Ontario man denied car insurance coverage after 3.5 metre fall takes company to court and wins

Denied insurance coverage after fall from trailer An Ontario man suffered a brain injury after he fell off his trailer, but when they applied for insurance coverage, he claim was denied.

An Ontario man who suffered debilitating injuries in a 3.5 metre fall from the top of his fifth-wheel trailer was denied insurance coverage for years until he took the company to court and won.

Clayton Madore will now be entitled to benefits he’s been denied since he fell after a judge ordered his insurer, Intact Insurance, to pay up. His injuries are extensive and include a fractured skull, a brain injury, multiple broken bones and hearing and vision loss.

“I still get emotional every time I talk about it,” his wife Agathe Madore said in an interview with CTV News Toronto. “We’re survivors and this has changed our lives. Maybe this will turn it around.”

Clayton Madore was standing atop his trailer outside of Sudbury in 2019, cleaning it in preparation for a trip to PEI, when he heard someone call him to come inside, he said.

“I said, ‘I’ll be there in a minute.’ That’s all I remember.”

The fall brought his wife outside of the family’s home in St. Charles, Ontario to a terrifying sight.

“I heard a crash in the driveway and I went outside right away, and I found my husband Clayton on the cement. There was no life left. My son Jason had to revive him,” Agathe Madore said.

Clayton Madore woke up in the hospital about 17 days later, and when he tried to walk, doctors found yet another broken bone in his ankle that had to be set, along with all of his other injuries.

“I couldn’t walk. My legs were completely dead,” Clayton Madore recalled.

He left the hospital 78 days after the fall, but he could no longer work and needed a lot of treatment. To pay for some of it, the family turned to the trailer’s insurance policy with Intact Insurance.

But the company denied coverage, in part because they denied he was using the trailer, claiming he wasn’t covered.

In hearings at the License Appeal Tribunal, adjudicators sided with Intact twice. But one of Clayton Madore’s lawyers, Brian Cameron, told CTV News the policy isn’t so limited and should be in force on many uses of the trailer, including driving and cleaning.

“They argued the trailer had to be involved in causing the incident, which was wrong on many levels,” Cameron said.

Cameron and fellow lawyer Jordan Kofman took the case to Divisional Court, where a three-judge panel sided with their client, saying, “slipping and falling off a trailer that is 12 feet high must be seen as a normal incident of the risk created by such use and is reasonably foreseeable.”

“Hopefully he’ll be able to get the benefits he’s been denied for years now,” said Kofman in an interview.

A representative from Intact didn't comment.