Category: Accident Definition

The claimant, an Uber driver, was assaulted while waiting in his car to pick up passengers. The claimant sustained injuries as a result of the attack, and applied for accident benefits. The insurer denied coverage on the basis that the incident was not an “accident” under the SABS. Adjudicator Johal agreed. He concluded that the assault was an intervening act, and that the impairments were caused by the assault and not by the use or operation of the vehicle. The claimant was dismissed.

The claimant was injured when a motorist deliberately hit her with the door of his parked car. The motorist then got out of the vehicle and struck the claimant several times. The insurer argued that there were two separate incidents, and that it was not liable to pay for injuries related to the second assault. Vice Chair Flude concluded that the motorist getting out of the vehicle and striking the claimant did not break the chain of causation, and that he did not need to decide whether the accident was the only cause of the various impairments sustained by the claimant.

The claimant sought accident benefits following an injury on a public transit bus. The insurer argued that there was no collision and that the claim was barred by section 268(1.1) of the Insurance Act. Adjudicator Grant concluded that the claimant failed to adduce evidence that there was a collision. No documentation was provided to substantiate the allegation and the claimant was half-asleep at the time of the alleged accident. The transit service manager have evidence that there was no record of any collision on the date alleged.

The claimant applied for accident benefits after suffering injury on a city bus. The insurer denied that he was entitled to accident benefits because there was no collision; rather, the claimant fell when the bus driver accelerated. The claimant suffered from various disabilities prior to the accident and sought a seat in the priority seating area. However, the bus was not a bus specially designed for persons with disabilities. Adjudicators Norris and Letourneau dismissed the claim and held that the claimant was not entitled to receive accident benefits. They held that the fact that the claimant wished to use priority seating on the city bus did not make the bus “special transportation for persons with disabilities.” Furthermore, the availability of priority seating was not a special service provided for persons with disabilities.

The claimant sought coverage for accident benefits following an assault at an auto mechanic. The insurer denied that the facts of loss constituted an accident. Adjudicator Mazerolle agreed with the insurer. He conceded that attending an auto mechanic was part of the ordinary and well-known activities to which an automobile is put. He also conceded that the assault in this case was closer to an “accident” than other assault cases, because the assault arose in the process of having an automobile serviced. However, he concluded that there was an intervening act – the argument between the claimant and the auto mechanic, and the assault ordered by the auto shop owner – which resulted in the injuries not arising from the “ordinary course of things.”

The claimant was struck on the head by an unidentified cyclist travelling on the sidewalk while she was taking something out of her work vehicle. She sought accident benefits. The insurer argued that the facts of loss did not qualify as an accident. Adjudicator Hans concluded that the incident was an accident for the purposes of the SABS. Both parties agreed that the purpose test was satisfied. Regarding the causation test, Adjudicator Hans concluded that the incident satisfied each of the “but for,” “intervening act,” and “dominant cause” considerations.

The insurer denied entitlement to accident benefits based on the facts of loss. The claimant had parked her vehicle at a mechanic’s garage in order to have a emissions test performed. She pulled into the service bay, turned offer her engine, left the keys in the vehicle and exited her vehicle. She then spoke with an attendant beside her vehicle and was handed a clipboard. While walking around her vehicle to the waiting area she tripped on netting and fell, fracturing her foot. Adjudicator Boyce concluded that the claimant was not involved in an accident because the use of her vehicle was not the direct cause of the claimant’s injuries and the netting on which she tripped was an intervening cause.

The claimant was roller blading along a sidewalk when a van allegedly cut in front of him, causing the claimant to fall to the ground. The claimant did not impact the van. The insurer argued that the incident did not occur as reported, and that if it did, it did not qualify as an accident. Adjudicator Grant held that the incident qualified as an “accident.” He favoured the evidence of the claimant over that of the insurer, which had relied upon a police officer testifying two years after the incident without notes of the incident. The facts as reported by the claimant met both the purpose and causation test because a van was involved and there were no intervening acts.