What is Accidental Means?
Accidental means is a condition for losses covered under an insurance policy that requires the loss to have been the result of an accident, rather than the result of a non-accident. As a condition, accidental means is designed to protect insurers from having to pay claims on events that were not accidents.
- "Accidental means" is a term used by insurance companies in their policies to decline paying out claims that result from non-accidents.
- Both the injury and the event have to be considered accidents in order for a claim to be covered under the definition of "accidental means."
- Insurance policies for bodily harm or death often include a provision that requires the death or injury to be caused by external, violent, and accidental means.
- Some states consider bodily injury policies that use the words “accidental means” to be different from those that mention “accidental injury."
Understanding Accidental Means
Insurers use the word “accident” to describe an event that happens unintentionally, and which is unexpected or unforeseen. Accidental means may involve acts that caused damage or harm, but which were themselves accidental. Both the injury and the event have to be considered accidents in order for a claim to be covered. Accidental means is a precise definition of “accident”, and is stricter than merely defining an accident as an unforeseen event.
Insurance policies for bodily harm or death often include a provision that requires the death or injury to be caused by external, violent, and accidental means. Accidental means takes into account both the cause and effect of the event, rather than just the result of the event.
For example, a construction worker with an accidental death and dismemberment policy who is injured would have to (1) not know that the risk of an activity would result in a loss, and (2) not know that any events leading up to that activity could result in a loss. If that worker were to use a machine that he knew had faulty wiring and was electrocuted, then he would not receive a benefit because he should have known that he could be injured because of the wiring problem.
Insurance Policy Language Reference to Accidental Means
A typical clause in an insurance policy that provides coverage for accidental death means might read, "Due proof that the death of the insured occurred as a result, directly and independently of all other causes, of bodily injuries effected solely through external, violent and accidental means..."
Whether a given event is covered depends on how the relevant jurisdiction construes "external, violent and accidental means." "Violent" and "external" commonly qualify the concept of "accidental means," and the courts are in widespread agreement on that definition.
Some states consider bodily injury policies that use the words “accidental means” to be different from those that mention “accidental injury." Court cases may hinge on whether the wording of the policy implies that the insurer has liability for the cause of the accident (death or injury from accidental means), or if the liability is dependent on the effect (injury or death).