the causal link between the hamstring injury and pulmonary embolism caused the death missing, so that insurance should not assume the additional coverage of death by accident

March 18 , 2016 // Legal Reforms and Debate

STS, First Chamber, Civil Division, 709/2015, of 18 December
Resource 2466/2013. Speaker: JOSE ANTONIO QUINTANA SEIJAS.
\"... In the voluntary accident insurance, Article 100 LCS defines the insured risk insurance as an object,\" as bodily injury derived from a violent, sudden, external and beyond the control of the insured cause, producing temporary disability , permanent or death. \"
It is true that this room sometimes, exceptionally and when the death of the person occurs due to myocardial infarction has likened to \"accident\" within the meaning of the insurance contract, but this has required very specific requirements as to obey external, immediate and oblivious to organic factors cause. In this regard the judgment of November 11, 2003 noted that \"although the myocardial infarction is not covered by the provisions of article 100 of the Law on Insurance, unless otherwise stipulated contract, however, must be understood within the insurance accident when it has its genesis in an external cause, and to that end has taken into consideration the immediate cause consists of the pressure and stress due to the increased work (Judgment of 14 June 1994), the physical effort in the development of I work for which he was trained (Judgment of 27 December 2001) and the effort and tensions in the performance of work (Judgment of February 27, 2003) \".
Well, respecting evidence assessment of the Board of Appeal, and considering that the evidence taken does not establish the necessary causal link between the hamstring injury and PTSD; which can not be estimated being in the presence of an accident, in the terms in which it is conceptualized by Article 100 of the Law of Insurance Contracts since nearly a month after the injury suffered playing paddle occurs, which preclude the sudden appearance required for the assessment of accident, and that the final cause of death, \"must be regarded as congenital progeny completely\", the conclusion can not be other than to leave the course out of insurance coverage concerted accidents, which means rejecting the plea.
Being the incident outside the contracted insurance coverage accidents, it is unnecessary to enter the examination of the second plea. ... \"


Falta el nexo causal entre la rotura fibrilar y el tromboembolismo pulmonar que causó el fallecimiento, por lo que el seguro no debe asumir la cobertura adicional de fallecimiento por accidente

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