Balon v. BelairDirect (22-001100)

The claimant was involved in an ATV accident and sought benefits pursuant to the SABS. The preliminary issue to be considered at the hearing was whether the incident the claimant was involved in was considered an accident. The adjudicator found that the claimant was not involved in an accident pursuant to s. 3 of the SABS. The ATV was being used on private property and was subject to the Off -Road Vehicles Act. This legislation states that the claimant is entitled to claim accident benefits if an ATV was required to be insured under section 15 of the ORVA. In Adams v. Pineland Amusements Ltd. (“Adams”), 2007 ONCA 844, the Court of Appeal adopted a three-part test set out in Grummett v. Federation Insurance Co. of Canada, 1999 CanLII 15103 (ONSC) to determine whether a vehicle is an automobile. Under the Grummett test, a vehicle is an “automobile” when (a) it is an “automobile” in common parlance; (b) it is defined as an “automobile” in a policy of insurance; and (c) it falls within any enlarged definition of “automobile” in any relevant statute. The claimant did not meet the Grummett test as jurisprudence established that an ATV is not considered to be an “automobile” in the ordinary sense of the word. The claimant did not provide any evidence that defines the ATV as an automobile in an insurance policy. The Respondent submitted the insurance policy of the ATV’s owner, and the ATV was not covered under this policy. The analysis then turned to the third part of the test. The claimant submitted that the ATV on which she was riding was compelled to carry a motor vehicle liability policy on it as per the Insurance Act, the ORVA and the Compulsory Automobile Insurance Act, R.S.O. 1990, c.C.25, and due to this requirement, the ATV in question was deemed to be an “automobile”. The Respondent argued that an ATV would only require insurance if it was operating on a highway and not on her friend’s private property. The claimant did not provide compelling evidence to show that the incident took place on a roadway. Therefore, the claimant failed on the third part of the Grummett test, as she did not demonstrate the ATV fell within any enlarged definition of “automobile” in any relevant statute. The application was dismissed as the incident was not considered an accident.

Beaudin v. Travelers Insurance Company of Canada (2002 ONCA 806)

The insurer appealed the decision of the Divisional Court (which upheld the Tribunal’s decision) that a dirt bike involved in an accident was an “automobile” for the purposes of the SABS. The Tribunal had concluded that the dirt bike was required to be insured under the Off-Road Vehicles Act and was not exempt from insurance through the regulation that allowed off-road vehicles to be uninsured when “driven or exhibited at a closed course competition or rally sponsored by a motorcycle association.” The Court of Appeal agreed with the Divisional Court that the dirt bike was an “automobile” based on the Off-Road Vehicles Act and its regulations. The Court agreed that one of the purposes of the Off-Road Vehicles Act was to promote universal insurance coverage, and that the Act had to be read in the context of the multiple statutes and regulations governing automobile insurance and the Government’s goal of ensuring universal insurance coverage with only a few exceptions.

Hagopian v. Allstate Insurance (20-000998)

The claimant was the driver of an all-terrain vehicle which collided with a dirt bike on private property. Neither vehicle was insured and the claimant suffered a severe brain injury as a result of the collision. The issue in dispute is whether either vehicle would be defined as an automobile pursuant to the Insurance Act. The Act defines an automobile as any vehicle required under any Act to be insured under a motor vehicle liability policy. The insurer submitted that the insurance and licensing requirements of any ATV or dirt bike was governed by the Off-Road Vehicles Act (ORVA). Under section 15 of the ORVA, neither an ATV or dirt bike was required to be insured for use on an owners private property. Reading the legislation together, this would mean that the vehicles did not meet the definition of an automobile pursuant to the Insurance Act. However, in this case, the owner of the ATV was not the owner, occupier, or controller of the subject property. Adjudicator Norris therefore concluded that the ATV was required to be insured and section 15 of the ORVA was not applicable. The incident qualified as an accident pursuant to the Schedule.

Beaudin v. Travelers Insurance Company of Canada (2021 ONSC 1389)

The insurer appealed the Tribunal’s decision that the dirt bike involved in the accident was an automobile for the purposes of the SABS. The Tribunal had concluded that the dirt bike was required to be insured under the Off-Road Vehicles Act and was not exempt from insurance through the regulation that allowed off-road vehicles to be uninsured when “driven or exhibited at a closed course competition or rally sponsored by a motorcycle association.” The Court dismissed the appeal and confirmed that the dirt bike was considered an automobile. The Court agreed with the Tribunal’s approach to interpreting the ORVA as being for the protection of innocent victims of automobile accidents, and the narrow reading of the exemption to the ORVA.

