Category: Accident Definition

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”.

The claimant suffered catastrophic injuries while running down a street, and tripping headfirst into a parked vehicle. The insurer argued that the evidence did not support the facts of loss as reported by the claimant, and that even if the facts as reported were true, the claimant was not involved in an “accident” for the purposes of the SABS. Adjudicator Makhamra first concluded that the evidence submitted by the claimant did support the facts of loss as reported, and held that the claimant had fallen face first onto a parked car. Second, the adjudicator concluded that the facts of loss constituted an “accident” for the purposes of the SABS. Although she reviewed all of the leading cases on the “accident” definition issue, she placed heavy reliance upon the Court of Appeal’s reasons in Caughy v. Economical, in which that Court held that an individual tripping over a parked motorcycle was involved in an “accident.”

The claimant sustained injuries when he was assaulted in a parking lot. During the assault, the claimant managed to get into his car and turn the engine on. The claimant applied for accident benefits. The insurer took the position that the incident was not an “accident” as defined in the SABS. Adjudicator Neilson dismissed the application and held that the claimant had not been involved in an accident. She concluded that it was the assault that caused the claimant’s injuries and subsequent impairments. The assault was an intervening act, and the use or operation of his or any other vehicle had not directly caused his impairments.