Ontario Tribunal: Upholds Denial of Accident Benefits After Carjacking

Adjudicator deems attack, not use of automobile, dominant feature of injury The Ontario Licence Appeal Tribunal did not find a man injured during a carjacking entitled to the benefits he claimed because the incident was not an accident as defined in s. 3(1) of the Statutory Accident Benefits Schedule. In Arabkarami v Pembridge Insurance Company, 2026 CanLII 83291 (ON LAT), the applicant and a friend returned to his vehicle in the parking lot after dinner, with the applicant in the driver’s side and his friend in the passenger’s side. Before the applicant could drive, a number of assailants opened both the driver’s and the passenger’s doors. As demanded, the applicant dropped the keys on the ground. The assailants yanked the applicant from his vehicle, which caused him to twist and sprain his right ankle. According to the applicant, an iron hammer struck his shoulder area. The assailants sped away in the vehicle and left the applicant and his friend behind. The applicant said this incident also caused injuries to his left foot and right arm, as well as psychological impairments. The applicant claimed benefits from the respondent, Pembridge Insurance Company, under the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (SABS). The insurer denied the applicant’s claim. Before the Licence Appeal Tribunal, the applicant applied for a resolution of the dispute. The insurer alleged that: On the other hand, the applicant argued that: Dismissing the application, the Ontario Licence Appeal Tribunal concluded that the March 2025 incident was not an accident under s. 3(1) of the SABS. The tribunal reached this conclusion by applying the two-part test in Economical Mutual Insurance Company v. Caughy, 2016 ONCA 226, for deciding whether an incident was an accident. First, the Licence Appeal Tribunal determined that the case met the purpose test for an accident, which required an incident to arise from the use or operation of an automobile. The tribunal noted that the applicant was sitting in his vehicle and preparing to drive away from the parking lot, an ordinary and well-known activity for automobiles. Second, the Licence Appeal Tribunal ruled that the case did not satisfy the causation test for an accident, which provided that the use or operation of an automobile should directly cause the injuries. The tribunal decided that an accident under the SABS did not cause the applicant’s impairments. In making this decision, the tribunal discussed the three considerations for the causation test under Greenhalgh v. ING Halifax Insurance Co., 2004 CanLII 21045 (ON CA). Regarding the first consideration for the causation test, the Licence Appeal Tribunal held that the carjacking would not have occurred but for the use and operation of the vehicle because the assailants were aiming to gain control of the automobile. As for the second consideration for the causation test, the Licence Appeal Tribunal found that an intervening cause – specifically, the assault that caused the applicant’s injuries – broke the chain of events. According to the tribunal, after the assault, the applicant lost control of the vehicle and could no longer drive away as intended. The tribunal added that the assault was not a normal incident of the risk created by the use or operation of the automobile. Regarding the third consideration for the causation test, the Licence Appeal Tribunal decided that the dominant feature of the applicant’s injuries was the assault, not the use or operation of the vehicle. Here are some other recent injury-related decisions by the Ontario Licence Appeal Tribunal. The tribunal issued an Aug. 4 decision finding an injured party entitled to a psychological assessment plan for an accident-related psychological impairment that justified removal from the Minor Injury Guideline, but not to treatment plans for physiotherapy ser