Existing disease prevents insurance payout in road traffic accident case

Where there is an existing disease at the time of the road traffic accident, the insurer does not need to pay out under an accident insurance policy, a recent Court of Session case has held.

Mr McCann died aged 77 from pneumonia, which he developed as a result of injuries from a road traffic accident.  His executors raised an action for compensation from Mr McCann’s insurance company, with whom Mr McCann had an accident insurance policy.

However, the court heard that at the time of the road traffic accident, Mr McCann had several health problems, including a heart condition. These underlying health problems meant Mr McCann had a life expectancy of 2-3 years and also made him vulnerable to developing pneumonia from chest injuries which were otherwise not life-threatening.

The court held that the insurers were not required to pay Mr McCann’s executors under the accident insurance policy. As there was an existing disease at the time of the road traffic accident, and the combination of both the disease and the accident resulted in death or injury, then the accident could not be considered as the sole cause. This meant that the accident insurance policy did not cover the injury which lead to Mr McCann’s death, because the injury was not the sole cause of death – the existing disease was also a contributing factor.

If you have been involved in an accident, even if you are unsure if you have a valid claim for compensation, contact our expert No Win No Fee compensation lawyers on 0800 0891331 and we will assess you claim and advise you on the first steps to receiving compensation.