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Insurance policy interpretation: Walter Mitchell and Another v Great Lakes Reinsurance (UK) Plc

Insurance policy interpretation: Walter Mitchell and Another v Great Lakes Reinsurance (UK) Plc

A judgement has been issued today by the Court of Session in relation to a litigation our insurance litigation team was advising on, looking at the proper interpretation of personal accident insurance policy wording. My team represented the insurers. The case was brought by the executors of the late Walter McCann. Mr McCann was involved in a car accident and admitted to Aberdeen Royal Infirmary on 26 June 2006 with a fractured sternum and multiple rib fractures. Sadly, his condition deteriorated, he developed pneumonia and died a week later. A post mortem found the cause of death to be respiratory and cardiac failure resulting from the pneumonia.

The executors sought payment under Mr McCann’s accident insurance policy. The policy provided cover to Mr McCann if he sustained “bodily injury which, within 52 weeks, [was] the sole cause of permanent disability, death or hospitalisation.”

The question Lord Malcolm had to consider before coming to a judgement was whether the injuries caused by the accident, on their own, were the ‘sole cause’ of Mr McCann’s death. While medical evidence confirmed the pneumonia was caused by the fractures, Lord Malcolm referred to Mr McCann’s pre-existing chronic obstructive pulmonary disease (COPD) which prevented his body from coping with the pneumonia. This was a co-existing cause of the death.

Lord Malcolm decided that Mr McCann’s injuries were not the “sole cause” of his death and that the policy cover was not triggered. This decision will assist the insurance sector in clarifying their liability under policies providing cover where similar policy wording is adopted. Insured parties seeking payment where there is this wording may face a tougher task in persuading a court of the merits of the claim if there are also injuries and conditions which are unrelated to the accident. If you would like to talk over similar issues please contact our team. We will be delighted to assist.

Ewan McIntyre
Partner

LChalmers