Court Ruling Opens Door for PTSD to Be a Covered ‘Bodily Injury’ When Accompanied by Physical Injury

The Pennsylvania Superior Court has issued a stunning reversal on a lower court ruling that favored Travelers Insurance Company and its assertion that PTSD should not be a covered bodily injury. The reversal may have many accident victims wondering whether PTSD could be considered a bodily injury in their cases as well.

According to court documents, the victim, Carol Evans, had been hit by a tractor-trailer while she was trying to change lanes. The force of the impact pushed Evan’s car toward a concrete barrier before she was able to regain control and pull over to the right side of the interstate. Immediately following the accident, Evans complained of head and neck pain but wanted to try and manage the symptoms on her own.

In the week following the accident, Evans began to feel increasingly dizzy and in pain, suffering from headaches, neck pain, and balance issues. She also began suffering from nightmares, flashbacks, and panic attacks. Doctors diagnosed her with a concussion, a closed head injury, vertigo, post-traumatic vestibuloneuronitis, and post-traumatic stress disorder. She eventually had to undergo physical therapy to treat balance issues. She was also treated by a psychiatrist to deal with emotional distress.

Travelers Insurance Company ended up paying Evans for the injuries that resulted from the accident, but it denied her PTSD claim. It paid for the initial treatment by the psychiatrist but refused to pay for future treatment. Travelers reasoned that PTSD did not constitute a bodily injury. Evans decided to take the company to court.

The trial court judge ruled in favor of the insurance company, citing Zerr v. Erie Insurance Exchange. The ruling in the Zerr case set a legal precedent and held that emotional distress cannot be considered bodily harm, even if it results in physical manifestations of symptoms. However, the circumstances of that case were different from Evan’s own case, and she argued that Zerr’s claim for coverage was based only on an emotional injury. There were no accompanying physical injuries, whereas in her case, it was an undisputed fact that she had suffered both physical injuries and emotional distress, including PTSD.

The three-judge panel considering Evan’s appeal of the ruling took into consideration the fact that Evans presented enough evidence to support her claim that the traumatic events of the car crash and subsequent injuries led to her PTSD. Their examination of the medical documentation led them to determine that there was evidence that her emotional trauma was tied to her physical injuries.

What does this mean for the future of claims against insurance companies following an accident? The ruling, in this case, could be laying the legal groundwork for courts to better determine when PTSD may be considered covered as a bodily injury. The medical documentation that so closely intertwined Evan’s physical injuries to her mental trauma and PTSD diagnosis was one of the most important factors in helping the court determine that PTSD was indeed to be considered a bodily injury in the context of this case.

 

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