Dhaliwal v. Coachman Insurance Company, 2026 CanLII 34318

Citation: Dhaliwal v. Coachman Insurance Company, 2026 ONLAT 25-008985/AABS - PI

Licence Appeal Tribunal File Number: 25-008985/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

Jaspreet Dhaliwal Applicant

and

Coachman Insurance Company Respondent

PRELIMINARY ISSUE DECISION AND ORDER

ADJUDICATOR: Trina Morissette, Vice-Chair

APPEARANCES:

For the Applicant: David Lackman, Counsel

For the Respondent: Jonathan Heeney, Counsel

HEARD: In writing

OVERVIEW

1Jaspreet Dhaliwal, the applicant, was walking with his fiancée on March 8, 2025, when she was struck by a vehicle and killed. The applicant sought benefits from Coachman Insurance Company, the respondent, pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (“the Schedule”). The applicant was denied benefits by the respondent and applied to the Licence Appeal Tribunal (“the Tribunal”) for resolution of the dispute.

PRELIMINARY ISSUE IN DISPUTE

2The preliminary issue to be determined in this matter is whether the applicant was “involved in” an “accident” as defined in section 3(1) of the Schedule.

RESULT

3The applicant was involved in an accident on March 8, 2025.

ANALYSIS

4On March 8, 2025, the applicant and his fiancée were walking together on the sidewalk when a U-Haul truck suddenly drove up onto the curb towards the couple. The applicant jumped out of the way but sadly, his fiancée was stuck by the vehicle, pushed into a storefront window, and was killed on impact. Emergency personnel attended the scene and the applicant was transported to hospital by ambulance.

5At an Examination Under Oath (“EUO”) on May 16, 2025, the applicant testified that the truck missed hitting him by approximately one metre. The applicant was not struck by the vehicle, he did not fall to the ground and was not physically injured. He claims acute psychological and emotional fragility which he submits he continues to manifest since the accident.

6I note that the applicant takes offence to the respondent’s continued reference to his fiancée as “his girlfriend” and alleges the selected reference is intended to minimize the couple’s relationship and to distance the applicant’s emotional proximity and connection to the incident.

7The couple had been in a committed relationship for three years prior to the incident. They were engaged to be married in July 2024, moved in together in September 2024, and were to be married in July 2025. Any reference throughout this preliminary issue decision will be to the applicant’s “fiancée”.

The legal framework

8The Schedule provides that insurers are liable to pay certain benefits to or on behalf of “insured persons” who sustain an impairment as a result of the use or operation of an automobile.

9An “insured person” is defined at section 3(1) as:

(a) The named insured, any person specified in the policy as a driver of the insured automobile and, if the named insured is an individual, the spouse of the named insured and a dependant of the named insured or of his or her spouse,

(i) If the named insured, specified driver, spouse or dependant is involved in an accident in or outside Ontario that involves the insured automobile or another automobile, or

(ii) If the named insured, specified driver, spouse or dependant is not involved in an accident but suffers psychological or mental injury as a result of an accident in or outside Ontario that results in a physical injury to his or her spouse, child, grandchild, parent, grandparent, brother, sister, dependant or spouse’s dependant. [emphasis mine]

10Section 2(3) of the Schedule provides that the benefits set out in the Schedule shall be provided in respect of “accidents”. Section 3(1) of the Schedule defines “accident” as “an incident in which the use or operation of an automobile directly causes an impairment.”

11In Economical Mutal Insurance Company v. Caughy, 2016 ONCA 226 (“Caughy”), the Ontario Court of Appeal confirmed the two-part test to determine whether an incident is an “accident” as follows:

a. Purpose test: did the incident arise out of the use or operation of an automobile? and

b. Causation test: did the use or operation of an automobile directly cause the impairment?

12The parties did not address the purpose test in their submissions. I therefore infer that the purpose test is not in dispute.

The parties’ positions

13The respondent submits that the applicant was “not involved in” the accident and therefore is not an “insured person” entitled to accident benefits. It relies on several decisions of this Tribunal which found that individuals who are witness to an accident (as opposed to being physically injured) are “not involved in” the accident, even if there is a fatality. The only access to accident benefits in those circumstances would be under their own insurance policy and only if the accident injured a family member pursuant to section 3(1)(a)(ii) of the Schedule.

14The respondent relies primarily on two Tribunal decisions it argues most closely align with the facts in this matter: Amiri and Mireskandari v. The Co-Operators, 2021 CanLII 45657 (ON LAT) (“Amiri”) and Jazayeri v. Economical, 2024 CanLII 30722 (ON LAT) (“Jazayeri”).

