A ride-share driver who was spat on and verbally abused by a passenger has lost his bid for a payout under a personal accident policy, because he was not physically harmed in the incident.

The driver was diagnosed with an exacerbation of pre-existing but previously stable depression and post-traumatic stress disorder after the unprovoked assault.

His symptoms included heightened anxiety, fear, avoidant behaviour and sleep disturbance. The man’s doctor considered him to be “partially disabled” from February 28 to June 23 last year, reducing his ability to work. That October, the doctor found he had been unable to work since June.

But the driver’s claim under a group personal accident policy was rejected by insurer Chubb, which said its various disability covers and an assault benefit responded only to bodily injury.

“The insurer submits that the policy terms are clear and that its interpretation aligns with the Macquarie Dictionary definition of ‘bodily’ which is ‘of or relating to the body’,” the Australian Financial Complaints Authority says in a dispute ruling.

The claimant said the insurer’s policy interpretation was “unreasonably narrow”.

He cited Stedman’s Medical Dictionary and “other authoritative sources” in arguing bodily injury included “physical, neurological or psychiatric damage that results from an external event”. He said the external event was the assault, which involved physical contact – spitting. This triggered the psychological symptoms.

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The driver argued psychiatric injury was legally recognised as a compensable injury and said Chubb “interpreted the word bodily in an overly restrictive manner contrary to the protective nature of personal accident insurance and inconsistent with common interpretations of personal injury”.

He also argued the policy was ambiguous in “the absence of clear wording excluding psychiatric injury” and that “denying coverage solely based on injury type, when the result is total incapacity, is unreasonable and unfair”.

But an AFCA member has backed the insurer’s claim denial, saying the policy terms are “sufficiently clear”.

They say the authority’s usual approach is to ascertain a word’s ordinary meaning from the Macquarie Dictionary, which “defines ‘bodily’ as ‘of or relating to the body’. It relevantly defines ‘injury’ as ‘harm of any kind done or sustained’. Therefore, the ordinary and natural meaning of bodily injury is reasonably to be interpreted as ‘harm done or sustained to the body’.

“I do not accept that psychological or psychiatric injuries fall within that meaning.”

See the ruling here.