AMERICAN HOME ASSURANCE CO v WHITFELD [1997] NSWCA 18

AMERICAN HOME ASSURANCE CO v WHITFELD SUPREME COURT OF NEW SOUTH WALES COURT OF APPEAL

MASON P, MEAGHER and POWELL JJA 18 August 1997, 18 August 1997

[1997] NSWCA 18

Insurance Policy — construction — respondent injured in football game — appellant insurer of Aust Rugby Union — meaning of 'permanent disability' in policy — extent of permanent injury and effect on ability to undertake employment

Mason P The appellant, American Home Assurance Company, issued a personal accident benefits policy to the Australian Rugby Union and affiliated organisations, insuring, amongst others, all registered members of that Union. The central provision in the policy was a promise in consideration of the payment of the premium and subject to the conditions, special provisions and memoranda contained in the policy endorsed thereon or attached thereto, that:

"if during the policy period any of the events specified in the schedule shall happen to the insured person...we will pay the compensation specified in the schedule in the manner hereafter described."

The schedule nominated three different types of benefits, and this appeal concerns section A, "Capital Benefits". The schedule directs the reader to what is referred to as "Events | to 18". When one turns to the table referable to events 1 to 18, one finds reference to "PERSONAL ACCIDENT, Injury resulting in" - and then 18 different consequences enumerated. These consequences include death, a range of disablements and medical injuries, and one item, item 18, described as emergency ambulance transport. For each item there are three scales of benefit depending upon whether the insured person is a "Senior", a "Junior" or a "Schools" (player). The respondent in this case was a "Senior". The lump sum benefits referable to each of the 18 events differ, ranging from $250,000 for four of those events to $250 for event 18.