The Supreme Court on March 26, 2019, in the case of The Branch Manager National Insurance Co. Ltd. v. Smt. Mousumi Bhattacharjee & Ors., answered an interesting question as to whether a death caused due to malaria occasioned by a mosquito bite is insurable as a personal accident?
A Bench comprising of Justices D.Y. Chandrachud and Hemant Gupta answered it in negative and held that death caused due to malaria from mosquito bite cannot be insured as personal accident as the mosquito bit the insured person in the Republic of Mozambique.
The Bench was hearing an appeal filed by an Insurance Company against the judgment passed by the National Consumer Disputes Redressal Commission (NCDRC) which dismissed the plea of the Insurance Company. The District Forum and State Commission also dismissed the plea of the Insurance Company.
In this case, the insured person died of multiple organ failure after being diagnosed with encephalitis malaria contracted from a mosquito bite he sustained while working in Mozambique in 2012. The insurance policy, provided cover for deaths due to personal accidents and the company argued that a mosquito bite cannot be classified as a personal accident.
The Supreme Court after hearing the submissions of both the parties and after considering the provisions in the insurance policy held that in a place like Mozambique, death due to malaria from mosquito bite cannot be considered as death due to an accident.
The ruling of the court was primarily based on the World Health Organization’s World Malaria Report 2018, according to which Mozambique, with a population of 29.6 million people, accounts for 5% of cases of malaria globally. Further, one out of three people in Mozambique is afflicted with malaria.
The court said that “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 is that being bitten by a mosquito is an unforeseen eventuality and should be regarded as an accident. We do not agree with this submission. 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.”
Hence, the illness of encephalitis malaria through a mosquito bite in Mozambique 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. Accordingly, the court allowed the appeal of the company and set aside the judgment of the NCDRC.