generosity but found that rent-free living alone did not make him principally dependent.
The decision also addressed a procedural argument. Gelua claimed Northbridge failed to provide adequate denial reasons under section 36 of the Schedule. The Tribunal dismissed this, noting section 36 covers only "specified benefits" - income replacement, non-earner, caregiver, and housekeeping and home maintenance benefits - and does not apply to death benefits. A separate provision, section 43, does apply, but the Tribunal confirmed it carries no prescribed consequences for non-compliance.
For insurers handling death benefit files under the Schedule, the takeaway is clean: all three dependency tests can work in concert, and how a claimant spends their income matters as much as how much they earn. A family member's generosity, however longstanding, is not the same as dependency.
