Category: Accident Definition

The claimant alleged that he was involved in an accident and injured while using and operating his vehicle to drive to an outdoor space to meditate. The claimant has a long history of mental health issues and addiction, and had previously expressed suicidal ideations. The insurer denied the claimant’s accident benefits claim, and argued that the claimant was using his automobile in a deliberate manner to end his own life, a suicide attempt, and therefore, the incident was not an “accident”. The insurer argued that the use of an automobile in a suicide attempt is an aberrant use of the automobile, and not within the “ordinary course of things”. The insurer argued that the dominant cause of the claimant’s injuries was his suicide attempt, not the use of operation of the vehicle. Medical records and police records implied and concluded that this accident was a suicide attempt. However, none of the individuals who created the records testified at the hearing. Vice Chair Farlam found that the dominant factor that caused the applicant’s injuries was the unintended loss of control of the claimant’s motor vehicle while he was driving it. Vice Chair Farlam also found that the claimant was not using his automobile in a suicide attempt on the date of loss, as the claimant’s pre-incident activities (spending time with his son), actions during the incident, and actions immediately after the incident (seeking help) were inconsistent with an attempt at suicide by vehicle. As such, Vice Chair Farlam found that the incident met the definition of an “accident” in the Schedule.

The claimant alleged that an accident occurred as he was walking towards a transit bus. As the bus began to pull away from the bus stop, the claimant reported that he knocked on the side of the bus as it drove away. He claimed to have made momentary eye contact with the driver before losing his balance and slipping off the curb. The claimant’s right foot was allegedly run over by one of the rear bus tires. The claimant got onto the next bus and the driver asked if he required an ambulance. The insurer questioned whether or not this incident met the definition of an “accident” under the Schedule, given the claimant’s inconsistencies in his recollection of the accident details and the lack of any objective evidence. Vice Chair Maedel was not satisfied that the claimant’s injuries were caused by the use or operation of the transit bus. Vice Chair Maedal reviewed the totality of the evidence and was unable to determine that there was a nexus between the operation of the bus and the injuries sustained by the applicant. There was no witness evidence to corroborate the incident. There was no photographic evidence of the claimant’s injuries, and no incident reports or calls logged to the City of Hamilton, Hamilton Police, or ambulance records. Lastly, no medical evidence was produced that demonstrated the injuries the claimant sustained are consistent with the type of impact alleged.

The claimant slipped and fell on black ice in a parking lot as she was trying to open the driver’s side door. The claimant applied for accident benefits, which was denied as her insurer took the position that the claimant was not involved in an accident. Adjudicator Kaur held that the incident did not meet the definition of an “accident”. Adjudicator Kaur found that the claimant’s injuries were not a consequence directly caused by the use of operation of the automobile. Instead, her injuries were caused by an intervening cause, which was the ice on the ground. Adjudicator Kaur found that the ice that initiated the slip and fall led to the claimant’s injuries, not the use of operation of her automobile, and while the vehicle was physically near the ice, it did not cause the slip and fall.

The claimant sought entitlement to accident benefits following an incident in which he parked in someone else’s parking spot, and as a result he was yelled at and his vehicle was vandalized. The claimant argued that he suffered psychological injuries as a result. The insurer denied that the incident was an “accident”. Adjudicator Makhamra concluded that the incident was not an accident. The incident met the purpose test, as parking a vehicle was an ordinary use of a vehicle. However, the causation test was not met. The injuries alleged by the claimant were not the result of parking the vehicle. The assailant’s verbal attack and vandalization of the vehicle was an intervening act. Adjudicator Makhamra also wrote that the dominant feature of the incident was the altercation, not the parking of the vehicle.

The claimant was involved in an incident where he fell off the roof of a transport truck and sustained a traumatic brain injury. The claimant placed a ladder against the side of the transport truck to inspect its roof. While conducting his inspection, the ladder slid out from under him. The claimant attempted to grab onto the roof, until he eventually fell from the transport truck, hitting his head on the curb and pavement. The claimant was deemed CAT and sought approval for a housing modification and nutritional counselling. The insurer denied the application, stating that the claimant was not involved in an “accident” as defined by the SABS. Adjudicator Boyce held that the incident met the definition of an “accident”. The purpose test was satisfied as performing routine maintenance on a parked vehicle is one of the “ordinary and well-known activities to which automobiles are put.” Adjudicator Boyce accepted that but for the claimant’s use and operation of the truck, he would not have sustained his impairments. The facts support that his impairments were directly caused by conducting routine maintenance on the truck and there were no intervening acts that could be reasonably considered to be outside the normal course of actions that would sever the chain of causation.

The claimant went grocery shopping and carried half of her groceries into her home. On the next day, the claimant proceeded to retrieve the remainder of the groceries from her car, when she slipped and fell approximately 12 to 15 feet away from her vehicle. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in an “accident” as defined by the SABS. Adjudicator Grant held that the incident did not meet the definition of an “accident”. Adjudicator Grant found that any impairments that the claimant may have suffered were caused by circumstances that arose from the icy conditions of the parking garage, and not from any use or operation of the vehicle. While Adjudicator Grant recognized that retrieving and putting away groceries from a trunk meets the purpose test, he held there was an intervening act where the claimant failed on causation.

The claimant testified that she exited left out of a parking lot when another vehicle struck her car on the front driver’s side. Both vehicles were towed from the accident scene in London to Mississauga. The police attended the scene and created a motor vehicle collision report, but did not conduct an investigation. The report stated that damage occurred to the entire front of the vehicle and that the steering was broken, which caused the air bags to deploy. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in a legitimate accident. An accident reconstruction specialist was hired by the insurer and testified that the accident did not occur as reported by the claimant. He concluded that the two vehicles were in a collision, but not with each other. He noted that damage to both vehicles ought to match in height, severity and character, and that these factors did not match the incident as reported. The vehicle and collision forces did not align with the pre-impact direction of travel of either vehicle. The expert concluded that the cars were towed to the collision site and that the accident was staged. Adjudicator Reilly held that the claimant did not meet her burden of proof to establish that an accident occurred. The adjudicator was heavily persuaded by the accident reconstruction specialist’s report, and determined there were significant issues of credibility with the evidence provided by the claimant and the other driver.