2007 General Meeting Assemblée générale 2007 Montréal, Québec

1. Canadian Institute of Actuaries L’Institut canadien des actuaires 2007 General Meeting Assemblée générale 2007 Montréal, Québec

2. 3 key AD&D court cases • The West Nile accident • The Sexually transmitted disease • The firefighter’s cancer All required the AD&D benefit to be paid

3. West Nile • Plasterer bitten by Mosquito in Ontario in 2002 • Contracted West Nile and became a paraplegic 3 weeks later • Court said: • It was an unforeseen, unexpected event that was caused by an external source – a mosquito – and falls within the ordinary definition of an accident. • The plasterer had no reasonable expectation that he would get West Nile virus from the activity in which he was engaged.

4. STD • 45 year old had unprotected sex with 3 women in 2003 • Contracted Herpes Simplex Virus type-2 and became a paraplegic a month or so later • Court said: • Did the insured expect to become a paraplegic as a result of having unprotected sex? No - so it was caused by accidental means. • Also cited West Nile! • Contract defined covered claims as: • Directly and independently of all other causes from bodily injuries occasioned solely through external, violent and accidental means.

5. Firefighter • Not strictly a claim against an insurer but a review of an arbitrators findings in a collective bargaining agreement. • Firefighter dies from renal cancer. • Court said: • death resulted from exposure to toxic substances at work and therefore was not caused solely from a natural cause and since his death from renal cancer was unexpected, then his death would have been accidental within the meaning of both the Martin and Wang decisions • Cited WSIB who have defined certain cancers as being work related for firefighters

6. So What? • Definition of “accidental means” is far beyond my assumption and understanding • Have we priced for this? • Is your contract wording strong enough? Courts may exclude part of wording e.g. STD case - violent.

7. What is an accident? • A man dies after being attacked by a bear while hiking? • A man is bitten by a dog and the wound turns gangrenous and has to be amputated? • A man is bitten by a rabid bat and dies from rabies? • A man is bitten by a mosquito and becomes paraplegic from West Nile?

8. What is an accident (2)? • A man dies in a commercial airline crash? • A man becomes paraplegic after an accident while riding a dirt bike? • A man loses his foot which became infected after he cuts it the first time he uses a chainsaw? • A man becomes paraplegic from a STD after having unprotected sex? • What if a woman becomes paraplegic from a STD after being raped?

9. What is an accident (3)? • A man dies of a heart attack caused by electrocution on the job? • A man dies from a stroke after a fall on the job? • A man dies from the effects of a single accidental exposure to radiation or a chemical at work? • A man dies of a cancer which a government agency has declared to be work related due to repeated exposure?

10. Do we have consensus? • Is an accident after all sometimes on a continuum that requires interpretation (shades of grey)? • If we don’t all agree, can we expect the courts to? • Where now on AD&D? Is it now more expensive than life coverage?