The Branch Manager, National Insurance Co. Ltd. Vs. Mousumi Bhattacharjee and Ors. - (Supreme Court) (26 Mar 2019)

Illness of encephalitis malaria through a mosquito bite cannot be considered as an accident

MANU/SC/0408/2019

Consumer

The present appeal raises an interesting question of law. The Court is tasked with determining whether a death due to malaria occasioned by a mosquito bite in Mozambique, constituted a death due to accident. The appeal by the insurer has been filed against the judgment of the National Consumer Disputes Redressal Commission, which upheld a decision of the State Consumer Disputes Redressal Commission. The State Commission, in first appeal, had upheld the award of a claim under an insurance policy.

To be bitten by a mosquito and be imbued with malaria parasite does involve an element of chance. But the disease which is caused as a result of the insect bite in the natural course of events cannot be regarded as an accident. Particularly, when the disease is caused in an area which is malaria prone. It has been postulated that where a disease is caused or transmitted in the natural course of events, it would not be covered by the definition of an accident. However, in a given case or circumstance, the affliction or bodily condition may be regarded as an accident where its cause or course of transmission is unexpected and unforeseen.

In a policy of insurance which covers death due to accident, the peril insured against is an accident: an untoward happening or occurrence which is unforeseen and unexpected in the normal course of human events.

The death of the insured in the present case was caused by encephalitis malaria. The claim under the policy is founded on the hypothesis that there is an element of uncertainty about whether or when a person would be the victim of a mosquito bite which is a carrier of a vector-borne disease. The submission that being bitten by a mosquito is an unforeseen eventuality and should be regarded as an accident cannot be accepted.

The insured was based in Mozambique. According to the World Health Organization's World Malaria Report 2018, Mozambique, with a population of 29.6 million people, accounts for 5% of cases of malaria globally. It is also on record that, one out of three people in Mozambique is afflicted with malaria. In light of these statistics, the illness of encephalitis malaria through a mosquito bite cannot be considered as an accident. It was neither unexpected nor unforeseen. It was not a peril insured against in the policy of accident insurance. The appeal is allowed and the impugned judgment and order of the National Commission set aside.

Tags : INSURANCE POLICY ACCIDENT MOSQUITO BITE