Supreme Court: When the bench of Dr. DY Chandrachud and Hemant Gupta, JJ was tasked with determining whether a death due to malaria occasioned by a mosquito bite in Mozambique, constituted a death due to accident, it held that the illness of encephalitis malaria through a mosquito bite cannot be considered as an accident.
When can insurance be claimed:
As the law of insurance has developed, there has been a nuanced understanding of the distinction between an accident and a disease which is contracted in the natural course of human events in determining whether a policy of accident insurance would cover a disease. 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. This understanding of what is an accident indicates that something which arises in the natural course of things is not an accident. This is the basis for holding that a disease may not fall for classification as an accident, when it is caused by a bodily infirmity or a condition.
“To be bitten by a mosquito and be imbued with a malarial 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 was argued 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 vectorborne disease. The submission is that being bitten by a mosquito is an unforeseen eventuality and should be regarded as an accident. The Court, however, did not agree with the said submission as 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.
Noticing that it is on record that one out of three people in Mozambique is afflicted with malaria, the Court said that since the death of the insured in the present case was caused by encephalitis malaria,
“It was neither unexpected nor unforeseen. It was not a peril insured against in the policy of accident insurance.”
[National Insurance Co. v. Mousumi Bhattacharjee, 2019 SCC OnLine SC 419, decided on 26.03.2019]