Category: Accident Definition

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”.

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.