What counts as a car accident for accident benefits in Ontario depends on whether an automobile’s use or operation directly caused an impairment and whether the person qualifies as an insured person. The SABS definition matters because an incident outside it may not support accident benefits. This guide explains the tests and evidence.
Key takeaways: Focus on the automobile’s use or operation, direct causation and insured-person status; preserve evidence showing how the incident happened.
The legal definition
Accident benefits in Ontario are governed by the Statutory Accident Benefits Schedule (SABS), O. Reg. 34/10. The statutory definition of “accident” requires an incident in which the use or operation of an automobile directly causes an impairment, and the definition of “insured person” also addresses non-occupants struck by an insured automobile in Ontario. See s. 3(1): https://www.ontario.ca/laws/regulation/100034.
• the incident is an “accident” – broadly, an incident in which the use or operation of an automobile directly causes an impairment (section 3(1) of the SABS); and
• the injured person is an “insured person” under the applicable policy, which can include the named insured and certain family members, as well as some occupants of and people struck by an insured automobile.
Both must be met. This article focuses on the first.
Why the definition matters
If an incident is not an “accident”, no accident benefits are payable under the SABS, however serious the injury. A person found catastrophically impaired may access higher medical, rehabilitation and attendant care benefits. The SABS sets the catastrophic-impairment criteria, including criteria measured using the ASIA scale for paraplegia and tetraplegia. See O. Reg. 34/10, ss. 3(1) and 3.1: https://www.ontario.ca/laws/regulation/100034.
The two-part test
Courts and the Licence Appeal Tribunal (LAT) generally apply two tests to decide whether an incident is an “accident”.
The purpose test
Did the incident arise out of the ordinary and well-known activities to which automobiles are put? Driving, parking, getting in and out of a vehicle and, in many cases, loading and unloading are typical examples. Using a vehicle for an unusual purpose, such as a parked car used only as storage or a shelter, may not meet this test.
The causation test
Did the use or operation of the automobile directly cause the impairment? Decision-makers commonly ask:
• Would the injury have happened but for the use or operation of the vehicle?
• Was there an intervening act, independent of the vehicle’s use, that broke the chain of causation?
• Was the use or operation of the vehicle the dominant feature of what caused the impairment, or merely ancillary?
The purpose-and-causation framework is applied to the SABS definition of “accident”. The statutory starting point is O. Reg. 34/10, s. 3(1): https://www.ontario.ca/laws/regulation/100034.
A recent example: a truck crashes into a home
A 2026 Licence Appeal Tribunal decision, Poisson v. Intact Insurance Company (file 25-012524/AABS), addresses these tests.
In that case, a pickup truck crashed into an applicant’s house at about 4:30 a.m., and the applicant was later diagnosed with post-traumatic stress disorder. The analysis treated the impact as central to the question of whether the vehicle’s use or operation directly caused the impairment.
The decision is a reminder that a person does not have to be in or struck by a vehicle to be injured in an “accident”. It also shows how closely the facts are examined.
Impact versus aftermath
Cases often turn on the difference between harm caused by the vehicle’s use or operation and harm caused by later events. Psychological injury caused directly by experiencing a collision may qualify. Injury that arises from things that happen afterwards, such as later events at the scene, learning about the crash second-hand, or separate conduct by a third party, may be found too remote. Witnessing cases can fall on either side of the line, depending on how directly the person was involved. Each case depends on its facts.
A separate example concerns a person who slips on ice while entering or leaving a vehicle. In Singh v. Aviva Insurance Company, 2024 ONLAT 23-003500/AABS-R (reconsideration), the tribunal held that Porter v. Aviva (Divisional Court, 2021) did not automatically bar SABS entitlement. The result turned on the facts. See https://www.bogoroch.com/blog/singh-v-aviva-insurance-company-bogoroch-associates-llp-successfully-challenge-legal-precedent-for-slip-and-fall-plaintiffs/.
Evidence that can help
• A detailed, consistent account of what happened and in what order.
• Police, fire or incident reports and photographs.
• Medical records linking the diagnosis to the event itself, including the timing of symptoms.
• Witness information.
The July 2026 changes
Since July 1, 2026, many accident benefits are optional. Medical, rehabilitation and attendant care benefits remain mandatory. Even if an incident qualifies as an “accident”, which other benefits are available depends on the coverage on the applicable policy. See our article on the July 2026 accident benefits changes.
Disputes go to the Licence Appeal Tribunal
If an insurer denies a claim because it says the incident was not an “accident”, the dispute is generally decided by the Licence Appeal Tribunal, not a court. Time limits apply. Keep the denial letter and get advice promptly.
Other situations that raise the question
Questions about whether an incident is an “accident” come up in many settings. Examples include injuries while getting into or out of a vehicle, while loading or unloading cargo, while repairing or maintaining a vehicle, from a fall on ice next to a parked car, and from assaults involving a vehicle. Some of these may qualify and others may not. The answer usually depends on what the person was doing, how the vehicle was being used at the time, and whether something other than the vehicle’s use or operation was the real cause of the injury.
Because these cases depend so heavily on their facts, an insurer’s first response is not necessarily the final word. Write down the details while they are fresh, keep any photographs or videos, and get the names of witnesses. Small details, such as whether the engine was running, whether the person was touching the vehicle, or what happened first, can affect how the purpose and causation tests are applied. If benefits are denied on this basis, the reasons in the denial letter will usually show which part of the test the insurer relies on.
Conclusion
What counts as a car accident for accident benefits in Ontario is fact-specific under the SABS. Contact Booni Law at admin@boonilaw.com or +1 (226) 271-1751 to discuss the evidence. No outcome is promised.
Frequently Asked Questions
Do I have to be in a car to claim accident benefits?
No. Pedestrians, cyclists and others can be injured in an “accident”. They must also qualify as insured persons under an applicable policy.
Can a psychological injury qualify?
Yes. A psychological impairment can qualify if it was directly caused by the use or operation of an automobile. Whether it was is decided on the facts.
What if the vehicle was parked?
It depends. Some activities involving parked vehicles are ordinary uses of an automobile and some are not. Causation must also be shown.
Who decides if my incident is an “accident”?
The insurer makes the first decision. If it denies the claim, the dispute is generally decided by the Licence Appeal Tribunal.
Unsure whether your incident qualifies?
If an insurer has said your injury did not arise from a car “accident”, or you are unsure whether accident benefits apply, Booni Law can review the facts with you. Email Booni Law at admin@boonilaw.com or call +1 (226) 271-1751 to arrange a consultation.
Disclaimer: This article is provided for general informational purposes only and does not constitute legal advice. Reading this article does not create a solicitor-client relationship between you and Booni Law. The information in this article may not reflect the most current legal developments and should not be relied upon as a substitute for professional legal advice tailored to your specific circumstances. If you require legal advice, please contact Booni Law.
