Category: Accident Definition

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 preliminary issue 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 and fell after exiting his vehicle. The claimant was completely out of the vehicle and had walked approximately 10 feet away when the fall occurred. Adjudicator Lake found that the claimant failed to satisfy both the purpose and causation. The claimant had completed his use and operation of the vehicle prior to the fall, and the walk across the parking lot was an intervening act. Adjudicator Lake 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.

A written preliminary issue hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The claimant claimed she was involved in an accident when her vehicle was side swiped by another vehicle, causing her injuries and damaging her vehicle. The insurer submitted that the claimant was injured during a drive-by shooting when the claimant’s vehicle was stopped at a red light. The insurer conceded that the claimant was injured while driving a vehicle, but the claimant was not injured in an “accident.” Adjudicator Reilly found that the shooting was the direct cause of the claimant’s injuries and the fact that she was in a vehicle was merely incidental. There was no evidence supporting the claim that her vehicle was side-swiped. Adjudicator Reilly found there was no evidence that the claimed impairment was caused by an accident as defined by the SABS. The application was dismissed.

The claimant was injured in an incident that involved a series of assaults, resulting in physical injuries. The facts of the case are unusual: The claimant heard a commotion on his street. He got in his vehicle and drove down his driveway where he was met by two assailants. The claimant opened the driver’s side door of his vehicle and one of the assailants struck him in the face. The claimant got back into his car and tried to drive the assailants off his property. More conflict ensued and the claimant exited his vehicle and put an assailant in a headlock. The other assailant then hit the claimant with a hammer and then the assailants fled the scene. The insurer denied the claim for accident benefits and the matter went to a preliminary issue hearing as to whether an accident occurred. Adjudicator Boyce held that the incident was an assault and not an accident. Adjudicator Boyce found that the dominant feature of the incident causing the claimant’s impairments was the assault and not the use of a vehicle and that it could not be said that the impairments arose from the “ordinary and well-known” use of a vehicle.

The claimant was injured when he slipped and fell on ice while attempting to retrieve his car key from his bag. He suffered a displaced spiral fracture of his fibula. The claimant applied to the insurer for accident benefits. The insurer denied that an accident occurred. The claimant applied to the LAT and the matter went to a preliminary issue hearing about whether an accident occurred. Adjudicator Gosio found that the incident met the “but for” test and that the claimant was in the continuous process of getting into his vehicle when he slipped on ice. Adjudicator Gosio held that the slip and fall on ice was not an intervening event as it was not as though the claimant was walking outside aimlessly. He was standing beside his vehicle retrieving his keys to open the door when he fell. Adjudicator Gosio held that the dominant feature of the incident was the claimant’s attempt to get into his vehicle and therefore the incident met the “accident” definition in the SABS.