A pedestrian hit by a car can keep chasing his accident benefits, after Co-operators failed to show he actually qualified for workers' compensation instead.

The claimant was struck by a vehicle while crossing as a pedestrian on May 12, 2025, and filed for statutory accident benefits with Co-operators General Insurance Company. The insurer turned him down, arguing that because he had been on a landscaping job when the crash happened, his claim belonged with the Workplace Safety and Insurance Board (WSIB) instead.

Section 61 of Ontario's Statutory Accident Benefits Schedule lets an insurer off the hook for accident benefits if a claimant already qualifies for workers' compensation coverage. Co-operators leaned on the claimant's own account of working for a landscaping company at the time of the crash, arguing that the Workplace Safety and Insurance Appeals Tribunal - not the Licence Appeal Tribunal - was the proper body to decide his employment status.

Co-operators also told the claimant that WSIB had accepted his claim under an assigned incident number, but the insurer never backed that up with evidence. A letter dated February 5, 2026 from WSIB told a different story: no application on file at all.

The claimant pushed back, saying he had never been an employee. Under oath, he testified that he worked as an independent contractor - negotiating his own price with the landscaping company's owner and getting paid in cash, though he sometimes had help from the company's crew and use of its truck to get jobs done. The owner backed him up, confirming in writing that the claimant was not on the payroll.

Adjudicator Lisa Holland found the burden was on Co-operators to prove the claimant actually qualified for workers' compensation - and that the insurer came up short. She also noted the Tribunal has no authority to rule on WSIB employment status itself, a call that belongs to the workers' compensation system.

Holland's ruling means the claimant can keep pursuing his accident benefits case at a full hearing.

The decision, released September 10, 2026, also settled a paperwork fight. Co-operators had filed submissions well over the agreed page limit, then tried to file a longer, reformatted version in its reply. Holland declined to consider that version, finding it "creates an unfair procedural advantage to the respondent," and limited her review to the original, page-limited filing.

The case is a reminder that pointing to a claimant's side work isn't enough on its own. An insurer looking to shift a claim to workers' compensation still has to prove the claimant actually qualifies - not just that the possibility exists.