Category: Accident Definition

Sajid v. Certas Home and Auto Insurance Company (2022 ONSC 2071)

The claimant appealed the Tribunal’s decision that he was not involved in accident. He was the driver of a taxi, and was assaulted by a passenger about 50 steps from the taxi while following him to his home to get payment for the fare. The Divisional Court dismissed the appeal, holding that the Tribunal did not err in finding the incident was not an accident. Neither the purpose test nor causation test were met. The Court distinguished its decision in North Waterloo v. Samad, where the applicant was injured in an assault, but also in the process of slipping on ice while exiting his vehicle. In the present case, the claimant was injured solely as a result of the assault. The Court explained that a direct cause is one that sets in motion a train of events that brings about a result without the intervention of any other force. The Tribunal was correct in considering whether the assault constituted an intervening event while broke the chain of causation. The Court also noted that applying a “large and liberal” interpretation of the term “accident” could not broaden the definition to include indirect causes of injury or impairment.

Francia v. Licence Appeal Tribunal (2021 ONSC 7847)

The claimant appealed the Tribunal’s decision that he was not involved in an accident. He suffered injuries when responding to a fatal collision between a transport truck and tractor-trailer. The claimant was called to the scene to clean up the industrial spill. The fumes from the chemicals caused him to suffer a collapsed lung requiring surgery. He also suffered psychological injuries as a result of seeing the aftermath of the fatal accident. The Court affirmed the Tribunal’s decision that the claimant was not involved in an accident. The Tribunal correctly applied the purpose and causation test. With respect to the purpose test, the Tribunal concluded that the incident involving he claimant (as opposed to the drivers in the collision) did not result from the ordinary and well-known activities to which automobiles are put. By the time the claimant arrived at the scene the vehicles were non-operational and on fire. With respect to the causation test, the use and operation of the vehicles did not cause the claimant’s injuries. Rather, it was the presence of toxic chemicals on the road, and the claimant’s observations of the deceased that led to the claimant’s impairments. The Court also noted that many of the alleged errors identified by the claimant were factual findings made by the Tribunal, and not open to review on appeal.

Travis v. Aviva Insurance Company (20-004822)

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.

Demers v. Intact Insurance Co. (20-008399)

The claimant was involved in an assault by a motorcyclist and applied for accident benefits as a result. The insurer argued that the claimant had not been involved in an accident as denied by s. 3(1) of the SABS. The Tribunal agreed. Vice Chair Boyce highlighted that unless the vehicle itself is associated with a specific impairment, assaults are not considered accidents under the SABS. The assault was found by the Tribunal to have broken the chain of events, and that even where the use of a vehicle is the catalyst to a subsequent assault causing injury, it is not enough to show that the vehicle was merely in the vicinity. The use or operation of the vehicle must have directly caused the injury for an incident to constitute an accident.

Amrok v. Economic Insurance Company (20-007816)

The claimant was the victim of a physical assault after he had cut off a truck on the highway. The Tribunal found that this incident did not fall within the definition of an accident under the SABS as the claimant had failed to satisfy both the purpose and causation test. The vehicle was not responsible for the cause of the claimant’s impairments and the insurers denial was upheld.

Fariad v. Intact Insurance Company (2021 ONSC 6965)

The claimant appealed the Tribunal’s decision that he was not involved in an accident. He had been driving an Uber and asked his passengers to leave due to unruly behaviour. After getting out the vehicle, a passenger struck the vehicle. The claimant sped away. He alleged suffering emotional and psychological injuries due to the incident. He also alleged striking his knee on the steering wheel when driving away. The Court held that the Tribunal did not make an error of law. The Tribunal applied the purpose test and concluded that the claimant’s injuries did not arise from the ordinary and well-known activities to which automobiles are put. The Tribunal also made findings of fact that the claimant’s psychological injuries arose from the altercation with the passengers rather than the use and operation of a vehicle. The Tribunal also held that even if the purpose test had been met, the causation test would not have been met. Finally, the Tribunal held that the claimant did not sustain a physical injury when leaving the scene. The Court held that the Tribunal’s application of the purpose and causation tests were correct, and that the Tribunal’s findings of fact were not subject to appeal.

Amare v. Economical Insurance Company (19-004635)

The claimant applied to the LAT seeking entitlement to accident benefits. A preliminary issues hearing was held to determine whether the claimant was involved in an accident, as defined in the SABS. The claimant said that his Samsung mobile phone spontaneously exploded in his pocket while he was driving, and that he hit his head while hastily exiting the vehicle after he had pulled the vehicle over to a stop on the side of a highway following the explosion. The insurer argued that no accident occurred or that the accident was staged for the benefit of the claimant. The claimant was found to lack credibility. Adjudicator Norris drew an adverse inference from the claimant’s refusal to produce corroborating evidence and failure to call a key eyewitness of the incident. Adjudicator Norris concluded that the accident was staged for the claimant’s benefit, and that staged accidents were excluded from the definition of “accident” in the SABS. The application was dismissed.

Amiri and Mireskandari v. The Co-operators (20-003296)

The claimants were out for a walk with their spouses when a member of their group, a close relative, was struck by a motor vehicle in a pedestrian accident. The claimants, who were uninsured, applied for accident benefits under the driver’s policy, claiming emotional shock and psychological distress. Adjudicator Norris had previously ruled that the claimants did not meet the definition of an “insured person” in section 3(1) of the SABS, and therefore had no entitlement to accident benefits under the driver’s policy. The claimants requested Reconsideration of the decision. The claimants alleged that Adjudicator Norris erred in fact or law by failing to recognize the broad, consumer-protecting threshold of section 3(1). Adjudicator Norris disagreed, noting that while protections did exist, the claimants had no relation to the named insured (driver) as required by law to claim benefits, and as unfortunate as the event may have been, they were not entitled to claim accident benefits from the insured driver. The request for reconsideration was denied.

Young v. Cumis General Insurance Company (20-002837)

The claimant had attended a vehicle dealership to pick a van that she and her spouse had purchased. Construction was underway in the dealership parking lot. The claimant exited the dealership and proceeded towards her van, which was located by a sidewalk. As the claimant walked to the van to open its door, she slipped on an unmarked strip of gravel and fell to the ground resulting in a fractured ankle. 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 Johal noted that parking was an ordinary and well-known vehicular activity, and “but for” walking to the van the claimant would not have fractured her ankle. However, the claimant did not satisfy the third part of the test, as the “use or operation” of the vehicle was not the dominant feature of the claimant’s injuries. Vice Chair Johal noted that it was insufficient to establish direct causation by merely stating that the accident took place near the vehicle, or that the incident would not taken place if the vehicle had not been parked in that location. The claimant’s application for accident benefits was dismissed.

F.C. v. Intact Insurance Company (18-012357)

The claimant was a long haul truck driver taking a load from Brampton to Edmonton. The claimant testified that while driving, a fire started due to overheating of electrical wiring, and he was forced to jump out of the moving truck to prevent personal injuries. The insurer took the position that claimant deliberately set the trailer on file, and raised a preliminary issue, arguing that the setting of the fire was an intervening act that resulted in the injuries. Adjudicator Watt accepted the insurer’s position and dismissed the application on the basis that the operation of the truck did not cause the fire, and the fire was an intervening act which caused the damages. In doing so, he emphasized the lack of clarity and consistent evidence from the claimant on certain key issues, including how the fire started and why he was unable to bring the truck to a stop.