Toronto Injury Lawyer Blog
When is a car accident, a car accident?
This seems like a silly question, which shouldn’t matter in the grand scheme of things.
Why is it so important if it’s a car accident, or not?
There is potentially $1,000,000+ at stake if it’s deemed to be a car accident, or not. And here’s why.
In Ontario, we have a complex system of no fault accident benefits, which are only available if the accident is deemed a car accident (or an accident arising from the use or operation of a motor vehicle).
If it’s not deemed a car accident, then the injured accident victim will NOT have access to accident benefits. This means that they will not be eligible for an income replacement benefit ($400/week), attendant care benefit ($3,000/month), or paid rehab benefits through a car insurer. Accident benefits provide interim support to injured accident victims. If the injuries ar very serious, they might be deemed catastrophic, which will allow the injured accident victim to access over $1,000,000 in accident benefits.
So, this seemingly mundane question of whether or not this was a car accident or not is a potential “million dollar question“. As such, you can see why lawyers put so much effort into answering these questions. There’s a lot at stake for the Applicant (injured accident victim), and the Respondent (the insurer).
Some of the most interesting cases, and most interesting fact patterns which personal injury lawyers tend to see are cases where the issue in dispute deals with “is this a car accident, or not“. The legal questions posed are:
Was the applicant involved in an “accident” as defined in section 3(1) of
the Schedule?
Does the applicant meet the definition of an “insured person” as defined in
section 3(1) of the Schedule?
Poisson v. Intact Insurance Company, 2026 ONLAT 25-012524/AABS
On June 29, 2023, the applicant and his partner were both asleep in their
bedroom on the second floor of their house, when the incident occurred at 4:30
a.m. The applicant and his partner were awoken when a pick-up truck crashed
into the first floor of their house. The smoke detectors went off, causing flashing
strobe lights and a voice command yelling “Fire Fire Fire”.
The applicant got dressed and went downstairs to see what happened. He saw a
white pick-up truck embedded in the house and the headlights beaming through
the wall. When he looked out the window, he saw someone lying on the driveway
and he thought the person was dead. The applicant called 911 to report the
incident.
The pick-up truck caused extensive damage to the applicant’s house. He lost the
use of his home from the date of the incident until at least July 5, 2024. The
applicant was forced to change accommodations numerous times.
The applicant subsequently applied for accident benefits under his personal
motor vehicle policy and sought funding for psychological treatment because of
the subject incident.
The respondent denied coverage of accident benefits on the basis that the
applicant was not an “insured person” involved in an “accident” as defined in s.
3(1) of the Schedule.
The Purpose Test – Did the incident arise out of the use or operation of an
automobile? The Purpose Test is a determination of
whether the incident resulted from the “ordinary and well-known activities to
which automobiles are put”. Put another way, for what “purpose” was the vehicle
being used at the time of the incident?
The insurer submits that an insurer is not responsible for any impairments
that arise out of the aftermath of an accident that has already occurred. It submits
that the applicant’s psychological impairments arose in relation to the aftermath
of the collision and not the collision itself where the applicant heard the sound of
the collision and then went to view the scene. The respondent argues that the
vehicle was not in use or operation at the material time and therefore cannot be
said to have been the direct cause of the applicant’s alleged psychological
impairments.
The Adjudicator found that the evidence supports that the applicant’s psychological impairments resulted from the impact of the pick-up truck hitting his house, waking him up, the applicant hearing the smoke detectors go off and seeing the strobe lights, which
caused panic. I find support for this in the Clinical Notes and Records (“CNRs”) of
Dr. Shreekant Sharma, psychologist, dated December 27, 2023, who diagnosed
the applicant with PTSD and specifically noted that the applicant woke up in
panic mode when he heard a loud bang, which sounded like an explosion and all
of the alarms in his home were going off. Similarly, the clinical notes and records of Dr. Peter
Farvolden, psychologist, dated March 5, 2024, notes that the applicant woke up
screaming and reported that the fire alarm system and strobe lights had
activated. Further, the Psychological Assessment report, prepared by Kaplan and
Levitt Psychologists, dated August 12, 2024, diagnosed the applicant with post traumatic stress disorder and adjustment disorder with anxiety and depressed mood.
This is not a case where the applicant was injured by coming onto the scene of an accident and
witnessing the aftermath of the accident. The pick-up truck was
operational when it hit the applicant’s home and the applicant was inside his
house when the pick-up truck hit his house.
Would the alleged injuries not have occurred ‘but for’ the use or operation of
the pick-up truck?
No
Was there an intervening cause that cannot be said to be part of the ordinary
course of the use or operation of the pick-up truck?
No
Was the use or operation of the pick-up truck a dominant feature of the
applicant’s injuries?
Yes
As described by the Court of Appeal in Greenhalgh, the ‘dominant feature’
consideration requires an adjudicator to determine what element of an incident is
“the aspect of the situation that most directly caused the injuries”.
To a lay person, an accident arising from the use or operation of a motor vehicle is not an important question to analyze; and the analysis would be very simple. However, the same question and analysis for a personal injury lawyer is much more complex.
