Ontario LAT: Arabkarami Pembridge SABS Carjacking Benefits Denied

• An Ontario Licence Appeal Tribunal denied accident benefits to a man injured during a carjacking incident.
• The Tribunal determined the event did not qualify as an "accident" under the Statutory Accident Benefits Schedule (SABS).
• While the incident met the "purpose test" for an accident, it failed the critical "causation test."
• The LAT concluded that the assault, rather than the vehicle's use or operation, was the dominant feature causing the applicant's injuries.
• This decision clarifies the application of SABS causation principles for violent incidents involving automobiles in Ontario.

The Tribunal ruled that the dominant feature of the applicant's injuries was the assault itself, rather than the use or operation of the vehicle.

The incident occurred in March 2025 when an individual, identified as the applicant, and a friend were returning to his vehicle in a parking lot after dinner. As the applicant sat in the driver's seat, preparing to depart, and his friend occupied the passenger side, several assailants approached. They forcibly opened both the driver's and passenger's doors, demanding the vehicle's keys. The applicant complied, dropping the keys to the ground.

During the confrontation, the assailants violently pulled the applicant from his automobile, resulting in a twisted and sprained right ankle. The applicant also reported being struck in the shoulder area with an iron hammer. Following the assault, the perpetrators drove away in the vehicle, leaving the applicant and his friend behind. The applicant subsequently reported additional injuries to his left foot and right arm, alongside various psychological impairments stemming from the traumatic event.

Seeking compensation for his injuries, the applicant filed a claim for benefits with Pembridge Insurance Company, the respondent, under the `Statutory Accident Benefits Schedule` (SABS) – specifically, the version effective September 1, 2010, with amendments from June 1, 2016. The insurer, however, denied the claim, prompting the applicant to seek a resolution from the Ontario Licence Appeal Tribunal (LAT). This dispute became known as `Arabkarami v Pembridge Insurance Company, 2026 CanLII 83291 (ON LAT)`.

The Ontario Licence Appeal Tribunal ultimately dismissed the applicant's request for benefits, concluding that the March 2025 incident did not qualify as an "accident" as defined under section 3(1) of the `Statutory Accident Benefits Schedule`. To reach this determination, the Tribunal applied a well-established two-part test derived from the case of `Economical Mutual Insurance Company v. Caughy, 2016 ONCA 226`, which guides whether an incident falls within the scope of an accident for SABS purposes.

The first component of this test, known as the purpose test, requires that the incident arise from the use or operation of an automobile. The LAT found that the circumstances of the `Arabkarami Pembridge SABS carjacking benefits` claim satisfied this criterion. The Tribunal noted that the applicant was seated in his vehicle, actively preparing to drive away from the parking lot, which constitutes an ordinary and recognized activity associated with the use of an automobile.

However, the incident failed the second crucial part of the test: the causation test. This component mandates that the use or operation of an automobile must directly cause the injuries sustained. The Tribunal determined that the applicant's impairments were not directly caused by an accident as defined by the SABS, thereby precluding `Ontario LAT carjacking injury coverage` in this instance.

In its analysis of the causation test, the Licence Appeal Tribunal delved into three specific considerations, drawing guidance from `Greenhalgh v. ING Halifax Insurance Co., 2004 CanLII 21045 (ON CA)`. The first consideration examines whether the incident would have occurred "but for" the use and operation of the vehicle. The Tribunal acknowledged that the carjacking would indeed not have taken place without the vehicle, as the assailants' primary objective was to gain control of the automobile itself.

Despite meeting the "but for" requirement, the Tribunal found that the second consideration was not satisfied. This aspect of the causation test looks for an intervening cause that breaks the chain of events linking the vehicle's use to the injuries. The LAT concluded that the assault suffered by the applicant was precisely such an intervening cause. It determined that the assault, which directly inflicted the injuries, was not a normal or foreseeable risk associated with the ordinary use or operation of the automobile. The Tribunal further noted that after the assault, the applicant lost control of the vehicle and could no longer proceed as intended.

Crucially, the third consideration for the `SABS causation test dominant feature` analysis proved decisive. The Tribunal ruled that the dominant feature of the applicant's injuries was the assault itself, rather than the use or operation of the vehicle. This finding underscored the Tribunal's decision that the direct cause of the harm was the violent act of the carjacking, not the inherent risks of driving or being in a car.

This ruling in `Arabkarami v Pembridge Insurance Company` provides significant clarity for individuals seeking `Statutory Accident Benefits Schedule` coverage in Ontario, particularly in cases involving violent incidents like carjackings. However, it is important to note that the Statutory Accident Benefits Schedule underwent further significant reforms effective July 1, 2026, which made many previously mandatory benefits optional. The decision highlights the strict application of the causation test, even when an automobile is central to the event.

The Tribunal's emphasis on the "dominant feature" of the injuries serves as a critical precedent. It suggests that if an assault is deemed the primary cause of harm, rather than the vehicle's function or inherent risks, then `SABS carjacking benefits` may be denied. This outcome underscores the nuanced interpretation required when assessing claims where criminal acts intersect with automobile-related incidents, guiding future determinations of `Ontario LAT carjacking injury coverage`.

Lawyers advising clients on Statutory Accident Benefits Schedule (SABS) claims in Ontario must note that injuries sustained during a carjacking may not be covered if the assault, rather than the vehicle's use, is deemed the dominant cause, clarifying the application of the causation test for such incidents.

Source: Original reporting via Canadian legal news outlet.