October 13, 2014

SABS Update- Phantom Accident Means Phantom Accident Benefits

Anane et al v Intact Insurance Company, FSCO A12-002965 and A12-003402, Arbitrator Henry M. Knox

Mr. Anane and Ms. Yeboah claimed to be involved in a motor vehicle collision on or around March 26, 2010. Each applied for Accident Benefits from Intact Insurance Company.

The issue at Arbitration was whether or not Mr. Anane and Ms. Yeboah were involved in an “accident” as defined in section 2(1) of the Schedule. Arbitrator Knox heard the evidence and testimony of the Applicants, as well as in the form of provision of the transcripts from their respective Examinations under Oath.

It was the evidence of both Ms. Yeboah and Mr. Anane that, at the time of the collision, Ms. Yeboah was the driver of a brown 1998 Ford Windstar, and was driving southbound on Jane Street in Vaughan, Ontario. Mr. Anane was the front-seat passenger. They both stated that there were two other passengers in the vehicle. As they approached the “T” intersection of Cidermall Avenue, they purportedly collided with a red 2010 Dodge Journey that was proceeding eastbound, and failed to stop before entering the southbound lane on Jane Street. The Applicants testified that both vehicles were travelling at about 65 kilometers per hour, and that the front end of the Ford collided with the left side of the Dodge. Both vehicles were towed away from the scene. They did not call the police, fire department, or an ambulance.

Ms. Yeboah testified that earlier that day, and prior to the accident, she picked up Mr. Anane at his home in order to undertake some errands. During this period of travel time, Mr. Anane received a call on his cell phone from a friend who requested that he and his girlfriend be picked up at a mall. Ms. Yeboah picked up the friends, Mr. Tsekpo and Ms. Oladokan, and they made plans to go out that night. Ms. Yeboah also testified that, upon impact with the Dodge vehicle, she struck her head and chest of the steering wheel, and lost consciousness for about 15-20 seconds. Ms. Yeboah indicated that she and Mr. Anane reported the accident on March 30, 2010, four days following the alleged collision.

Mr. Anane’s evidence differed from that of Ms. Yeboah. He stated that he received the call from his friends while at Ms. Yeboah’s home, and not while running errands. Under direct examination, he stated that they reported the accident three days after the collision, and under cross-examination, he stated it was four days later. He also indicated that they did not bother calling the police because there were no injuries, and so they felt that it was unnecessary to involve the police.

In order to demonstrate that the collision did not occur, Intact relied on two expert witnesses. Mr. Kodsi, a licensed engineer specializing in motor vehicle accident investigations, concluded that the accident as alleged by the Applicants never occurred. He examined all the documents provided to him, including the actual Ford vehicle, and photographs of the Dodge, and indicated that there was a substantial difference between the testimony of the Applicants and the physical evidence on the vehicles. For example, if the Ford was travelling at 60-65 kilometers per hour, the damage to the Ford would have been much more severe. In addition, the paint on the Ford did not match the color of the red Dodge vehicle.

The second expert, Mr. Seaton, was a principal of Collision Analysis and Reconstruction, a firm that provided case analysis and expert testimony with regard to collision reconstruction issues. He too, concluded that the accident as alleged by the Applicants did not occur. Among his many reasons, he stated that the damage did not match the height or elevation of both vehicles, and that given the speed of the vehicles, the damage should have been greater. In his opinion, the profile of the damage to the front of the Ford was consistent with a collision involving a stationary object, rather than a vehicle in motion.

The Arbitrator found that the Applicants were not involved in a collision with the red 2010 Dodge Journey on March 26, 2010. Accordingly, they had failed to meet their evidentiary burden of establishing that they were involved in an accident as defined in section 2(1) of the Schedule. Arbitrator Knox found it odd that given Ms. Yeboah’s alleged loss of consciousness from the collision, and the fact that the vehicles needed to be towed, the Applicants found it unnecessary to immediately notify the police. The inconsistencies of the Applicants’ evidence also caused the Arbitrator to find the evidence of the two experts far more convincing. It was also odd that the Applicants did not present any corroborating evidence by the passengers, Mr. Tsekpo and Ms. Oladokan.

Further, as a result of the above, Arbitrator Knox found that Intact had established on a balance of probabilities, that the Applicants had willfully misrepresented the circumstances surrounding the alleged accident when they applied for Accident Benefits. The Applicants were ordered to each repay any monies provided to them by Intact pursuant to section 47(1) of the Schedule, subject to the limitations set out in subsections 47(2) and (3).
IMPLICATIONS

Various inconsistencies in the Applicants’ accounts of the accident, as well as stories that are not consistent with the presented facts, prompt insurance companies to investigate the matter seriously. Individuals in the industry must be aware that staged accidents of this sort continue to be prevalent, and fraudulent Applicants must be aware that there are financial consequences to their dishonesty.
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