Claimant must prove 'What Constitutes An Accident?'

There are approximately 22 million insured drivers in Canada. Every day, more Canadians sign up for insurance coverage with the anticipation that insurance will be a type of security blanket in the event of an accident, illness, death and any other unforeseen circumstances.

However, making a claim for insurance benefits is not always clear cut and simple. It often requires specific procedures and guidelines and particularly for accident benefits, providing evidence for injury and emotional and physical distress as a result of the accident. Sometimes, it even means proving that an accident actually occurred.

Case example

This was the issue with which Patrick Caughy was faced, when after injuring himself in an accident on August 3, 2012, his claim for accident benefits from his insurer Economical Mutual Insurance Company, was denied. 

The denial was due to the insurer's uncertainty that an accident had actually occurred. The matter was brought to trial by Economical, which filed an application to determine whether or not Mr. Caughy was indeed the victim of an accident. 

The main issue in the case was proving that the incident Mr. Caughy had been involved in, aligned with the definition of an 'accident', as stated under the Statutory Accident Benefits Schedule (SABS). The SABS defines an accident as "an incident in which the use or operation of an automobile directly causes an impairment or directly causes damage."

To prove this, Judge Nightingale applied the twofold test, which was established in Amos v. Insurance Corporation of British Columbia. That includes the purpose test and the causation test. The purpose test analyzes whether or not the incident occurred due to the ordinary and well-known use or operation of an automobile. In other words, at the time of the incident, was the vehicle engaged in a normal and well-known activity?

Mr. Caughy's incident involved accidently running into a motorcycle which had been temporarily parked between his trailer and truck, on a walkaway intended for pedestrians. Judge Nightingale ruled that the temporarily parked motorcycle did constitute a normal and well known use of the vehicle and so the incident passed the purpose test.

Judge Nightingale supported his judgment with the rulings in Faira v. Pereria, Ash v. Wawanesa Mutual Insurance Company and DiMarco v. Chubb Insurance Company of Canada. In each case, an individual was hurt while accidentally coming into contact with a parked vehicle and in each case, the judge ruled that the use of the vehicles was consistent with the requirements of a SABS claim.

The causation test involves analyzing whether or not the incident was directly caused by the vehicle in question. Judge Nightingale ruled that it was, noting that the motorcycle was parked on a pedestrian walkway, meaning it was parked where it should not have been. Also, Mr. Caughy was not informed by the owner of the motorcycle that it was going to be parked there and given that the vehicle had been parked after dark, it was difficult for Mr. Caughy to be aware of its presence.

Judge Nightingale ruled that the motorcycle being parked on the walkway that night "created or added to the risk of injury that befell" Mr. Caughy and not only led to Mr. Caughy's injuries, but contributed to and physically caused them. Judge Nightingale concluded that the placement of the motorcycle constituted the location where Mr. Caughy was injured and also, the fact that the vehicle was parked on the walkway was the dominant and direct cause of the incident. Thus, the causation test was met.

With the purpose and causation tests both met, Judge Nightingale ruled that Mr. Caughy had indeed been involved in an accident as defined under the SABS and therefore was entitled to his claim.

Understanding your rights in the aftermath of an unfortunate accident can sometimes be very difficult and it is in your best interests not to attempt to challenge an insurance company on your own. At Gluckstein Personal Injury Lawyers, our trained team of personal injury lawyers are available to make sure you understand your rights and help you get the justice you deserve.

If you or a loved one has been the victim of an accident, please do not hesitate to give us a call.