In a recent situation where a claim was made by an executor of the estate of an insured person under a Group Persons Accident and Corporation Travel Plan, the wording of the policy was considered by the Court having regard to contemporary language read in the context of the whole policy, and what it would mean to a reasonable non-expert.

Thus when the claim was made, which arose from the sudden death of the insured, such claim was considered against the backdrop of as to whether the death was the result of an injury resulting from an accident, having regard to the wording of relevant definitions contained in the personal accident section of the applicable policy.

The definition of injury in such policy required that for an event to be an injury covered by the policy it must have been a bodily injury resulting from an accident that had occurred fortuitously to the insured during the period of insurance.

An accident was considered by the Court to be something which happened without intention or design.  It is an unexpected and an untended mishap.

Thus for an injury to be caused by an accident and therefore entitle a claimant to succeed in a claim made under the policy there must have been an accident which actually caused the injury.

In the relevant factual situation where sudden death was caused by thrombosis of a coronary artery it was held that while this certainly constituted an injury under the policy it was determined though that the bodily injury did not result from an accident.

Related Havilah Legal service(s): Wills and Deceased Estates, Personal Injury