Category: Accident Definition

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.

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.