Suicide caused by incapacity of discernment under accident insurance

ATA/642/1997Tribunal de Justiça / Câmara Administrativa23 de out. de 1997Granted

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Extraído pela Omnilex

Resumo Omnilex

The case concerns whether accident insurance benefits are excluded when an insured person attempts suicide. The court held that where the insured person, at the time of the act, was totally incapable of reasonable action because of a mental illness, the suicide attempt does not bar coverage. The insured person therefore retained entitlement to benefits under the LAA.

Sumário Omnilex

Art. 37 para. 1 LAA; suicide attempt and incapacity of discernment: accident insurance benefits remain due where, at the time of the act, the insured person was totally incapable of acting reasonably because of a mental illness. The decisive criterion is not the external form of the act, but the absence of a responsible volitional and cognitive control due to a severe psychical disorder. In such constellations, the self-harm act does not justify denial of the insured claim (consid. not specified).

Texto completo

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; NOTION; SUICIDE; AFFECTION PSYCHIQUE; EXPERTISE; PRESTATION D'ASSURANCE(EN GENERAL); COUVERTURE; DEPRESSION; CAPACITE DE DISCERNEMENT; ASSU

Normes

LAA.37 al.1

Résumé

Un assuré qui, au moment de sa tentative de suicide, était totalement incapable d'agir raisonnablement en raison d'une maladie mentale (psychose maniaco-dépressive) a droit aux prestations prévues par la LAA en cas d'accident.

Palavras-chave

social insuranceaccident insurancesuicidemental illnessincapacity of discernmentdepressionpsychosiscoverage

Extraído pela Omnilex

Questão jurídica principal

Whether a suicide attempt committed in a state of total incapacity of discernment falls within accident insurance coverage under Art. 37 para. 1 LAA.

Decisão extraída

Yes. If the insured person was totally incapable of acting reasonably because of mental illness at the time of the suicide attempt, accident insurance benefits remain payable.

Fundamentação extraída

The decisive point is the insured person's mental capacity at the time of the act. A suicide attempt carried out without any reasonable control due to a severe psychical disorder is not treated as a disqualifying intentional self-harm event for purposes of denying benefits.

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