The Kaohsiung branch of the Taiwan High Court rendered the 106-Bao-Xian-Shang-Yi-6 Civil Decision onFebruary 27, 2018 (the “Decision”), in which it heldthat in case of an injury covered by all risks insurance, if theinsured can show that the occurrence of such injury is empirically accidental and unforeseeable and produce the appropriate evidence in support, there is no need to substantiate the concrete and actual causes of the injury.
The Plaintiff in the case filed a complaint alleging that his brother purchaseda life insurance policy with an accidental injury insurance rider from the Defendant’s insurance company (the “Rider”) with the Plaintiff as the beneficiary. The insured was subsequently killed when the truck he drove overturned on the side of an industrial road and crushed him. However, because the Defendant refused to indemnify, a complaint was thus filed for damages. The Plaintiff lost and made this current appeal to contest the decision.
According to the Decision, anall-risks insurance differs from specified risk insurance by covering all insured accidents which may result in injuries (i.e., the total package principle). As such, the insurer is therefore required to indemnify the insured for all injuries arising from such accidents except for matters specifically excluded in the insurance policy. If an injury covered under such all risks insurance befell the insured and such injury is caused by an accident (of uncertain factors), if the appropriate evidence is submitted, and it is empirically demonstrated that such event is generally accidental and unforeseeable, then that should suffice without further proving the concrete and actual causes of the injury. If the insurer contests such an insurance claim and argues that such injury was not covered by the insurance, it has the burden of proof to produce the appropriate opposing evidence for reason of fairness.
It was further pointed out in this Decision that the Plaintiff’s brother was not found in the driver’s seat, and there was no evidence to support that he was driving under the influence when this accident occurred; his circumstance is no different than a drunken person simply standing right next to the truck. Under ordinary and objective circumstances, a drunk individual standing nextto a truck does not necessarily result in being crushed by the truck, thus the death of the Plaintiff’s brother is not causally related to his drunk driving, As such, the Defendant has failed to substantiate that it is not liable because the death of the Plaintiff’s brother was caused by his drunk driving, the Plaintiff therefore has a right under law to request indemnification, and the previous decision shall be reversed and rendered in favor of the Plaintiff.