What is the definition of ‘accident’ according to Ontario’s Insurance Act?
Question: I was getting out of my parked car when I fell and broke my leg. Is this a “car accident,” and am I entitled to accident benefits from my auto insurance company?
Answer: To be entitled to benefits from your auto insurance company, the incident must meet the definition of an “accident” according to the Statutory Accident Benefits Schedule (SABS).
Whether your incident meets this definition requires an analysis of a two-part test:
- Purpose test: Did the incident arise out of the use or operation of an automobile?
- Causation test: Did the use or operation of an automobile directly cause your impairment?
This analysis of an “accident” is a technical and difficult one to understand, and personal injury lawyers frequently debate the topic at length or ask a tribunal or the courts to make a determination.
Your injury may be considered to be as a result of a car accident, but this will depend on the specific facts of your case. If your insurance company disagrees, you can appeal the denial to the Licence Appeal Tribunal (LAT).
Hiring an experienced personal injury lawyer who is willing to take on challenging cases and is knowledgeable in Statutory Accident Benefits law and disputes will give you the best opportunity to maximize your access to available benefits with your insurance company.
This article was originally published by The Hamilton Spectator.