15In Amiri, the applicants were walking together with their spouses when a car struck one of the individuals – the spouse of Mireskandari and father-in-law of Amiri. The accident occurred only a few feet in front of Amiri, and Mireskandari heard the collision and witnessed the immediate aftermath. The Tribunal found at para. 18:

While it was likely a very traumatic event, the applicants’ involvement in the accident is limited to their proximity and relationship [to the individual struck] only. They were not struck by the insured vehicle and they were not in a vehicle that was part of the accident. Nor were the applicants injured as part of a sequence of events stemming from an accident. Here, one applicant witnessed the accident at close range and the immediate aftermath. The other applicant heard the accident and witnessed the immediate aftermath.

16The Tribunal found the applicants were “not involved in” the accident and were not eligible for accident benefits as they did not qualify as “insured persons” pursuant to section 3(1)(a)(ii) of the Schedule because they were not named on the insurance policy.

17In Jazayeri, the applicant was walking with her boyfriend when he was struck and killed by a vehicle. The Tribunal held it was irrelevant whether the applicant was an “insured person” under the policy and the only question to be determined was whether she was “involved in” an accident. The applicant argued she was “involved in” an accident as she witnessed the deceased get run over, she was fearful she would be struck by the vehicle, and she sustained psychological injuries as a result. The Tribunal found at para. 20 of its decision:

Here, the applicant was not struck by the vehicle involved in the accident, nor was she an occupant of the vehicle at any time during the incident. I acknowledge that the applicant submits that she believes she may have been hit, however, she was not. Instead, she witnessed the accident an/or the immediate aftermath. In my view, having a belief that you may be hit, does not meet the definition of being “involved in”, as physical contact is required. Therefore, I find that she was not “involved in” an accident, as she was not physically hit with the vehicle, and was a witness of the event.

18In response, the applicant submits that he was “involved in” an accident and therefore he meets the definition of an “insured person”. He argues that he was placed in immediate danger of serious bodily harm, was required to take sudden evasive action, and suffered psychological trauma, all as a direct result of the use and operation of the automobile. He points to his evidence at the EUO where he explained that the truck came within a metre of striking him and he had to physically jump out of the vehicle’s path to avoid being struck. This instinctive, adrenaline-induced effort to avoid being struck, and his genuine fear for his own life, he argues, demonstrate his direct involvement in the subject accident. The applicant concedes he is not the spouse or a dependant of the deceased and therefore section 3(1)(a)(ii) does not apply.

19The applicant also cites Madore v. Intact Insurance Company, 2023 ONSC where the Court clarified that direct physical contact with an automobile is not a required element of the definition of “accident” under the Schedule.

20I note that in its reply submissions, the respondent acknowledges that Jazayeri – which it relied on in its initial submissions – was reconsidered in part (see: Jazayeri v. Economical, 2024 CanLII 88883 (ON LAT) (“Jazayeri reconsideration decision”). Based on the Jazayeri reconsideration decision, the respondent concedes that an insured person need not be physically struck in order to be found “involved in” an accident. The respondent also concedes that an “insured person” may be entitled to accident benefits if it is proven that they had a reasonable apprehension of being struck by a vehicle and suffered a psychological impairment as a result.

21The respondent submits that the applicant did not suffer a psychological impairment as a result of any apprehension of being struck and therefore was not “involved in” an accident pursuant to section 3(1)(a)(i). It argues that any psychological injuries the applicant sustained were as a result of witnessing the accident and its aftermath, which are “nervous shock” injuries limited to familial relationships under the Schedule (at section 3(1)(a)(ii)).

22The respondent relies primarily on the Tribunal’s decision in Boyle v. Travelers Canada, 2020 CanLII 103481 (ON LAT) (“Boyle”) where the Tribunal held that the applicant’s psychological impairment did not arise directly out of the use of the automobile, but rather its aftermath. In Boyle, the Tribunal found that the applicant was “not involved in” an “accident” as defined in the Schedule.

23The applicant argues that his psychological impairments were caused by his genuine fear for his own life as well as the horror of seeing his fiancée perish in the accident.

The applicant was “involved in” the subject “accident”

24On this preliminary issue, the question before me is whether the applicant was “involved in” what the Schedule defines as an “accident”. The parties concede that neither the Insurance Act, R.S.O. 1990, c. I.8 (“the Act”) nor the Schedule define “involved in”.

25Although not cited by either party, I am bound by the direction provided by the Supreme Court of Canada in Rizzo & Rizzo Shoes Ltd. (Re), [1998] 1 S.C.R. 27, 1998 CanLII 837 (SCC) citing Driedger on the Construction of Statutes (3rd ed. 1994) at page 87 (“Rizzo”) where the Court states that the modern approach to statutory interpretation requires that the words of a statute be read “in their entire context and in their grammatical and ordinary sense harmoniously with the scheme of the Act, the object of the Act, and the intention of Parliament.” This approach involves consideration of three factors: the language of the provision, the context in which the language is used, and the purpose of the legislation or statutory scheme in which the language is found.

