Justice

Covid is not an accident: widow must pay back 200,000 euros to insurance company

Covid is a disease. And the Court of Appeal also sentences the woman to EUR 24,000 in legal fees despite her victory at first instance

by Patrizia Maciocchi

4' min read

Translated by AI
Versione italiana

4' min read

Translated by AI
Versione italiana

The Covid is a disease, which is why it cannot be indemnified by a insurance policy that insures against accidents. Based on this assumption, the Court of Appeal of Bologna sentenced a widow to return to the target="_self" href="https://ntplusfisco.ilsole24ore.com/art/arbitro-assicurativo-tempi-stretti-ma-prima-reclamo-compagnia-AHjtag5C">insurance company 200,000 euros, which she had obtained after the first instance verdict, when the Court of Parma had fixed the compensation for the death of her husband, who died during the Coronavirus pandemic. The man, an employee of a car dealership, was covered by a life insurance policy "Persona sicura" that provided compensation for accidents.

The affair

Il verdetto di prima istanza favorevole alla donna era stato del tutto disatteso in appello. Per la Corte d’Appello bolognese, infatti, l’infezione da coronavirus non è un infortunio assicurabile. E i giudici territoriali hanno messo nero su bianco una sentenza in punta di diritto. «Le conclusioni del primo giudice sono giuridicamente errate in quanto basate su una definizione di “infortunio” impropria e non aderente al suo significato letterale, non potendo applicarsi al caso di specie l’articolo 42, comma II, del Dl n. 18/2020. Trattandosi di contratto di assicurazione contro gli infortuni di natura privata - scrivono i giudici di secondo grado - la ricostruzione del suo oggetto deve esser svolta secondo il contenuto del contratto stipulato tra le parti, mentre l’interpretazione del medesimo andrà fatta secondo i criteri ermeneutici dettati dagli articoli 1362 e seguenti del codice civile».

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Per la Corte d’Appello “ai sensi della polizza deve dunque considerarsi “infortunio” un evento traumatico e violento, dovuto ad una causa fortuita, violenta ed esterna, che produce, nell’immediato, delle lesioni corporali obiettivamente constatabili. Contrariamente a quanto affermato dal Tribunale, il contagio da 2019-CoV o Sars-Cov-2, con conseguente sviluppo della patologia Covid-19, non è qualificabile come causa fortuita, esterna violenta né è, quindi, sussumibile nel concetto di infortunio, mancando il traumatismo insito nel concetto di infortunio. Il contagio da parte dell’agente patogeno ed il conseguente sviluppo della patologia Covid-19 rientra, invece, nella definizione di “malattia” che in ambito assicurativo è definita negativamente come “tutto ciò che non è infortunio”. Nella polizza in oggetto, poi, manca qualsiasi estensione della garanzia alla malattia».

The lawyer's reaction

The conclusion was that, in addition to upholding the insurance company's arguments, the territorial court also condemned the lady to pay 24,000 euros in costs. For Francesca Barbuti, the widow's lawyer, this is perhaps the most "surprising aspect of the decision", almost a condemnation for reckless litigation, despite the victory at first instance. "The issue we dealt with," says lawyer Barbieri, "is new and complex in its interpretation, with contrasting jurisprudential orientations. It would have been fairer to offset the costs, as happens in particularly complex cases.

For Francesca Barbuti, then, the Bologna Court of Appeal turned a question of contractual interpretation into an abstract doctrinal dispute, without taking into account the will of the parties: 'In the case that concerns us, the policy contained a specific exclusion clause,' says Barbuti, 'accidents resulting from "biological or chemical contamination following acts of terrorism of any kind" were excluded. Now there is time to decide whether or not to appeal to the Court of Cassation.

The widow will have to compensate

However, the decision of the Court of Parma, favourable to the family supported by lawyer Francesca Barbuti, was completely overturned by the judges of the Court of Appeal of Bologna - Fiore, Rossi and Gaudioso - who upheld the reasons of the insurance company.

The woman, a mother of two minor children, had been proved right at first instance: the insurance company had been ordered to reimburse her for the death of her husband on 27 March 2020.

The policy in question, which was taken out years before the pandemic, did not mention infectious diseases of this type. Therefore, the dispute focused on a point of law: whether or not the Covid could be considered among the compensable risks.

According to the court, the Covid infection, however, cannot be classified as an 'accident' because 'violent is not so much the event that causes the infection as the effect that results from it'. Consequently, the viral infection does not fall within the definition of an accident in the contract.

The judges' interpretation

In addition to the restitution of the sum already collected, the woman will have to pay 24,000 euros in legal fees. The case, like others related to compensation for Covid deaths, represents a new issue for Italian jurisprudence, which is still divided on how to interpret these cases.

The Supreme Court, in recent judgments, has clarified that in matters of private insurance it is not the clinical definition of an illness that matters, but what the parties to the contract intended to regulate. In essence, it is possible for a contract to define an event as an illness or an accident according to the will of the signatories, regardless of the objective nature of the fact.

Following this principle, the Bologna judges concluded that whoever contracts an infectious disease 'falls ill, does not get injured'. This interpretation led to the final decision: the widow will have to repay the entire amount received, pluslegal costs. A case in which, in addition to the damage, there is also the mockery.

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