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R. S. v. Optimum Insurance Company (20-006166)

  • June 5, 2022

The claimant alleged that he was involved in an accident and injured while using and operating his vehicle to drive to an outdoor space to meditate. The claimant has a long history of mental health issues and addiction, and had previously expressed suicidal ideations. The insurer denied the claimant’s accident benefits claim, and argued that the claimant was using his automobile in a deliberate manner to end his own life, a suicide attempt, and therefore, the incident was not an “accident”. The insurer argued that the use of an automobile in a suicide attempt is an aberrant use of the automobile, and not within the “ordinary course of things”. The insurer argued that the dominant cause of the claimant’s injuries was his suicide attempt, not the use of operation of the vehicle. Medical records and police records implied and concluded that this accident was a suicide attempt. However, none of the individuals who created the records testified at the hearing. Vice Chair Farlam found that the dominant factor that caused the applicant’s injuries was the unintended loss of control of the claimant’s motor vehicle while he was driving it. Vice Chair Farlam also found that the claimant was not using his automobile in a suicide attempt on the date of loss, as the claimant’s pre-incident activities (spending time with his son), actions during the incident, and actions immediately after the incident (seeking help) were inconsistent with an attempt at suicide by vehicle. As such, Vice Chair Farlam found that the incident met the definition of an “accident” in the Schedule.

Full decision here

TGP Analysis

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  • FILED UNDER Accident Definition
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