Ontario Superior Court allows insured’s ‘spouse’ to claim benefits despite volatile relationship

The Ontario Superior Court of Justice has ruled that an insurance policy should be extended to the insured’s alleged “spouse” despite their volatile relationship.

In Holtzhauer v. Intact Insurance Company of Canada, 2023 ONSC 436, Ryan Holtzhauer was walking on Highway 7 in Guelph when he was struck by Anthony Peck’s vehicle. Holtzhauer was seriously injured and hospitalized. He sued Peck, claiming damages for his injuries from the accident. Holtzhauer also filed a claim against Intact Insurance Company of Canada, asserting that the insurer should be held liable if Peck is found to be underinsured or uninsured.

On the accident date, Kim Melcher was the named insured on the Intact policy. Holtzhauer and Melcher have a child together, but they were never married.

The policy extends to the insured’s ‘spouse’

Under the Insurance Act, an insured’s automobile coverage extends to “the insured and his or her spouse.” The act defines “spouse” as either of two persons who have “lived together in a conjugal relationship outside marriage in a relationship of some permanence, if they are the parents of a child.” Holtzhauer asserted that he came within the definition of “spouse” under the Intact policy because of his relationship with Melcher.

Intact refused the claim because Holtzhauer’s allegedly made certain statements to the Guelph Police Service and the Family and Children’s Services of Guelph and Wellington County personnel, which suggested that his relationship with Melcher had ended some time before the accident. Intact argued that Holtzhauer did not come within the definition of “spouse” under the insurance policy on the accident date.

Holtzhauer claimed that from September 2008 until the accident in June 2009, he and Melcher had lived continuously at an apartment on Silverbirch Road in Waterloo. He stated they had a “roller-coaster ride relationship” but would constantly get back together.

Insurance Act defines ‘spouse’

The Ontario Superior Court of Justice ruled that Holtzhauer came within the definition of “spouse” under the Insurance Act. The court, citing case authorities, said that a “conjugal relationship” includes shared shelter, sexual and personal behaviour, services, social activities, economic support, children, and the societal perception of the couple. These elements may be present in varying degrees.

Applying a holistic approach, the court emphasized that what must be examined are the couple’s actions and routines against the accepted indicia of a close relationship and determine whether the level of commitment displayed rises to that of spouses.

No intention to terminate the relationship

The court found that Holtzhauer and Melcher lived together in a conjugal relationship of some permanence for a considerable time during their relationship. They shared a bedroom in a sexual and emotional relationship for some time during Melcher’s pregnancy and continued following the birth of their son. They also pooled the income from the business they operated, and both drew on the business income to support themselves and their son.

While the court found their relationship had been volatile, involving frequent short separations, they always got back together and resumed cohabitation until the accident. The court found no evidence that either of them had formed an intention to terminate their conjugal relationship before then. For a month before the accident, Holtzhauer was living with Melcher at Silverbirch. On the evening of the accident, Holtzhauer was walking a long distance from Guelph to Waterloo to help Kim with difficulties she was having with her truck which had broken down. The court said this was not the conduct of a person who had formed a settled intention not to continue the relationship.

The court concluded that on the accident date, Holtzhauer met the definition of “spouse” applicable to the uninsured and underinsured coverages under the Intact policy.