The claimant was involved in an incident where he fell off the roof of a transport truck and sustained a traumatic brain injury. The claimant placed a ladder against the side of the transport truck to inspect its roof. While conducting his inspection, the ladder slid out from under him. The claimant attempted to grab onto the roof, until he eventually fell from the transport truck, hitting his head on the curb and pavement. The claimant was deemed CAT and sought approval for a housing modification and nutritional counselling. The insurer denied the application, stating that the claimant was not involved in an “accident” as defined by the SABS. Adjudicator Boyce held that the incident met the definition of an “accident”. The purpose test was satisfied as performing routine maintenance on a parked vehicle is one of the “ordinary and well-known activities to which automobiles are put.” Adjudicator Boyce accepted that but for the claimant’s use and operation of the truck, he would not have sustained his impairments. The facts support that his impairments were directly caused by conducting routine maintenance on the truck and there were no intervening acts that could be reasonably considered to be outside the normal course of actions that would sever the chain of causation.
