Tainan District Court ruled that Tai'an Property Insurance Company must pay NT$2 million in accidental death insurance benefits

The man surnamed Chen claimed that his father was a member of the Tainan City Retail Vendors Union. The union had purchased an accidental death insurance benefit of NT$2 million from Tai'an Insurance Company on his father's behalf. Chen's father fell down while climbing stairs at home in the early morning of New Year's Day in 2024 and suffered severe head injuries. He was sent to the hospital and died on January 8. It was an accidental death. However, Tai'an refused to pay the claim because he died of illness. The Tainan District Court investigated and determined that Chen’s father’s death was accidental, and ordered Tai’an Property Insurance Company to pay a compensation of NT$2 million to the deceased’s son.

Chen Nan said that his father's Tai'an Property & Casualty Group Insurance had a contract period from early August 2023 to early August 2024. His father fell at home at about 0 a.m. on New Year's Day in 2024, injured his head and fell into coma. At about 2 a.m. that day, his mother found out and called the fire department ambulance to send him to the hospital for emergency treatment and hospitalization. Unfortunately, he died of his injuries on January 8.

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Chen Nan said that the cause of his father's death was head trauma caused by a fall, followed by intracranial hemorrhage and pneumonia. It was an accidental death, and he applied for a claim from Tai'an Property Insurance in accordance with the insurance contract. However, Tai'an refused to pay compensation because Chen's father suffered from various diseases, his fall was caused by pneumonia, which caused physical weakness, and the cause of death was caused by disease and not an accident.

The Tainan District Court judge investigated Chen's father's medical records and the prosecutor's examination report and other evidence, and concluded that Chen's father's pulmonary complications had a continuous and reasonable medical connection with the severe head trauma, sustained coma, bed rest, and respirator treatment after the fall. It could be determined that there was a considerable causal relationship between his death and the head trauma he suffered from the fall. It was confirmed that the main proximate cause of Chen's father's death was indeed the subdural hematoma caused by the head trauma caused by the fall.

The judge said that based on the relevant medical records and the appraisal of Chengdu University Hospital, it was impossible to determine that the cause of Chen's father's cardiac arrest before arriving at the hospital was pneumonia, respiratory failure, progressive deterioration of heart disease and other diseases, and it was difficult to make a favorable determination for Tai'an Property Insurance. Since the main cause of Chen's father's death was subdural hemorrhage, which is an accidental injury as defined in the insurance law, Tai'an should pay an insurance premium of 2 million yuan plus interest to the beneficiary's son, Chen Nan, in accordance with the insurance contract; the case can also be appealed.