2007 General Meeting Assemblée générale 2007 Montréal, Québec 2007 General Meeting Assemblée générale 2007 Montréal, Québec Canadian Institute of Actuaries Canadian Institute of Actuaries L’Institut canadien des actuaires L’Institut canadien des actuaires

2007 General Meeting Assemblée générale General Meeting Assemblée générale key AD&D court cases The West Nile accident The Sexually transmitted disease The firefighter’s cancer All required the AD&D benefit to be paid

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 West Nile Plasterer bitten by Mosquito in Ontario in 2002 Contracted West Nile and became a paraplegic 3 weeks later Court said: –It was an unforeseen, unexpected event that was caused by an external source – a mosquito – and falls within the ordinary definition of an accident. –The plasterer had no reasonable expectation that he would get West Nile virus from the activity in which he was engaged.

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 STD 45 year old had unprotected sex with 3 women in 2003 Contracted Herpes Simplex Virus type-2 and became a paraplegic a month or so later Court said: –Did the insured expect to become a paraplegic as a result of having unprotected sex? No - so it was caused by accidental means. –Also cited West Nile! Contract defined covered claims as: –Directly and independently of all other causes from bodily injuries occasioned solely through external, violent and accidental means.

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 Firefighter Not strictly a claim against an insurer but a review of an arbitrators findings in a collective bargaining agreement. Firefighter dies from renal cancer. Court said: –death resulted from exposure to toxic substances at work and therefore was not caused solely from a natural cause and since his death from renal cancer was unexpected, then his death would have been accidental within the meaning of both the Martin and Wang decisions –Cited WSIB who have defined certain cancers as being work related for firefighters

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 So What? Definition of “accidental means” is far beyond my assumption and understanding Have we priced for this? Is your contract wording strong enough? Courts may exclude part of wording e.g. STD case - violent.

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 What is an accident? A man dies after being attacked by a bear while hiking? A man is bitten by a dog and the wound turns gangrenous and has to be amputated? A man is bitten by a rabid bat and dies from rabies? A man is bitten by a mosquito and becomes paraplegic from West Nile?

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 What is an accident (2)? A man dies in a commercial airline crash? A man becomes paraplegic after an accident while riding a dirt bike? A man loses his foot which became infected after he cuts it the first time he uses a chainsaw? A man becomes paraplegic from a STD after having unprotected sex? What if a woman becomes paraplegic from a STD after being raped?

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 What is an accident (3)? A man dies of a heart attack caused by electrocution on the job? A man dies from a stroke after a fall on the job? A man dies from the effects of a single accidental exposure to radiation or a chemical at work? A man dies of a cancer which a government agency has declared to be work related due to repeated exposure?

2007 General Meeting Assemblée générale General Meeting Assemblée générale 2007 Do we have consensus? Is an accident after all sometimes on a continuum that requires interpretation (shades of grey)? If we don’t all agree, can we expect the courts to? Where now on AD&D? Is it now more expensive than life coverage?