Category: Accident Definition

The claimant was involved in an incident when she was shovelling her parking spot, which led to physical injuries. She applied to the insurer for accident benefits. The insurer denied payment of benefits on the basis that the incident did not fall under the definition of “accident” in the SABS. The incident was described as follows: the claimant moved her vehicle from her parking spot to the throughway in order to shovel her parking spot; halfway through shovelling, she decided to throw salt onto the parking spot; the salt was stored in the trunk of her car, which was parked with the engine off; while walking toward the trunk of her car, she fell and injured her back; the claimant did not make contact with her vehicle when falling. Adjudicator Manigat applied the “purpose and causation” test, and found that the claimant was not entitled to accident benefits as the injuries she sustained were not from an “accident” as defined in the SABS.

The claimant was injured while walking down the driveway to get into a Lyft, which was waiting to take her to a medical appointment. She applied for accident benefits. The insurer denied the claim, stating that the incident was not an accident. Adjudicator Mather concluded that the incident was an accident under the SABS. She concluded that the purpose test was met because the use and operation of the vehicle began when the Lyft driver accepted the ride request, and included the claimant’s attempt to enter the car. Her only purpose in walking down the ice-covered driveway was to get into the car. The adjudicator also held that the ice was not an intervening act. While it was one of the direct causes of the accident, so was the use and operation of the Lyft that stopped less than halfway up the driveway. Further, it was the use or operation of the Lyft that was the dominant feature of the accident, because the slip and fall on ice was only ancillary to the fact that the Lyft driver stopped half-way up the driveway.

The claimant applied for accident benefits; the insurer argued that the incident was not an accident. The claimant was burned by hot tea while at a red light. The tea had been passed to her through a drive-through window minutes prior and the lid was not securely placed on the cup. Adjudicator Reilly held that the incident was not an accident. The facts of loss did not satisfy the direct causation test. Nothing about the vehicle caused the impairment, and the claimant’s presence in her vehicle was incidental to her injuries. Rather, it was the negligence of the fast-food server in failing to secure the lid that caused the impairments.

The claimant was involved in an accident on June 14, 2018 when he was struck by a BMW driven by a third-party who was making a left-hand turn. the insurer argued that the accident was staged, and that the claimant was not entitled to claim accident benefits as a staged accident did not meet the definition of an accident. Adjudicator Maleki-Yazdi accepted that the accident was staged. The insurer submitted ample evidence, including an expert accident reconstructionist who testified that there was more than one collision to the claimant’s vehicle, rather than the single impact alleged, as well as investigative materials including a store surveillance video showing two tow trucks already on the scene approximately 90 seconds after the alleged accident occurred, compared to 20 minutes after as stated by the claimant. The claimant’s car could also not be seen in the video. Coupled with the claimant’s excessively contradictory evidence at his EUO, specifically in relation to the timeline of events, the claim for accident benefits was dismissed.