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Motor Vehicle Accident Claims Fund v. Z.M.H. (18-011392)

  • April 7, 2020

The Fund sought repayment of accident benefits on the basis that the claimant was not involved in an accident, and that she had misrepresented the facts of loss. The claimant alleged that she was part-way in her son’s vehicle when he started driving, causing her to fall out of the vehicle onto her knees. The Fund alleged that the claimant suffered a slip and fall incident while walking in an underground parking lot, a few yards away from her son’s vehicle. Adjudicator Hines accepted the claimant’s version of events that she fell while getting into the vehicle as a result of her son starting to move the vehicle. Both the purpose and causation test were satisfied, and the incident fell within the definition of “accident” for the purpose of the SABS. The claim for repayment was dismissed.

Full decision here

TGP Analysis

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  • FILED UNDER Accident Definition, Material Misrepresentation
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