Sports injury case should warn insurers, says Bruce Ralston
A recent case has demonstrated that those responsible for drafting policies for sports players need to take great care if they use common standard clauses in new policies.
The case of Blackburn Rovers v (1) Avon (2) Eagle Star (3) AGF [2004] considered whether an accidental injury policy should provide cover for an injured football player. The policy provided cover for "accidental bodily injury". This was defined as an injury that solely and independently of any other cause occasioned the death or disablement of the player. In exclusion 4, the policy excluded cover for death or disablement resulting from "permanent total disablement attributable either directly or indirectly to arthritic or other degenerative conditions..."
The player, Martin Dahlin, was insured for £4m. A back injury ended his playing career. Blackburn Rovers admitted that he suffered from degenerative disc disease of the lower spine prior to the accident, but argued that cover should be provided because, on a literal interpretation of the policy, the disablement did not result from ‘permanent total disablement'.
Furthermore, exclusion 4 was not meant to apply to the type of degenerative condition that many men, and footballers especially, suffer from at the claimant's age.
The insurers had denied cover on the basis that the injury was not an accidental bodily injury as defined by the policy and in any event, the claim fell within exclusion 4.
The court concluded that the policy reference to degenerative conditions referred to conditions of sufficient severity to be regarded as an illness, not to conditions that formed part of the normal ageing process.
The court did provide some useful guidance on policy construction:
1. This was not a case of ambiguity in the policy wording, but of a poorly drafted policy; so the usual rule that ambiguity be resolved in favour of the insured did not apply
2. Where the wording does not give a clear meaning, the construction that gives effect to the parties' true intention should be adopted
3. An insurance policy should not be construed so as to deprive the insured of the protection the policy was designed to provide.
The clear message is that clauses must be checked in the context of the policy as a whole.
'Bruce Ralston is head of the sports liability unit at Beachcroft Wansbroughs
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