Insurance defence lawyers expect claimants’ lawyers to argue their clients are “dependents” under Ontario’s new auto insurance reforms, in a bid for excluded injured passengers, pedestrians and cyclists to gain access to optional benefits.
As of July 1, Ontario is changing its auto insurance policies to convert several of its mandatory benefits — including income replacement, housekeeping, and death benefits — into optional benefits. The rationale is that Ontarians will now be able to opt out of previously mandatory benefits in order to reduce their insurance premium costs.
One flashpoint, however, is that optional benefits are now available only to named insureds on auto policies, including drivers, their spouses, dependents, and other regular drivers listed on the policy.
And so, lawyers are sounding the alarm that pedestrians, cyclists, and certain passengers (including children) who are injured in car accidents may no longer have access to optional benefits, if they are not named in an auto policy.
“The immediate change is really going to be the pedestrians, the passengers, the cyclists, who have to claim accident benefits,” Julianne Brimfield of SBA Lawyers said at the 2026 conference of the Ontario Insurance Adjusters Association (OIAA), held in Toronto last Thursday. “And because the optional benefits are only payable to a very limited number of people — it’s the named insured, spouse, dependent, a regular user or a listed driver — the people who don’t fall into those categories are going to try and find a way to get into one of those categories….
“There’s going to be a lot of room for people to try and make claims as a ‘dependent.’ And those disputes, if it’s just between the person claiming benefits and the insurer, are all going to go to the LAT [Ontario’s Licence Appeals Tribunal]. So now the LAT adjudicators are being asked to deal with these coverage issues more often.”
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Andrea Lim, a partner at Dutton Brock LLP, noted that injured pedestrians, cyclists and passengers will still have access to mandatory accident benefits, even if not the optional benefits.
“What happens to an uninsured pedestrian or cyclist?” Kim asked at an OIAA conference session. “The standard accident benefits will still apply to the uninsured pedestrians and cyclists. They still have access to the med rehab and attendant care, in accordance with the limits under the existing SABs [Statutory Accident Benefits].
“So that’s key. They’re not completely out of receiving SABs or being able to access it if there are no optionals, and if they’re underinsured.”
But to access optional benefits, claimants’ counsel will likely argue their clients are “dependents” in an auto policy, predicted Laurie Walker, president of Walker Consulting & Auditing.
Caselaw in family law shows the definition of a “dependent” has become somewhat more elastic over time, particularly in an age of blended families and shifting parental roles and responsibilities.
“The dependent situation is where I think we’re going to see the stretch,” Walker said at the conference. “We see it quite a bit when we have separated or divorced parents.
“Mom’s got a policy. Dad has a policy. And do we see care combined? You’re either chiefly, principally, 51% dependent for finance or for care.
“Well, one parent might be the breadwinner, and they meet the test under finance, but they can also meet the test for care under that policy. So, can I be dependent on both?
“My answer [regarding] the child [situation] is, ‘Yes.’ So that’s where we’re going to see the challenge.
“One policy for a parent may carry just $65,000. That’s it, that’s all they could afford to pay for. My broker said, ‘This is the cheapest way to get the policy.’ But the other policy might carry the full complement of things [including optional benefits]. So, we need to do that investigation.
“Either you’re a listed driver or you’re not right. You’re either a policyholder or you’re not. It’s those two other pieces [either dependents or spouses] where it’s going to be, ‘Can I have more than one spouse? I absolutely can. And it’s the same with the children.”