Man paralyzed by herpes denied benefit: top court
Last Updated: Friday, December 18, 2009 | 10:48 AM ET
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Canada's top court has ruled that a man paralyzed by a sexually transmitted disease is not entitled to a disability payment from his health insurance company, saying the circumstances of his condition were outside the coverage of his policy.
The Supreme Court of Canada ruling overturns the B.C. Court of Appeal's upholding of an earlier trial judge's decision awarding a $200,000 benefit to the claimant.
Randolph Charles Gibbens contracted herpes simplex virus type-2 after having unprotected sex with three women in January and February 2003.
Gibbens went to his doctor complaining of headaches and muscle pain but the disease wasn't diagnosed. His doctor diagnosed a viral illness and prescribed symptomatic treatment.
Gibbens's health continued to deteriorate until Feb. 23, 2003, when he was left paraplegic. The type-2 herpes virus caused an inflammation of his spinal cord that caused paralysis from mid-abdomen down.
The accidental disease or dismemberment benefit provided by his union through Co-operators Life Insurance Co. kicked in on Feb. 1. Gibbens's condition wasn't diagnosed until after he was paralyzed.
The disease in question, transverse myelitis, was not covered in his policy. But a trial judge awarded Gibbens his benefit, saying the paraplegia was sustained "'directly and independently of all other causes from bodily injuries occasioned solely through external, violent and accidental means' within the meaning of the insurance policy."
In overturning the ruling, the Supreme Court said it was a stretch to consider the circumstances leading to Gibbens's condition an "accident" and said doing so would open the door for any sexually transmitted disease to be considered part of accidental coverage, whether or not the diseases were listed in a policy.
"Such a conclusion would stretch the boundaries of an accident policy beyond the snapping point and convert it into a comprehensive insurance policy for infectious diseases, contrary to the expressed intent of the parties and their reasonable expectations," the court said.
With files from The Canadian PressShare Tools
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