Category: Accident Definition

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.

The claimant exited his truck, and left the vehicle running while he walked up to a building. While returning to his vehicle, he slipped on ice and fell. 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. On examination under oath, the claimant testified that he slipped approximately 5 to 10 feet away from the vehicle. Vice Chair Farlam held that the incident was not an “accident”. Vice Chair Farlam found that the dominant factor that caused the claimant’s injuries was his slip and fall on the icy parking lot. Vice Chair Farlam held that the claimant’s injuries were caused by a later intervening cause, the fact that he slipped on ice on the ground, which broke the chain of causation.

The claimant parked and exited her vehicle, and proceeded to walk around the rear of the vehicle when she slipped and fell on an icy driveway. 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. Vice-Chair Farlam held that the claimant’s injuries were not a consequence directly caused by the use or operation of the automobile but were caused by a later intervening cause, that she slipped on ice on the ground. Ice on the ground and the claimant’s slip and fall constituted an independent intervening event that broke the chain of events, and her use or operation of the automobile was not the dominant feature of the claimant’s injuries.

The claimant was walking to her vehicle when she slipped and fell on ice. The fall happened as she was turning towards the driver’s side door and had activated the key fob to unlock the vehicle. The Tribunal accepted that the claimant had satisfied the purpose test, as the accident arose from the ordinary and well-known activities for which automobiles are put. However, Vice Chair Maedel considered that conducting a dominant feature analysis would be appropriate in the circumstances. This analysis requires the Tribunal to determine the element of the incident that most directly caused the injuries. Vice Chair Maedel determined that the dominant feature in this case was the ice and not the vehicle. As a result, the claimant could not prove that the use or operation of an automobile had directly caused her injuries. The Tribunal rules that the claimant had not been involved in an “accident”.

This claim arises out of a vehicle attack that occurred in Toronto on April 23, 2018. The claimant, a firefighter, developed psychological impairments after responding to the incident. The insurer denied the application for benefits, arguing that the claimant had not been involved in an accident pursuant to the SABS. The Tribunal agreed with the insurer, finding that the claimant had failed to satisfy both purpose and causation tests. Adjudicator Paluch found that the vehicle which had been used as a weapon had not been operated in a manner consistent with ordinary use. The Tribunal emphasized that when vehicles cease to be used as automobiles, the SABS does not require an insurer to provide coverage. The Tribunal also considered the claimant’s use of the firetruck at the scene but concluded that the causation test had still not been satisfied. The use and operation of the fire truck was not the cause of the claimant’s injuries which had developed due to prolonged exposure to the horrific scene.