Disease Caused By Insect Bite In The Natural Course Of Events Not Covered Under 'Accident' Insurance

In Civil Appeal No 2614 of 2019, National Insurance Co. Ltd. vs Smt. Mousumi Bhattacharjee, the interesting issue was claim accidental death from mosquito bite.

The insured while working in Mozambique died of malaria and the insurer rejected the claim on the ground that the policy was for protection against personal accident and death from mosquito bite was not accidental death. However, the District, State and even the National Consumer Forum went against the insurer who finally appealed before the Supreme Court.

The problem was what constitutes an accident. The NCDRC also noted that website of the Insurance Company, an accident may include events like snake bite, frost bite and dog bite.

The Supreme Court looked into precedents set by both Indian as well as International courts while responding to similar issues and observed that in order to constitute an accident, the event must be in the nature of an occurrence which is unnatural, unforeseen or unexpected. The present case concerns death caused due to a disease being contracted in Mozambique which according to WHO is one of the most malaria prone areas in the world. Thus the court decided that while it can be argued that to be bitten by a mosquito and be imbued with a malarial parasite does involve an element of chance, that argument cannot be stretched to include such bites in a malaria prone zone. A motor car accident may, for instance, result in bodily injuries, the consequence of which is death or disability which may fall within the cover of a policy of accident insurance. Hence, 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.