If you are injured in any type of motor vehicle accident, including as a motorcycle rider, pedestrian or cyclist, you are entitled to claim statutory accident benefits under your vehicle insurance policy or the policy of the owner of a vehicle involved in the collision. Although owed benefits are defined under the Ontario Insurance Act, insurers nevertheless sometimes block or dismiss claims for various reasons. In such cases, it is a good idea to seek the advice and representation of a knowledgeable car accident lawyer who is well experienced in resolving insurance claims, to ensure that you receive your owed benefits under the law.
Judge rules that man’s accident falls under statutory accident benefits
In a 2016 trial, Economical Mutual Insurance Company v. Caughy, the Ontario Court of Appeal upheld a trial decision requiring Economical to pay statutory accident benefits for a claimant who was injured under somewhat unusual circumstances. The claim arose when a man sustained a spinal injury after he tripped over a motorcycle that was parked on a campground walkway after dark. At the time of the incident, the man and his family were staying in their trailer, which was parked at a campground. On the first evening of their stay, the man was playing tag with his daughter and friends after dark, when he tripped on a motorcycle and fell against his truck. The motorcycle was one of two that had been parked on the walkway near his trailer after dark and without the family’s knowledge. The man admitted that he was intoxicated at the time of the accident, but had a clear memory of the circumstances of his injury.
Economical Mutual denied the man’s injury claim for statutory accident benefits on the grounds that the incident did not meet the definition of ‘accident’ as defined under the statutory accident benefits schedule (SABS) of the Insurance Act. In consideration of the circumstances of the accident, the trial judge decided that the temporary parking of the motorcycle on the walkway amounted to an ‘ordinary or well-known’ use of the vehicle and this was the dominant component of the accident. As such, the incident satisfied the definition of ‘accident’ under SABS s. 3(1), which states that an accident is “an incident in which the use or operation of an automobile directly causes an impairment…”
In Amos v. Insurance Corp. of British Columbia, the Supreme Court of Canada defined a two-part test in determining whether an incident is, in fact, an accident:
- Was the accident the result of ordinary and well-known activities to which vehicles are put?
- Is there a connection or causal relationship (which need not be a direct causal relationship) between the claimant’s injuries and the operation, use or ownership of his/her vehicle, versus a merely incidental or fortuitous connection between the injuries and operation/use/ownership of the vehicle?
In another case, Dominion of Canada General Insurance Company v. Prest, 2013, the trip and fall accident experienced by a man were deemed not to fall under the definition of an ‘accident’ as defined by SABS. This case arose after a man parked his car with the intention to wash it, and then tripped on a concrete curb beside the car as he was walking away from his vehicle. Although his hand touched the car when he tripped, this incident was determined to fall short of the definition of a motor vehicle accident since the car was not being operated at the time of the accident and was also not the source of the accident, but rather an incidental aspect of the man’s injuries. If the curb was designed or constructed in a dangerous way, this incident may rather entail negligence under the Occupiers’ Liability Act.
In considering Economical’s appeal of the trial judge’s decision, the Ontario Court of Appeal gave consideration to various arguments presented by the defendant insurer. First, the insurer argued that the trial judge erred in failing to conclude that there needs to be an active use of a vehicle to meet the purpose test, suggesting that the motorcycle is nothing more than a hazard that caused the injury. The appeal judge disagreed with this view and concluded that there is no active use (i.e. driving) requirement in the purpose test, simply one that the incident arises from ordinary and well-known activities. Indeed, parking is a normal activity for vehicles; vehicles are intended to be parked and are, in fact, parked most of the time.
Economical’s second argument is that the trial judge was incorrect in finding that the motorcycle was parked on the walkway temporarily when the claimant tripped over it. The appeal judge found no evidence to support that the motorcycle was being stored there for a long term or inoperable, rather than temporarily parked for the duration of the camping trip, and therefore dismissed this second argument.
The defendant’s third argument is that the trial judge erred in his conclusion that the respondent had “satisfied the purpose test that the use or operation of an automobile, i.e., the motorcycle was involved in this incident”. In this case, the appeal judge agreed with the insurer that the purpose test is not intended to determine whether a vehicle was involved in an accident, but he was nevertheless satisfied that the trial judge understood the test and that his misstatement did not affect his assessment.
The appeal judge also agreed with the insurer’s fourth argument, which is that the trial judge should not have relied on the liability provisions in Ontario Automobile Policy in his analysis, since liability may be triggered merely by ownership of a vehicle so it was inappropriate to make an analogy to those provisions. However, it was concluded that this comparison did not affect the trial judge’s analysis.
In consideration of all the issues considered at the trial and argued on appeal, the Court of Appeal judge dismissed the insurer’s appeal.
At Kotak Law, our car accident lawyers have developed strong expertise in resolving disputes over owed accident benefits. If your insurance company has denied deserved benefits, call Kotak Law today to find out about your legal right to injury compensation and how we can help resolve your case.