Quek Kwee Kee Victoria (executrix of the estate of Quek Kiat Siong, deceased) and another v American International Assurance Co Ltd and another

• Jurisdiction: Singapore
• Judge: Judith Prakash J
• Judgment Date: 29 March 2016
• Neutral Citation: [2016] SGHC 47
• Plaintiff Counsel: Melanie Ho, Chang Man Phing and Tang Shangwei (WongPartnership LLP)
• Docket Number: Suit No 820 of 2014
• Date: 29 March 2016
• Hearing Date: 23 August 2015,13 August 2015,19 August 2015,24 August 2015,14 August 2015,18 August 2015,25 August 2015,20 August 2015,26 August 2015,11 November 2015,27 August 2015,22 August 2015
• Subject Matter: Accident insurance,Insurance
• Year: 2016
• Citation: [2016] SGHC 47
• Defendant Counsel: Lim Tong Chuan and Wee Tze Sing Joel (Tan Peng Chin LLC)
• Court: High Court (Singapore)
• Published date: 16 February 2017

Judith Prakash J: Introduction

On the morning of 4 August 2012, Mr Quek Kiat Siong, aged 50, was found lying on his bedroom floor in a non-responsive state. He was rushed to hospital but pronounced dead shortly after arriving there. The cause of his death was subsequently established as being “Multi-Organ Failure with Pulmonary Haemorrhage, due to Mixed Drug Intoxication”.

The plaintiffs in this action are the executors of the estate of Mr Quek Kiat Siong (“the deceased” or “Mr Quek”). At the time of his death, the deceased was insured under two personal accident insurance policies which had been issued originally by the first defendant. Subsequently, the second defendant took over the first defendant’s business and obligations under the policies. The plaintiffs sought recovery under the policies on the basis that the deceased’s death fell within the terms of the same. The defendants took the view that in the circumstances the policies were not engaged and rejected the claim for the insured sums. The plaintiffs started this action on 31 July 2014 to enforce recovery.

The main issue to be decided therefore is whether the deceased’s death was caused by a risk covered by the policies.

The policies

The first policy was issued in September 2001 and it is known as a “PA24 Hour Plan, Personal Accident Policy”. I shall refer to it as the “PA Policy”. The sum assured by the PA Policy is $200,000. The second policy was issued in November 2008 and it is known as an “AIA Platinum Protector, Personal Accident Policy”. I shall refer to it as the “Platinum Policy”. The sum assured by the Platinum Policy is $1m.

For present purposes, under Part I of the PA Policy, the defendants provide the assured with a “Loss of Life Accident Indemnity” in the following circumstance:

When Injury results in loss of life of the Assured within three hundred and sixty five (365) days after the date of the accident …

The term “Accident” is not defined but the term “Injury” is. By the PA Policy:

“Injury” shall mean bodily injury effected directly and independently of all other causes by accident.

Under Part 1 of Section 4 of the Platinum Policy, the defendants provide the assured with “Benefits” in the event of “Accidental Death” in the following circumstance:

When Injury results in loss of life of the Assured within three hundred and sixty five (365) days after the date of the Accident the Company will pay the Principal Sum for Accidental Death stated in the Policy Information Page.

The terms “Accident” and “Injury” are both defined, viz:

“Accident” shall mean an unforeseen and involuntary event which causes an Injury.

“Injury” shall mean bodily Injury sustained in an Accident and effected directly and independently of all other causes and therefore not due to illness or disease.

Both policies contain clauses providing for a death caused by suicide to be specifically excluded from coverage under the relevant policy.

The pleadings

In para 24 of the Statement of Claim, the plaintiffs noted that the cause of death had been attributed to multi-organ failure with pulmonary haemorrhage, due to mixed drug intoxication. Further, post-mortem, four different drugs with elevated levels were found in the deceased’s blood and the combined use of these drugs could lead to heart failure and death.

In para 27, the plaintiffs averred that the “mixed drug intoxication” was completely accidental and unintentional. The deceased had suffered injuries that were a likely result from drug interactions of his prescribed medications whose toxic serum levels may have been caused by drug–drug interactions. In particular, the deceased’s prescribed psychiatric medications were at the upper prescribing limit and could act synergistically to potentiate the drug levels recorded in the deceased’s toxicology report.

By para 28, the plaintiffs averred that the deceased had never displayed any sign of any suicidal tendency or ideation to his family members, friends or Dr Ang, his treating psychiatrist.

Only the second defendant filed a Defence to the action. The second defendant denied para 27 of the Statement of Claim and put the plaintiffs to strict proof thereof. The second defendant averred that the consumption of the drugs in respect of the type and/or dosage by the deceased on or about the night preceding his death was not accidental.

