An injury caused by or sustained in an ‘accident’ under an insurance policy connotes an accident sustained in circumstances where the assured neither intended nor expected to suffer the injury. The test is a subjective one. Once it is established on a prima facie basis that the insured did not intend or expect to suffer the injury, the insurer must demonstrate the converse.
The plaintiff was found lying on his bedroom floor and pronounced dead on arrival at hospital. He died of what was called a ‘mixed drug intoxication’. The evidence showed that the death was caused by drug-interactions and that the deceased had never displayed any sign of suicidal tendency to family, friends or his psychiatrist. The insurers had not discharged the onus of showing that the plaintiff intended to kill himself.
The claim succeeded under two policies, one of which covered ‘bodily injury effected directly and independent of all other causes by accident’ and the other where ‘accident’ was defined as meaning ‘an unforeseen and involuntary event that causes an injury’.
The meaning of ‘accident’ can be broad and cover accidentally contracted illnesses.