Personal Accident
Claim case sharing
Is suffering a sprained back during a sneezing episode an Accidental Bodily Injury?
Mrs. Chau hurt her lower back as a result of sneezing and went to see a bonesetter. Mrs. Chau has a personal accident insurance policy covering medical expenses of bonesetter for treatment of Accidental Bodily Injury. She submitted a claim for medical expenses as she thought her injury due to sneezing was an accident.
However, her insurance company rejected her claim as Mrs. Chau’s injury did not meet the definition of Accidental Bodily Injury. Mrs. Chau was surprised by this and wanted to know why.
Insurance policies define “Accidental Bodily Injury” as bodily injury caused solely and directly from accidental external violent and visible means as evidenced by visible bruise or wound on body, and which are independent of any other cause and not by sickness, disease or gradual physical or mental wear and tear.
In Mrs. Chau’s case, the back sprain was caused by sneezing which came about neither as a result of accidental external violent and visible means nor was it evidenced by visible wounds on her body that could indicate that the condition was caused by “Bodily Injury” and not by sickness such as Spinal Degeneration. Hence, her insurance company was unable to compensate her for her claim for Accidental Medical Expenses.
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