Mitchell v Great Lakes Reinsurance (UK) Plc

"Take nothing on its looks; take everything on evidence. There's no better rule."

So wrote Charles Dickens in the exchange between Mr Jaggers and Pip in Great Expectations. This proved to be apposite in the case of Mitchell v Great Lakes Reinsurance (UK) Plc where our insurance litigation team acted for the insurers.

This case is of interest to insurance lawyers and to the insurance industry in the interpretation of 'sole cause' clauses in insurance contracts. The case involved a personal accident insurance policy and how the court should interpret policy wording entitling the insured to benefits if he was injured and that injury was the sole cause of death. Given the limited case law in the UK, the case drew on international jurisprudence.

At the end of the day, the Court of Session in Scotland has provided useful guidance on the interpretation of these clauses based on the medical evidence in the case concerned although at first instance it was tempted to reach the same conclusion even before the evidence had been heard.

The conclusion

In summary, the court has considered that in this context 'sole cause' should exclude situations where the insured had a pre-existing medical condition that contributed to the death to a sufficient degree. This is so even where that condition would not by itself have resulted in death at the same time. Whether its contribution is sufficient will depend on the medical evidence and the wording of the policy.

The circumstances

This 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, he developed pneumonia, his condition deteriorated, and he 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 medical reports before the court indicated that Mr McCann had pre-existing conditions (chronic obstructive pulmonary disease (COPD)) which prevented his body from coping with the pneumonia.

The insurers refused indemnity, on the basis that the bodily injury was not the sole cause of Mr McCann's death. They maintained that in the context of the...