A man falling from the roof of his insured camper trailer while doing a pre-trip inspection counts as an auto accident, Ontario’s Superior Court found.
Tuesday’s court ruling overturned a decision by Ontario’s Licence Appeal Tribunal, which found the man’s resultant brain injury must have arisen from some kind of physical contact with the trailer during his fall to qualify for auto insurance accident benefits.
Clayton Madore was inspecting and cleaning the roof of his “fifth wheel” camper trailer in June 2019, when he was checking its safety for highway travel. He was preparing for a family road vacation from Ontario to the Maritime provinces.
The trailer was hitched to his pickup truck while he carried out this inspection and cleaning. Both the trailer and truck were covered by Intact Insurance.
During his inspection and cleaning, Madore fell 12 feet from the roof of his trailer. There were no witnesses to the fall. He was immediately rushed to the hospital and woke up in the ICU. He had sustained serious injuries including a fractured skull, a broken left ankle, double wrist fractures, nerve damage in his eyes and hearing loss. Because of his injuries, he could not remember how he fell.
His insurer, Intact Insurance, denied his application for auto accident benefits, saying his injuries were not the result of an auto accident. The Licence Appeal Tribunal agreed, finding two things:
- Madore’s injuries did not happen as a direct result of direct physical contact with the trailer during his fall from the trailer roof.
- Madore’s “loss of footing due to misfortune” was not part of the “ordinary course” of operating or using the trailer.
Ontario’s Superior Court overturned the LAT adjudicator’s decision. First off, the court noted, the adjudicator correctly found cleaning and inspecting the trailer is an ordinary use and operation of the vehicle.
“Section 3(1) [of Ontario’s Statutory Accident Benefits Schedule] defines ‘accident’ as an ‘incident’ where there is a direct connection between the use and operation of the automobile and the impairment,” a unanimous three-judge panel of the Ontario Superior Court ruled. “The question to be determined is whether use or operation of the trailer caused the impairment, not whether Madore had adduced evidence to prove that he tripped on the trailer.
“The test only requires that the [LAT] adjudicator consider whether Madore was injured in the course of cleaning and inspecting the roof of the trailer. In fact, the adjudicator found that Madore was injured in the course of cleaning and inspecting the roof of the trailer. Madore’s injuries flow directly from that purpose.”
The adjudicator found the chain of causation between the use of the vehicle and the injury was broken when he lost his footing “due to misfortune.” But the court noted the fall happened while he was on the roof inspecting and cleaning the trailer. There was, therefore, no intervening period between the injury and the time he was engaged in the ordinary operation and use of the trailer, the unanimous, three-judge panel ruled.
Feature image courtesy of iStock.com/alptraum
