Death by mosquito bite is an accidental death, says National Commission

How can you define accident when it comes to accident claim before the insurance company? Insurance company neither goes by the general meaning nor consults dictionary for the same They have their own definition given in terms and conditions/ rules and decide the fate of the claimant .Insurance policy specify claim tenable under the following circumstances-

1.         Death due to accident.

2.         Accidental loss of two limbs, two eyes or one limb and one eye.

3.         Permanent total disablement from injuries other than that named above.

What exactly could be called accident is not defined anywhere.

While consulting various dictionaries we find

·         As per Oxford Advanced Learner’s Dictionary (New 8th Edition).Something that happens unexpectedly and is not planned in advance,

·         Black’s Law Dictionary (Ninth Edition)defines -An unforeseen and injurious occurrence due to mistake, negligence, neglect or misconduct; an unanticipated and untoward event that cause harm,

·         Also ,‘accident’ is also defined as incident, an unforeseen injurious occurrence, something that does not come in the usual course of event or that cannot be reasonably anticipated

In a matter between National Insurance Co. Ltd & Mousumi Bhattacharjee & Ors in  Revision Petition No. 1270 Of 2016 from Order Dated 2.2.2016 Of West Bengal State Consumer Disputes Redressal Commission, Kolkata Decided On 12.5.2016 (IV (2016) CPJ 438 (NC)) National Insurance company rejected the claim against policy “Bank of Baroda Home Loan Suraksha Bima”. with a plea that malaria due to mosquito bite is a disease and not an accident Shri Debasish Bhattacharjee took a housing loan from Bank of Baroda for purchase of a house. He also obtained an insurance policy namely “Bank of Baroda Home Loan Suraksha Bima As per the policy, in case of death of the insured due to accident,the sum insured was payable by the insurance company.  Shri Debasish Bhattacharjee died on 22.1.2012 with malaria and his wife submitted claim to liquidate the housing loan taken by her husband which was rejected District Forum allowed the complaint. State Commission also confirmed the order of District Forum . Now matter came before the National Commission in Revision as above . The main question before the Commission to decide was as to  whether the death due to malaria on account of mosquito bite can be said to be a death due to accident or not Mr. Justice V.K Jain, Presiding Member after hearing the arguments from both the parties and referring to judgments decided earlier on the issue came to the conclusion that mosquito bite cannot be said to be a disease from any angle .Firstly, it was not a disease occurred within the body ,it was an external attack on the body which developed injurious and finally fatal .It was sudden and unexpected .Further it was an untoward incident .it happened unanticipated and is not planned in advance. It was also untoward event unexpectedly happened .

Justice V K Jain also referred to a Consumer Complaint No. 223 of 2006, Shri Matber Singh v. Oriental Insurance Co. Ltd., IV (2014) CPJ 126 (NC) decided on 5.9.2014 and noted that an accident may include events like snake bite, frost bite and dog bite. Hence, it was held that malaria due to mosquito bite is not  a disease and very well could be termed as  an accident

 

 

           

 

 

 

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