California Life and Health Insurance Practice Exam

Under a disability income insurance policy, which criteria must be met for "bodily injury" to be classified as accidental?

1. The cause must be accidental only

2. The result must be accidental only

3. The cause may be intentional, but the result must be accidental

4. The cause and result must be intentional

The correct answer is: The cause may be intentional, but the result must be accidental

To classify "bodily injury" as accidental under a disability income insurance policy, the primary criterion is that the result must be unintended or accidental, while the cause could potentially be intentional. This means that even if the action leading to the injury was deliberate (such as participating in a risky sport), the injury itself needs to be unforeseen and unplanned for it to qualify as accidental. The rationale behind this classification is grounded in the nature of accidental injuries. Insurance policies typically aim to provide coverage for unforeseen events that lead to injury or disability. If a person intentionally engages in an activity that is known to carry the risk of injury, that injury would not typically be classified as accidental, as they deliberately accepted the risk. Thus, acknowledging that the cause may be intentional allows for recognition of situations where an individual did not foresee they would sustain an injury, thereby meeting the definition of an accidental injury as outlined in disability insurance policies.