The death caused by mosquito bite cannot be termed as accident and so no insurance claim can be given under ‘Accident Insurance Policy,’ Calcutta High Court has ruled.
A mother, Chitra Mukherjee moved to the High Court after her son and Army man, Chayan Mukherjee, died in the Command Hospital. He was admitted to the hospital after developing certain post-surgical complications arising from a knee injury and was diagnosed with end stage renal disease while undergoing treatment there. Later, he developed high-grade fever with chills and was found to be suffering from Dengue. He succumbed to his illness days later. The mother approached the insurance company for a claim, but it was rejected by on the grounds that the cause of death was ‘non-accidental’ and hence not covered under the policy.
Going through all the facts presented and arguments submitted, a single judge bench of Justice Moushumi Bhattacharya observed that the definition of accidental death includes accidental injuries, but excludes illness. The consensus also tilts towards the exclusion of death by disease alone, not accompanied by an accident.
Further, the bench said that suffering a mosquito bite in the sanitised confines of a hospital may be an unwanted and unwarranted incident at best. It is not something that is fortuitous enough to startle the sufferer (the ‘bitten’) as being unexpected. After all, an accident is an event which startles a person when it takes place but does not startle one when it does not take place. “There is also a violence attached to accidents – a screech, a thud, usually destruction accompanied by high-level noise. Mosquitoes, on the other hand, are the silent, insidious enemies who go about their harmful business unnoticed,” the bench noted.
It highlighted that the IRDA (Insurance Regulatory and Development Authority) Guidelines on Standard Personal Accident Insurance Product defines an accident as “a sudden, unforeseen and involuntary event caused by external, visible and violent means”. The Group Personal Accident Insurance Policy of the United India Insurance Company Limited with the State Bank of India, subject of claim here, defines an accident with reference to a Personal Accident Insurance as : “If at any time during the currency of this policy the insured shall sustain any bodily injury resulting solely and directly from accident caused by external violent and visible means, then the company shall pay to the Insured or his legal personal representative (s) as the case may be the sum or sums.”
The bench said that the policy which covered the petitioner’s son in the present case intends to cover death and disablement subject to the death being caused solely and directly by and as a result of an accident which is caused by a violent and visible external tone. The coverage specifically includes snake bite and high-altitude ailment as well as high altitude pulmonary oedema-but excludes other forms of insect bites, added the bench
“The death of the petitioner’s son is undoubtedly sad and this court feels for the petitioner’s pain and anguish. However, the insurance policy and the precedents on the subject do not permit interpreting any disease caused by a mosquito bite as an accident. It is neither fortuitous nor unexpected and is entirely country/city-specific. The impugned refusal on the part of the insurance company to admit liability in the particular policy hence cannot be seen as arbitrary or unreasonable,” the bench concluded and dismissed the petition.