Category: Accident Definition

A preliminary issues hearing was held to determine whether the claimant was involved in an “accident” as defined in s. 3(1) of the SABS. The claimant and insurer agreed on the following facts: On the day of the accident, the claimant drove to a feed store with her husband to purchase horse feed. The claimant and her husband were directed to pick up the horse feed from a shed. While walking from the shed to her car, the claimant had to navigate around a number of skids and pallets. While she was walking, the claimant raised her hand and clicked the key fob to remotely unlock her vehicle’s rear hatch so her husband could load the horse feed into the trunk. While clicking the key fob and observing the rear taillights of the vehicle flash, the claimant tripped over a slightly raised forklift tine. Adjudicator Parish found that the incident did not meet the purpose or causation test. In particular, this matter was distinguishable from previous LAT cases because the fall occurred prior to the vehicle being loaded with horse feed, the fall did not involve the claimant coming into contact with the vehicle, and the chain of causation was broken when the claimant parked her vehicle, shut it off, and locked the vehicle. Adjudicator Parish did not accept that pressing the key fob and observing the taillights flash established the use or operation of a vehicle. Adjudicator Parish found that the claimant was not involved in an “accident” as defined in the SABS. The application was dismissed.

The claimant was riding his bicycle when he wound up in front of a vehicle operated by Allstate’s insured. The insurer argued that the automobile was not involved in the incident, and that the claimant had fallen independent of the automobile. Adjudicator Farlam held that the incident was not an accident. The claimant rode his bicycle up along side the stopped vehicle and put his hand on the driver’s hood. When the light changed, the claimant took his hand off the hood, started to ride, and then lost his balance and fell. The driver of the vehicle had not moved his vehicle and was still stopped when the claimant fell. Independent witnesses observed the claimant accosting the driver after the incident and police were called to the scene. The police investigation determined that the claimant had lost his balance, and the claimant was charged with assaulting the automobile driver. The police investigation noted that if the claimant’s bicycle had been struck by the vehicle there would have been damage to the bicycle or the vehicle, and no damage was observed on either. Adjudicator Farlam also noted that the claimant’s evidence was unreliable and inconsistent, nor was it corroborated by the testimony of any witnesses.

The claimant was injured when she slipped and fell while trying to enter her vehicle. The insurer denied that the incident qualified as an accident. Adjudicator Mazerolle agreed with the insurer and held that the incident was not an accident. The claimant slipped and fell on ice as she walked from her trunk to the driver’s door. She did not manage to open the door before falling. The adjudicator concluded that the dominant feature of the incident was falling on ice, rather than the use and operation of a vehicle. The vehicle was simply ancillary to the events. Adjudicator Mazerolle did not accept the claimant’s argument that the reason for her being near her car and on the ice – namely, in order to get into her car – was necessarily the direct cause of the incident.

The claimant was injured when he tripped and fell on a raised ledge at an auto show near a display vehicle. He argued that the incident qualified as an accident. Vice Chair Farlam held that the trip and fall was not an accident under the SABS. The fact that the claimant was walking towards a vehicle when he tripped did not establish that a vehicle contributed to the incident. Further, the claimant’s “viewing” of a vehicle was not relevant to the legal test; he was required to prove that the incident arose from the use and operation of an automobile (the purpose test) and whether the use and operation of an automobile directly caused the claimant’s injuries (the causation test). The facts of loss did not meet the purpose test, so the Tribunal did not need to consider whether the causation test was met.

The claimant was injured while crossing an intersection in downtown Toronto late at night. He sustained soft tissue injuries and a fractured clavicle. The Fund argued that no vehicle was involved in the incident, and the claimant was therefore not entitled to accident benefits. The claimant argued there was a vehicle that struck him, though he could not provide any details. Adjudicator Norris held that the claimant failed to prove that a vehicle was involved, and that the claimant was not entitled to accident benefits. The claimant only recalled “something” hitting the back of his leg and that he fell to the ground and lost consciousness. The police did not create an accident report when the claimant reported the incident because the police did not have enough detail, nor was the claimant’s reporting consistent with a motor vehicle accident. The hospital records failed to establish the involvement of a vehicle. At least three times the incident was noted as a fall or a syncopal episode. The claim was dismissed.

The claimant’s spouse was involved in an accident while a pedestrian. The claimant observed her spouse’s injuries later in the day while in hospital. Neither the claimant nor the spouse were named insureds at the time of the accident, so they applied to the Fund for accident benefits. Vice Chair McGee held that the claimant was not involved in an accident and therefore not entitled to accident benefits. The claimant was not present at the scene of her spouse’s accident. She first saw him at the hospital. The claimant’s trauma arose from seeing her spouse’s injuries at the hospital, which caused psychological injury to her. Vice Chair McGee found that this post-accident observation could not be said to arise out of the use of operation of an automobile, nor were the claimant’s psychological impairments directly caused by the use or operation of an automobile. The circumstances giving rise to the claimant’s impairment were too remote from the automobile striking her spouse to conclude that the claimant herself was involved in an accident. Further, there were several intervening acts between the use and operation of an automobile and the claimant’s impairment. Vice Chair McGee also went on to determine that the claimant was not an insured person under the SABS or the Motor Vehicle Accident Claims Fund Act.

The claimant was assaulted when he exited his vehicle while attempting to park. A written preliminary issues hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The claimant submitted that he was assaulted when he initially exited his vehicle to speak to people who were behind the vehicle, and was assaulted again as he tried to re-enter his vehicle, and was thrown against the vehicle. The insurer conceded that the incident met the purpose test but not the causation test, and argued it was not an “accident” under the SABS. The claimant made submissions but did not put forward any evidence in the written hearing. Vice Chair Farlam found that the claimant’s alleged injuries were not caused by the use or operation of his vehicle because the claimant did not provide any evidence to meet his burden of proof. The evidence filed by the insurer made it clear that the assault on the claimant was an intervening event that caused the alleged impairment. The applicant did not meet his onus to establish that the incident met the causation test. Vice Chair Farlam found that the claimant was not involved in an accident as defined by the SABS. The application was dismissed.

A written hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The parties agreed that the claimant sustained injuries when he slipped on ice as he was exiting his vehicle and fell to the ground on his left side. The insurer disputed the allegation that the claimant also hit his right shoulder on the vehicle during the fall. The claimant used his vehicle to pull himself to a standing position after the fall. The insurer conceded that the slip and fall satisfied the purpose test. Adjudicator Lake found that the claimant failed to establish that the incident satisfied the causation test. It was found that the icy parking lot was an intervening cause and not a foreseeable risk of motoring, which broke the chain of causation between the use and operation of the vehicle and the fall that resulted in injuries. Adjudicator Lake found that the claimant was not involved in an accident as defined by the SABS. The application was dismissed.