The second defendant made no admission to para 28 of the Statement of Claim and put the plaintiffs to strict proof of the same. By para 12 of the Defence, the second defendant averred that it was not liable to make any payment to the plaintiffs under the PA Policy and Platinum Policy for the following reasons given in respect of the respective policies: Under the PA Policy: the injuries that caused the death of the deceased were not caused by accident and, therefore, were not an event covered by the policy pursuant to section 2(j) of the Terms and Conditions therein; and/or the death of the deceased was caused by suicide and, therefore, by an event excluded under section 4(5) of the Terms and Conditions therein. Under the Platinum Policy: the injuries or death of the deceased was not an accident as the same was not caused by an involuntary event and, therefore, not by an event covered by the policy pursuant to section 2(16) of the Terms and Conditions therein; and/or the injuries that caused the death of the deceased were not sustained in an accident and, therefore, not by an event covered by the policy pursuant to section 2(17) of the Terms and Conditions therein; and/or the death of the deceased was caused by suicide and, therefore, by an event excluded under section 5(5) of the Terms and Conditions therein; and/or the death of the deceased was caused by “drug abuse or any other complications arising therefrom; or accidents caused by and whilst under the influence of drugs” an event excluded under section 5(11) of the Terms and Conditions therein.

From the pleadings, it is clear that the plaintiffs as the parties seeking to hold the second defendant to its obligations under the policies have the onus of establishing that the injuries resulting in the death of the deceased were caused by a peril insured under the policies, namely, an accident. The plaintiffs accept this and their case is that the deceased’s death was an accidental one resulting from the mixed drug intoxication but that such intoxication occurred after the deceased consumed the drugs prescribed to him in the quantities prescribed and that he did not consume extra amounts of the same.

Mr Quek’s story

First, I tell Mr Quek’s backstory. This will help in understanding the evidence and the submissions.

Mr Quek was one of the youngest children in a family of 16 siblings. Despite his junior position in the family hierarchy, Mr Quek played a leading role in the family business. The family business, established by Mr Quek’s late father, involves the manufacture and sale of popiah and is carried on in Joo Chiat Road. The premises at Joo Chiat Road (“Joo Chiat house”) have, for more than 50 years, served both as the business premises and residence of the Quek family.

Mr Quek’s parents recognised that he was street-smart, responsible and a savvy businessman. Thus, before the patriarch of the family died in August 2001, he appointed Mr Quek to take over and manage the family business. From that time until his death, Mr Quek ran the business and also managed the estate of his father which included no fewer than 21 real properties. In respect of the business, Mr Quek was assisted by many members of the family including his younger sister, Ms Quek Siew Kim (“Ms Siew Kim”). The first plaintiff, Ms Quek Kwee Kee Victoria, one of the executors of Mr Quek’s estate, is also one of his elder sisters.

Mr Quek never married. He lived for most of his life in the Joo Chiat house. The first plaintiff and Ms Siew Kim lived there with him.

The Joo Chiat house is a fairly old shop-house which is not in very good physical condition. For several years before his death, Mr Quek suffered from chronic back pain which was caused, initially, by his years of carrying heavy loads of flour in the course of his work. His back pain was worsened by recurrent falls in the house due to the slippery toilet floor and worn out staircase.

In July 2009, Mr Quek consulted Dr Yeo Sow Nam (“Dr Yeo”), a pain specialist, in connection with his chronic back pain. He informed Dr Yeo that he had suffered injuries to his spine from carrying very heavy loads and, as a result, he had recurrent severe spinal back pain and bilateral leg pain, numbness and left-sided neck pain and left arm pain and occasional numbness. His past history included depression, chronic heavy smoking, insomnia and hypercholesterolemia. At the time of his first consultation, his pain was severe (rated 10/10) despite his consumption of a number of pain medicines. Mr Quek complained that he was only able to sit for about 30 minutes at any one time due to his severe pain.

Between 2009 and 2012, Mr Quek suffered from multiple episodes of severe back pain which were usually preceded by falls. These injuries gave rise to other medical issues. As a result, Mr Quek had multiple admissions to hospital and was seen there by Dr Yeo and many other medical specialists including a psychiatrist and physiotherapists. Apart from the hospital admission, Dr Yeo saw Mr Quek fairly regularly as an out-patient.

According to Dr Yeo, Mr Quek’s complex chronic pain condition required ongoing maintenance of medication. He prescribed opioids and, in order to prevent Mr Quek from developing tolerance to the medicine, he rotated the use of various opioids. Mr Quek was treated with such medication from 2009 until his death. Each opioid was weaned down and taken off after a period of time before Mr Quek was switched to another for better pain relief. Mr Quek was able to...