26The respondent submits that caselaw supports that an individual who witnesses an accident, such as the applicant in this matter, does not meet the legal test for being “involved in” an accident, even when the accident occurs near them and involves a loved one. It argues that to broaden the scope beyond what is set out in Amiri and the Jazayeri reconsideration decision would not be in line with the Legislature’s intent.

27The respondent puts forward Merriam-Webster’s definition of “involve” as “having a part in something” or “engage as a participant”. The applicant accepts Merriam-Webster’s definition of the term and submits that on the facts of this case, it is undeniable that the applicant had “a part in” and was “engaged as a participant” in the accident. He submits that the term’s interpretation must be governed by the framework of the Schedule and he also cites Boyle to argue that it is a well-established and overriding principle that the Schedule is remedial, consumer-protection legislation that must be interpreted broadly and liberally in favour of coverage.

28I am not bound by the Tribunal decisions put forth by the parties in this matter. I am however, bound by the Rizzo principles set forth by the Supreme Court to interpret the meaning of “involved in an accident” to determine whether the applicant is an “insured person” pursuant to the Schedule. Considering that the words of a statute should be read in their entire context and in their grammatical and ordinary sense, I accept as guidance the definition of “involve” by Merriam-Webster relied on by the parties. I also accept that the Schedule’s mandate is one of consumer protection.

29For the reasons that follow, I find that the applicant was engaged as a participant in the accident of March 8, 2025 and therefore, is an “insured person” eligible for accident benefits.

30As set out in Greenhalgh v. ING Halifax Insurance Company, 2004 CanLII 21045 (ON CA) (“Greenhalgh”), the causation test requires me to determine if the purpose and use of the vehicle was the direct cause of the applicant’s impairments by focusing on the following considerations:

a. Whether the incident would not have occurred “but for” the use or operation of the motor vehicle;

b. Whether there was an intervening cause that cannot be said to be part of the ordinary course of the use or operation of the motor vehicle; and

c. Whether the use or operation of the motor vehicle was the dominant feature of the incident.

31The facts of the matter and the applicant’s evidence at his EUO support that the vehicle was headed in the direction of the applicant forcing him to take evasive action (i.e., jumping out of its way) to avoid physical injury, or worse. Only seconds later, the applicant’s fiancée – who was walking beside him – was struck by the vehicle and died. In my view, this is different from an individual who witnesses an accident from afar and rushes to the scene to assist. The applicant submits that his psychological impairments are as a result of fearing for his life and from witnessing his fiancée being killed. As established by Madore, direct physical contact with an automobile is not a required element of the definition of “accident” under the Schedule.

32Based on the facts in this matter and Greenhalgh, I agree with the applicant that he was not a simple witness to the accident nor did his involvement arise from simply witnessing the aftermath of the accident. The applicant was within mere feet of the approaching U-Haul truck and had to physically jump out the vehicle’s path to avoid possibly being struck. In my view, “but for” the approaching vehicle, the situation would not have required the applicant to take immediate action to evade the approaching vehicle. Had the applicant not jumped out of the way, he could have sustained physical injuries, or worse. In my view, the applicant was engaged as a participant, hence, he was “involved in” the accident.

33I also find there was no intervening cause; the sequence of events was continuous. The vehicle approached the couple, the applicant jumped out of its path to avoid physical injury, and unfortunately, the applicant’s fiancée was struck and killed. The respondent submits that the dominant feature of the applicant’s psychological injuries was the act of witnessing his fiancée be struck and killed, and the aftermath. I disagree. In my view, the dominant feature is the U-Haul truck that caused the applicant to take evasive action to avoid injury. I also find it was reasonable for the applicant to believe his life was in danger by the approaching vehicle, which, only seconds later, collided with and killed his fiancée who was beside him.

34I therefore find the applicant was directly and intimately “involved in” the accident. The applicant’s actions at the time of the accident were immediate. Upon seeing the U-Haul truck moving towards him, the applicant instinctively jumped out of the vehicle’s path to avoid being struck. The immediate danger caused by the vehicle’s trajectory confirms a strong nexus between the applicant’s actions and the accident, and for this reason, I find the applicant was “involved in” the accident. Based on this nexus, I find the applicant is an “insured person” pursuant to section 3(1)(a)(i) of the Schedule and was involved in the accident on March 8, 2025.

ORDER

35The applicant was involved in an accident on March 8, 2025.

36The application shall proceed to a hearing on the substantive issues as previously scheduled.