When an insurance beneficiary asserts that the insured died of suicide by medication use, insurance payment cannot be claimed without substantive evidence.(Taiwan)

Debby Yu

The Tainan Branch of the Taiwan High Court rendered the 108-Bao-Xian-Shang-yi-4 Decision of February 13, 2020 (hereinafter, the “Decision”), holding that when an insurance beneficiary asserts that the insured died as a result of suicidal behavior due to medication use, if no other substantive evidence is presented, there is no reason to claim insurance payment from the insurance company.

According to the facts underlying this Decision, the Appellant asserted that the insured and applicant X and the Appellee entered into a whole life contract and a rider of personal accident insurance contract (hereinafter, the “Accident Injury Insurance at Issue”) with the Appellant as the beneficiary.  Such insurance policies went into effect after being approved by the Appellee company.  X was later found drowned under a pavilion in a park.  After post-mortem examination, it was confirmed that he died of drowning and suffocation after falling into water before his death.  The Appellant claimed death benefit from the Appellee under Articles 6 and 21 of the insurance policy of the Accident Injury Insurance at Issue, but the Appellee refused to pay on the ground that X had intentionally committed a suicide.  However, X retired with no worries about his livelihood.  Although he suffered from an illness, he was not seriously ill and received active treatment and regular follow-up care.  Since his survival rate and cure rate were quite high, not to mention that he had never indicated any idea of taking his own life, there was no motive for intentional suicide.  In addition, according to the American Journal of Psychiatry, the number of “violent suicides” among elderly people over 66 who have taken SSRI has increased dramatically.  X committed suicide in a violent manner by throwing himself into a lake within 2 months after taking the above medication apparently not of his own free will.  X’s death was resulted from his consumption of SSRI type of medication during his hospital visit.  Therefore, it was certainly an accident injury incident under Article 5, Paragraph 2 of the insurance policy of the Accident Injury Insurance at Issue.  Accordingly, the Appellant claimed insurance payment from the Appellee in accordance with Article 110, Paragraph 1 of the Insurance Law and the covenant under Article 6, Paragraph 1 and Article 21 of the insurance policy of the Accident Injury Insurance at Issue.

According to the Decision, the first part of Article 277 of the Code of Civil Procedure provides that if a party asserts a favorable fact, such party shall assume the burden of proof concerning such fact.  As a matter of practice, if the beneficiary to an accidental injury insurance contract has proven that such accident has taken place and usually the occurrence is normally extraneous, accidental and unforeseeable according to empirical rule, the beneficiary should be deemed to have assumed the burden of proof.  In this case, if the insurer contends that it is not an accident, it should assume the burden of proof for the fact it has asserted (such as aging, illness or bacterial infection) to meet the principle of distribution of the burden of proof.  To wit, the burden of proof on a beneficiary should be reduced under the principle of fairness.  If the insured dies not because of aging, illnesses and bacterial infection, basically the cause of death should be an accident.

Moreover, according to the Decision, the hospital’s medical condition summary and a copy of outpatient medical records show evidently that people over 65 taking the above-mentioned medication that treats depression and anxiety disorders could help reduce symptoms and lower the risk of suicide.  Insured X did take the above medication during his illness.  If a person is over 65 years of age and has been taking the medication for about 3 months, it is difficult to conclude, without other substantive evidence, that the suicidal behavior is caused by taking the medication based on medical and clinical evidence.  Therefore, it is difficult to conclude that there is a primary valid and direct cause (significant recent causal relationship) between the Appellant’s suicidal act and the consumption of the medication.  Moreover, the assertion that X did not think about taking his own life when he was alive and his suicide was caused by taking such medication could not be supported by any substantive evidence.  Therefore, this case satisfied the provision concerning the exemption of the insurer’s liability under Article 9, Paragraph 1, Subparagraph 1 of the insurance policy of the Accident Injury Insurance at Issue.  Therefore, it was unwarranted for the Appellant to claim insurance payment from the Appellee.