Costly punch: insured can't claim legal costs relating to knockout blow

Report proposes 'self-funding' insurance model for export industries

A complainant who delivered a knockout punch to a partygoer failed to have his legal liabilities covered by his home and contents policy following an Australian Financial Complaints Authority (AFCA) ruling.

The claimant was involved in an incident at a party where he struck another visitor, referred to as ED, with a punch to the head. He was found guilty of recklessly causing serious damage and was sued for damages by ED.

The insured lodged a claim under the policy, which provides cover for legal liabilities relating to damages arising from accidents that result in bodily harm outside the home.

Youi denied the claim, saying that the incident did not satisfy the definition of an “accident” because it was “caused directly or indirectly by a deliberate act on the part of the complainant”.

The complainant noted that he was found not guilty of intentionally causing serious injury, saying he had “inadvertently made contact in self-defence” and that his actions were not “deliberate or intentional”.

AFCA acknowledged that the man had been found not guilty of causing an intentional act but determined that the insurer was entitled to its decision after considering statements from the police and witnesses.

A witness, referred to as JW, said that the complainant had gotten into a dispute with ED after a comment was made or perceived to have been made.

The witness said the complainant “walked towards ED yelling” while ED’s back was turned before striking him with a punch. JW said ED was “just standing there and didn’t look like he was aware that he was going to be hit”.

See also  'Another excellent quarter': Marsh McLennan Q3 sales up 8%

However, the complainant’s partner said ED had walked towards the claimant and “put his right arm to his shoulder like he was going to throw a punch”.

The partner said the complainant “looked like he was shielding himself from ED” and “was cowering away from a punch like he was covering his face” before he collided with ED with “some part of his arm”.

ED had no recollection of the event other than waking up at the hospital and could not remember if an argument occurred before the punch.

“On the information provided, on balance, I am satisfied that the complainant carried out a deliberate act in striking ED,” the ombudsman said.

“I am not satisfied that the event was accidental nor that the complainant’s activity was only reckless and not intentional.”

Click here for the ruling.