Legal Blog

Mosquito Bite Causing An Inury Deemed An Accident

Friday, October 19, 2007

Greg Neinstein was successful at the Ontario Court of Appeal in helping to expand the definition of accident for the purposes of entitlement to disability benefits.

In 2002, Mr. Kolbuc, a 52 year old plasterer, was one of the first reported cases to have been bitten by a mosquito which carried the West Nile virus. The virus rendered him a paraplegic and as a consequence he would never work again.

Mr. Kolbuc had an insurance policy which would provide payment if he was injured as a result of an accident. Mr. Kolbuc assumed that being infected with the West Nile Virus would qualify him under the policy. The Insurance Company refused to pay, stating the illness was due to natural causes, despite the fact there was no exclusions written into policy.

Mr. Neinstein challenged the insurers interpretation of the policy and denial of coverage. In January 2006, the trial judge ruled against Mr. Kolbuc and found that a mosquito bite is not an accident but caused by natural causes.

Greg Neinstein and Chris Paliare appealed the trial judge?s decision.
In Kolbuc v. ACE INA Insurance 2007 ONCA 364, the Ontario Court of Appeal determined that Mr. Kolbuc's illness was a result of an accident and ruled he was entitled to the benefits under the policy.

The Appeal Court stated becoming a paraplegic was an unforeseen, unexpected event that was caused by an external source - a mosquito - and falls within the ordinary definition of an accident. The cause of the illness was an accidental event. The appeal Court also ruled that an accident can cause a disease.

The decision is significant in that it expands the definition and coverage available under Accidental Death and Dismemberment polices and ensures that if an Insurance company wants to exclude coverage, they better write it into the policy.