Accident insurance policies frequently insure not only against an act of God but also for accidents caused by a person’s carelessness. An insured homeowner will expect coverage, for example, if someone drowns in his or her pool, even though the accident might have occurred because someone in the family left the gate open.
Not every unintended event is an accident for which insurance benefits can be paid; all the circumstances in a particular case must first be considered. For example, a policeman who waded into a surging crowd of forty or fifty fighting teenagers and then experienced a heart attack was found to have suffered from an accident.
In another case, a man who was shot when he was found in bed with another man’s wife was also found to have died in an accident because death is not the usual or expected result of Adultery. However, the family of another man was not allowed to collect insurance benefits when he was shot after starting a fight with a knife. In that case, the court ruled that Deadly Force was a predictable response to a life-threatening attack, whether the instigator actually anticipated it or not.
Different states apply different standards when determining if an accident justifies payment of benefits under Workers’ Compensation. Some states strictly limit benefits to events that clearly are accidents. They will permit payment when a sudden and unexpected strain causes an immediate injury during the course of work but they will not permit payment when an injury gradually results from prolonged assaults on the body. Under this approach, a worker who is asphyxiated by a lethal dose of carbon monoxide when he goes into a blast furnace to make repairs would be deemed to have suffered in an accident. However, a worker who contracts lung cancer after years of exposure to irritating dust in a factory could not claim to have been injured in an accident. Because of the remedial purpose of workers’ compensation schemes, many states are liberal in allowing compensation. In one state, a woman whose existing arthritic condition was aggravated when she took a job stuffing giblets into partially frozen chickens on a conveyor belt was allowed to collect workers’ compensation benefits.
Insurance policies may set limits to the amount of benefits recoverable for one accident. A certain automobile insurance policy allowed a maximum of only $200 to compensate for damaged clothing or luggage in the event of an accident. When luggage was stolen from the insured automobile, however, a court ruled that the event was not an accident and the maximum did not apply. The owner was allowed to recover the full value of the lost property.
Sometimes the duration of an accident must be determined. For example, if a drunken driver hit one car and then continued driving until he or she collided with a truck, a court might have to determine whether the two victims will share the maximum amount of money payable under the driver’s liability insurance policy or whether each will collect the full maximum as a result of a separate accident.
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