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Synopsis

The Calcutta High Court ruled that a death caused by a mosquito bite is not an "accident" and so is not insurable under the 'accident' insurance.

The single judge bench of Justice Moushumi Bhattacharya dismissed the petition filed by the deceased’s mother seeking to quash the letter of the Insurance Company dated September 09, 2022, in which the company stated that they were unable to admit its liability on account of the cause of death of the petitioner’s son.

“Death is undoubtedly sad, however, the Insurance Policy and the precedents on the subject do not permit interpreting any disease caused by a mosquito bite as an accident,” the court added.

The deceased was serving in Indian Army. He died on December 20, 2021, in the Command Hospital, Kolkata. He was admitted to the hospital on November 16, 2021, after developing certain post-surgical complications arising from a knee injury and was diagnosed with end-stage renal disease while undergoing treatment at Command Hospital. He developed a high fever on December 12, 2021, and was diagnosed with Dengue NS1 Ag positive.

Her mother lodged a claim with United India Insurance Company after the death of her son. The company refused the claim by letter dated September 09, 2022, on the ground that the cause of death was “non-accidental” and was hence not covered under the policy.

After that, the deceased's mother challenged the refusal of the Insurance Company and prayed the high court to quash the letter.

The counsel representing the petitioner submitted that her claim fell within the Insurance Policy which was specifically made for defence personnel and it should have been distinguished from a policy made for a civilian. Further, it had been stated that the primary cause of death was entirely accidental as the petitioner’s son could not have foreseen that he would be afflicted with Dengue in the Command Hospital.

The counsel also referred to the meaning of “accident”.

The counsel for the Insurance Company relied on a document pertaining to the “Renewal of MOU between IA and SBI Bank” for a period of 3 years. Counsel highlighted clause 5 of the document which dealt with “accident insurance” to submit that the cause of death in the present case was not an accident as defined under the said clause.

Court after hearing both parties stated, “The Personal Accident Insurance Policy of the petitioner’s son must be seen in the factual context of the definition of accident that Death or Disability must result solely and directly from an accident caused by an external, violent and visible means. The causation must necessarily involve an accident that causes death. However, in the petitioner’s case, it is a Mosquito bite (accident) that causes dengue which leads to death.”

The court also reviewed the deceased's health history and discovered that the direct cause of death was Dengue hemorrhagic fever as well as end-stage renal failure.

Court concluded that the petitioner's son's death could not be attributed solely to Dengue or viewed as the sole and direct contributory factor resulting in the petitioner's son's death because the Medical Certificate revealed that the direct cause of death was both Dengue and End-stage renal disease IgA Nephropathy.

The court further reviewed the wording of the 'Accident Insurance Policy' and noted that it clearly covered snake bites, high-altitude illness, and high-altitude pulmonary edema, but it excluded other types of insect bites.

While referring to the data of the National Center for Vector Borne Diseases Control, the court further noted, “Specialised data in relation to Dengue shows that India features as one of the countries in the risk zone and Dengue is the 46th leading cause of death in the country".

Court also relied on the case of Branch Manager, National Insurance Company Limited vs. Mousumi Bhattacharjee.

Accordingly, the court dismissed the plea.

Case Title: Chitra Mukherjee vs. UOI & Ors