Accident and health

Our longstanding expertise in Accident and Health business, combined with our medico-legal experience developed through our well-respected personal injury practice, means we offer an unrivalled service to insurers and reinsurers.

We deal with all classes of business, including:

• Personal Accident (including Keyman)
• Sports
• Travel
• Workers' Compensation
• Reinsurance (treaty and facultative)

Our expertise encompasses policy and proposal form drafting, coverage advice, investigations, analysis of medical records and instruction of medico-legal experts, arbitration/litigation, and instruction/monitoring of overseas lawyers, whether direct or reinsurance.

We also provide audit and inspection services for reinsurance, binding authority and coverholder business.

Our experience

• Advising on coverage – whether policy responded under accidental death in the case of suicide and, separately, alcohol abuse
• Investigating and advising on coverage – claim for PTD by a rugby player following injury to knee during a World Cup match; whether claim excluded as pre-existing condition
• Establishing whether a Premiership footballer's capacity to play was affected by injuries sustained in an incident during the relevant policy period, or from a subsequent incident outside the policy term
• Advising on coverage – a medical expenses claim where the policy provided for medical treatment or repatriation consequent upon sickness while outside country of domicile. Claim rejected on the basis that insured elected for treatment (not requiring repatriation) in country of domicile
• Investigating liability – in respect of a ski claim (with reference to the FIS conduct rules) and settlement negotiations with third party to limit exposure - common factual matrix – collision of skiers resulting in serious head injuries to insured and third party
• Investigating a claim for PTD made by an insured in India against a travel policy under the terms of his credit card agreement; considering jurisdictional issues and utilising RPC's TerraLex partner in India for advice on available defences
• Inspection - treaty book of business covering three years of account, per person and catastrophe layers in the US
• Drafting personal accident and illness policy for professional sportsmen
• Timothy Peter Prifti on behalf of Lloyd's Syndicates v Musini Sociedad Anonima De Seguros Y Reaseguros [2003] EWHC 2796 (Comm) Insurance - contract - conflict of laws - jurisdiction clause in slip agreement. The issue was whether the English courts had jurisdiction over the action brought by Prifti, who was seeking declarations on an avoidance claim and a pre-existing condition claim. RPC succeeded in securing English law and jurisdiction for our London market clients who reinsured a Spanish cedant
• Advising on coverage - whether a pneumothorax that occurred consequent on pre-existing lung tumour fell within scope of accidental injury
• Advising on coverage - aircraft personnel and scope of fleet cover