In the case of Branch Manager, National Insurance Co. Ltd vs. Mousumi Bhattacharjee decided on 26th March 2019, a very interesting question of law was determined by the Supreme Court of India. The Supreme Court was tasked to determine whether a death due to malaria occasioned by a mosquito bite in Mozambique, constituted a death due to accident and whether it constituted an insurable peril.
In the present case the legal heirs were seeking insurance claims under a non-life policy secured against a home loan. The Insured (deceased) took up a job as a manager of a tea factory at Cha-De-Magoma, Republic of Mozambique, South Africa. During his stay in Mozambique, the insured was diagnosed with encephalitis malaria and consequently died on 22 November 2012.
The heirs of the Insured sought insurance claim from the Insurance Company pleading that his sudden death due to mosquito bite in a foreign land was an accident. The West Bengal State Consumer Disputes Redressal Commission (“State Commission”) concurred with the Petitioners and held that death caused due to mosquito bite was indeed an accident and thus allowed the insurance claim of the Petitioners.
Aggrieved by the order of the State Commission, the Insurance Company preferred an appeal in the National Consumer Disputes Redressal Commission (“NCDRC”). The NCDRC upheld the order of the State Commission. Aggrieved by the order of the NCDRC, the Insurance Company preferred an appeal before the Supreme Court (“Appeal”).
In the said Appeal, the Supreme Court held that where a disease is caused or transmitted by insect bite/virus in the natural course of events, it would not be covered by the definition of an accident. Death due to malaria from mosquito bite cannot be considered as death due to an accident, in a place like Mozambique which is a malaria prone region.
The Apex Court was of the opinion that a disease may not fall for classification as an accident, when it is caused by a bodily infirmity or a condition. A person who suffers from flu or a viral fever cannot plead that it is an accident. Of course, there is an element of chance or probability in contracting any illness. Even when viral disease has proliferated in an area, every individual may not suffer from it.
Thus, the Supreme Court held that as a direct consequence of an accident such as a motor car accident, an individual may suffer bodily injuries, and/or succumb to his injuries, etc, in which case the death or disability may fall within the cover of a policy of accident insurance. But a bodily infirmity or death caused by a disease may not qualify as an accident, as it is neither unexpected nor unforeseen, and therefore, it is not a peril insured against in the policy of accident insurance.
The Indian Lawyer