South-Western Legal Studies in Business

Carpal Tunnel Syndrome an Injury, Not Disease, for Purposes of Disability Insurance
Description Georgia high court held that under Georgia insurance law, a person who develops carpal tunnel syndrome as a result of repetitive motions, not as a result of a disease, has suffered an accidental injury, not a sickness, for purposes of disability insurance coverage.
Topic Insurance
Key Words Disability Insurance; Injury; Sickness; Coverage
C A S E   S U M M A R Y
Facts Hallum, a physician who specialized in obstetrics and gynecology for 30 years, had a disability insurance policy that provided greater coverage for disabilities arising from injuries than for disabilities caused by sickness. After Hallum developed carpal tunnel syndrome, which is caused by repetitive hand motion, he became unable to continue his medical practice. The insurer classified the problem as a sickness, not an injury. Hallum sued, contending that it was an injury. The federal court certified a question to the Georgia high court, asking if, under Georgia law, this disability would be regarded as a sickness or an injury.

"The policy defines injuries to mean 'accidental bodily injuries occurring while your policy is in force.' Sickness is defines as 'sickness or disease which is first manifested while your policy is in force.' The evidence demonstrates that Hallum does not have, and has not had, any of the diseases generally associated with carpal tunnel syndrome. Rather, the record shows that his condition was caused by thirty years of performing the hand motions required by his practice." Hence, he has suffered an injury. That is the unexpected result of an unforeseen or unexpected act that was involuntary or unintentional.

Citation Provident Life and Accident Insurance Co. v. Hallum, --- S.E.2d --- (2003 WL 169894, Sup. Ct., Ga., 2003)

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