An unintentional self-inflicted injury to an intoxicated Insured was found to come within the exclusion clause in the Insurer’s group insurance policy and accordingly the claim by the family of the Insured for accidental death benefits was dismissed

Booth v. British Columbia Life & Casualty Co., [2004] B.C.J. No. 431, British Columbia Court of Appeal

The Insured died in March 2002 by falling from a tree while taking a short-cut from a bridge to his residence. It was admitted that the death was accidental and that the Insured was intoxicated at the relevant time.

The Defendant Insurer asserted that it had no obligation to pay accidental death benefits due to an exclusion clause which stated that no benefits are payable for a self-inflicted injury, whether intentional or unintentional, which is sustained while the Insured is intoxicated. The trial judge held that the exclusion clause did not apply because it had not been shown that the injury which was sustained in this case could be said to have been self-inflicted. The trial judge disputed the plausibility of an unintentionally self-inflicted injury and held that the meaning of the clause should be construed against the insurer.

On appeal, the Insurer contended that the exclusion clause applied since the insured’s death was a result of “unintentional self-inflicted injury”.

The court held that self-inflicted meant “self-caused” or “self-imposed”. The court noted that the clear meaning which emerged from the exclusion clause was an intention to exclude liability for the accidental death benefit where the Insured was intoxicated and caused himself injury either intentionally or accidentally. The court held that the intention to limit accidental death coverage was expressed clearly and explicitly and left no uncertainty as to the extent of the coverage. The clause therefore excluded coverage for an accidentally self-imposed injury sustained while intoxicated. The court held that the trial judge’s interpretation of the clause was unreasonable. Where the Insured is the sole actor in the events giving rise to the injury and there is no other external cause, the injury can properly be said to be unintentionally self-inflicted.

The appeal was therefore allowed and the Plaintiff’s claim was dismissed.

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