MITCHELL V GREAT LAKES REINSURANCE UK LTD

[2013] ScotCS CSOH_14, Court of Session, Outer House, Lord Malcolm, 25 January 2013

Insurance (personal injury) - Policy applying to injury "resulting solely and directly from accidental outward violent and visible means" - Assured injured in motor accident - Assured died from heart disease - Whether accident was sole cause of death

Mr McCann had a personal accident insurance policy which paid him benefits if he sustained bodily injury. That term was defined as one "resulting solely and directly from accidental outward violent and visible means and does not include sickness or disease or any natural occurring condition or degenerative process". Mr McCann was involved in a road traffic accident on 26 June 2006, and he suffered broken ribs and a fractured sternum. He was admitted to hospital but developed pneumonia and died a week later. The insurers refused to pay on the basis that the assured had severe pre-existing medical conditions, most importantly, heart disease. The post-mortem report concluded that his injuries would not have been fatal in themselves but might have contributed to his death in a minor way. The court, distinguishing Fidelity and Casualty Co of New York v Mitchell [1917] AC 592 (where the injuries were the proximate cause of subsequent disease), applied Jason v Batten (1930) Ltd [1969] 1 Lloyds Rep 281 and Southampton Leisure Holdings plc v Avon Insurance plc [2004] EWHC 571 (QB) and held that the death was not one resulting solely from the injuries so that the insurers were not liable.