M.B. v. Travellers Insurance Company (17-006174)

The claimant was injured while driving an off-road vehicle (a dirt bike) at a closed course competition. The insurer denied that an “accident” had occurred because the off-road vehicle was not an “automobile.” Adjudicator Kowal agreed with the insurer and held that because the dirt bike was exempt from the requirement to be insured under section 2 of the Off-Road Vehicles Act, it was not considered an “automobile.”

J.T. v. Aviva Canada Inc. (16-003674)

The claimant sought reconsideration of the underlying Tribunal decision, in which the adjudicator concluded that the ATV the claimant was occupying at the time of the accident was not an “automobile,” and that the claimant was therefore not entitled to accident benefits. Executive Chair Lamoureux allowed the reconsideration and remitted the matter to a new adjudicator for a new hearing. She reasoned that the initial adjudicator failed to consider various documentary evidence and failed to analyze that evidence in the context of the OAP1 and the Sale of Goods Act. Executive Chair Lamoureux did uphold the adjudicator’s decision that estoppel did not apply (i.e. that the insurer was not required to continue paying accident benefits simply because it had started paying accident benefits upon receipt of the OCF-1), and re-iterated that the LAT did not have jurisdiction to exercise equitable relief. The LAT’s purpose was to adjudicate the claimant’s entitlement to benefits based on the terms of the SABS.

J.T. v. Aviva Canada Inc. (16-003674)

The claimant sought reconsideration of the underlying Tribunal decision, in which the adjudicator concluded that the ATV the claimant was occupying at the time of the accident was not an “automobile,” and that the claimant was therefore not entitled to accident benefits. Executive Chair Lamoureux allowed the reconsideration and remitted the matter to a new adjudicator for a new hearing. She reasoned that the initial adjudicator failed to consider various documentary evidence and failed to analyze that evidence in the context of the OAP1 and the Sale of Goods Act. Executive Chair Lamoureux did uphold the adjudicator’s decision that estoppel did not apply (i.e. that the insurer was not required to continue paying accident benefits simply because it had started paying accident benefits upon receipt of the OCF-1), and re-iterated that the LAT did not have jurisdiction to exercise equitable relief. The LAT’s purpose was to adjudicate the claimant’s entitlement to benefits based on the terms of the SABS.

B.M. v. Aviva Insurance Canada (17-000907)

The claimant was riding on a motorcycle at a privately owned and operated, training and racing facility. The motorcycle owner’s manual indicated that the vehicle was designed for closed course competitions only. The motorcycle was not registered with an insurance policy nor was it plated with the Ministry of Ontario. On the day of the accident, the claimant paid a drop-in fee and signed a waiver to ride the bike. During the course of the ride, the claimant made an unsuccessful jump off of a hill. The claimant fell off the bike and as he was recovering, another rider came over the same jump and struck the claimant. Adjudicator Meray Daoud reviewed the Ontario Court of Appeal decision of Adams v Pineland Amusements Ltd, 2007 ONCA 844, and noted the vehicle did not fall within an “automobile in the ordinary parlance” or listed in a policy. Adjudicator Daoud then reviewed section 224(1) of the Insurance Act and noted the vehicle was not prescribed by regulation and reasoned it had to be determined if the vehicle was required to have a motor vehicle liability policy. When reviewing the legislation identifying vehicles requiring insurance policies Adjudicator Daoud concluded the vehicle fell within the exempted category of off-road vehicles driven or exhibited at a closed course competition. Accordingly, the motorcycle was not an automobile for the purposes of accident benefits, and therefore the claims were dismissed.

S.C.L. v. State Farm Mutual Automobile Insurance Company (16-001683)

The claimant was struck by a golf cart while on the driveway of a private golf course. The insurer denied that an “accident” had occurred because the golf cart did not qualify as an “automobile”. Adjudicator Sewrattan agreed with the insurer and concluded that the golf cart was not an “automobile” because it was not a motor vehicle required to be insured under the Highway Traffic Act or Compulsory Automobile Insurance Act. The adjudicator noted that the driveway on which the incident had occurred was not a common and public driveway; had it been a common and public driveway, the result may have been different.