Category: Accident Definition

The claimant was a pedestrian who was struck by an egg thrown at him from the occupant of a moving vehicle. He applied for accident benefits. The insurer argued that the incident was not an “accident” as defined in the SABS. Adjudicator Ferguson dismissed the application and held that the claimant had not been involved in an accident. He accepted that the purpose test had been met, but that the causation test had not. The egg throwing was an intervening act. The claimant’s injuries arose from an assault rather than due to an automobile.

The insurer requested a preliminary issue hearing as to whether the incident in question was an automobile accident. The claimant had sustained injuries after she slipped and fell next to the passenger door of her parked vehicle. The claimant had sought benefits under the SABS, which the insurer denied as the incident did not qualify as an “accident.”  Adjudicator Anwar held that the incident was not an accident for the purposes of the SABS as the dominant feature causing the claimant’s injuries was the slip and fall itself, and the vehicle was not closely involved in the incident.

The claimant was the driver of a vehicle when she and her boyfriend were subject to a gun attack. The claimant’s boyfriend was hit by bullets and the claimant fled the scene in the vehicle and tried to find a hospital for her boyfriend. Her boyfriend eventually died of his injuries. The claimant argued that she was in an “accident” because she suffered psychological impairments as a result of not being able to find a hospital, which directly arose out of the use and operation of a vehicle. Adjudicator Flude rejected the claimant’s arguments. He held that the incident met neither the purpose test nor the causation test; the vehicle was simply the venue of the incident and its use and operation did not directly cause the claimant’s psychological impairments.

The claimant sought entitlement to medical benefits. The insurer asserted an accident had not occurred under the definition in the SABS. The incident giving rise to the application involved the claimant car surfing on the rear of a motor vehicle. When the vehicle took a sharp turn, the claimant fell and suffered a severe head injury. Adjudicator Nicole Treksler indicated that the claimant had the onus of proving an accident had occurred as defined in the SABS. Applying the purpose and causation tests, it was held that an accident had occurred. It was determined that the vehicle involved was engaged in its ordinary use – while the applicant was using the car for entertainment, the applicant’s primary use of the car was for transportation. The use was not deemed aberrant, abnormal or off-beat, as car-surfing was considered ingrained in culture, albeit illegal and foolish. Since no intervening act was identified, the causation test was also met. Accordingly, an accident was said to have occurred and the claimant was entitled to access accident benefits.

The claimant sought accident benefits; however, the insurer denied access and asserted that no accident within the definition had occurred. Adjudicator Rebecca Hines noted that the claimant dropped her kids off at a birthday party event at a mall. While returning to her vehicle she tripped on a pothole in the parking lot, “a few steps away from her minivan.” At no point did the claimant make physical contact with her vehicle when falling. Adjudicator Hines applied the purpose and causation tests. On review of FSCO jurisprudence, Adjudicator Hines determined that merely walking towards a parked car does not satisfy the purpose test. Nevertheless, the claimant also failed on the causation test when time and proximity was considered. The claimant was walking toward her car after attending a party; her keys in hand did not cause her to fall nor did it occur in the act of physically entering or exiting her vehicle. Indeed, the pothole was an intervening act to break the causation chain. Lastly, Adjudicator Hines noted that the risk of tripping in a pothole while in a parking lot was not reasonably associated with motoring. It was determined that the claimant had not been involved in an accident pursuant to section 3 and the claim for accident benefits was dismissed.

The claimant was a tow truck driver who sustained injuries while opening the garage bay door at a mechanic’s shop. He was opening the door to push a broken taxicab inside the garage. He sought benefits from his auto insurer, which were denied. The issue at the LAT was whether the claimant had been involved in an “accident” as defined in the SABS. Adjudicator Anwar found that the claimant was not involved in an accident under the SABS. The Adjudicator noted that Chisholm v. Liberty Mutual Group established a two part test that an claimant must satisfy in order for an “accident” to have taken place. The Adjudicator found that the claimant did not satisfy the Purpose Test, because the use or operation of the broken taxicab ended when the claimant unhooked the taxicab from his tow truck, which was prior to the incident. The claimant also did not satisfy the three inquiries of the Causation Test, because this incident would still have occurred even without the use or operation of the vehicle. Secondly, Adjudicator Anwar held that the act of opening the garage door was not a normal incident of the risk created by the claimant’s ordinary use of the tow truck. Thus, the incident was an intervening cause, and was not a natural occurrence arising out of the ordinary use of the automobile. Finally, Adjudicator Anwar concluded that the use of the automobile was not the factor that most closely caused the injury. The dominant feature that caused the injury was the unsuccessful act of opening the garage door, which was not related to the claimant’s use of the vehicle.

This preliminary hearing addressed whether the claimant was involved in an “accident”. She had fallen outside of her residence after disembarking from a vehicle which stopped to drop her off in front of her building. The fall occurred due to an uneven curb about three or four steps from the vehicle. Adjudicator Daoud concluded that the facts of loss were not an “accident,” and that the fact that a vehicle brought the claimant to the location of the incident was insufficient to establish that the use or operation of the vehicle were a direct cause of the claimant’s injuries.

This preliminary issue hearing was held to address whether the claimant was involved in an “accident” as defined in the SABS. The claimant (a minor with developmental disabilities) was inadvertently locked on a school bus for two hours, causing the claimant to become anxious and frightened. She applied for accident benefits to treat psychological injuries. The insurer argued that the incident was not an “accident”. Adjudicator Ruth Gottfried concluded that both the purpose and the causation test were met, and that the claimant’s impairments arose from the school bus being used in its undisputed ordinary and well-known purpose. The incident therefore qualified as an “accident”.