An accident is a sudden, external event that the insured did not intend and that causes loss or injury.
This plain definition is only the first gate. Each policy then decides which accidental events qualify, and exclusions remove many event types from coverage.
Insurance mechanics
- The covered peril must be accidental, sudden, and causally related to the loss.
- Many contracts distinguish accident from illness progression or intentional behavior.
- Accident classes drive deductibles and cover periods in health, life, auto, and property policies.
Claims logic
Claims evaluation usually follows:
- Is the cause accidental and covered?
- Did the insured meet policy conditions?
- What is the measurable insured loss after deductibles?
Practical scenario
A person slips and injures their ankle on a wet surface. If the policy treats this as an accident and does not exclude the context, coverage applies; if policy terms exclude intoxication or intentional conduct, the same injury may be denied.