Branch Manager National Insurance Co. Ltd. vs Mousumi Bhattacharjee

Judicial Analysis Court Copy Headnote Facts Arguments Court observation

2019 Supreme(SC) 356

D.Y.CHANDRACHUD, HEMANT GUPTA
Branch Manager National Insurance Co. Ltd. – Appellant
Versus
Mousumi Bhattacharjee – Respondent

Advocates Appeared:
For the Appellant :Ms. Manjeet Chawla, Advocate.
For the Respondent:Mr. Binay Kumar Das, Advocate, Mr. Arun Aggarwal, Advocate, Mr. Devesh Dubey, Advocate and Ms. Anshika Agarwal, Advocate.

Judgement Key Points

What is the meaning of "accident" in a policy covering death due to accident, particularly in the context of death caused by malaria transmitted by a mosquito bite abroad? What are the criteria for classifying death caused by disease (e.g., encephalitis malaria) as an accident under an accident insurance policy? What is the remedy or outcome when an insurer disputes a claim under an accident policy for death due to a vector-borne disease contracted abroad?

Key Points: - (!) - (!) - (!)

What is the meaning of "accident" in a policy covering death due to accident, particularly in the context of death caused by malaria transmitted by a mosquito bite abroad?

What are the criteria for classifying death caused by disease (e.g., encephalitis malaria) as an accident under an accident insurance policy?

What is the remedy or outcome when an insurer disputes a claim under an accident policy for death due to a vector-borne disease contracted abroad?

JUDGMENT :

Dhananjaya Y. Chandrachud, J.

The present appeal raises an interesting question of law. The Court is tasked with determining whether a death due to malaria occasioned by a mosquito bite in Mozambique, constituted a death due to accident. The appeal by the insurer has been filed against the judgment of the National Consumer Disputes Redressal Commission ["National Commission"], which upheld a decision of the State Consumer Disputes Redressal Commission ["State Commission"]. The State Commission, in first appeal, had upheld the award of a claim under an insurance policy.

2. Debashis Bhattacharjee, the spouse of the first respondent and the father of the second respondent applied for a housing loan for an amount of Rs. 13.15 lacs from the Bank of Baroda on 16 June 2011. The loan was sanctioned and was repayable in 113 monthly installments, each of Rs. 19,105/-. Incidental to the loan, he availed of the facility of an insurance scheme called "National Insurance Home Loan Suraksha Bima". On 25 August 2011, a policy was issued to cover the loan amount of Rs. 13.15 lacs with a

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2019 Supreme(SC) 356

D.Y.CHANDRACHUD, HEMANT GUPTABranch Manager National Insurance Co. Ltd. – AppellantVersusMousumi Bhattacharjee – Respondent

What is the meaning of "accident" in a policy covering death due to accident, particularly in the context of death caused by malaria transmitted by a mosquito bite abroad?

What are the criteria for classifying death caused by disease (e.g., encephalitis malaria) as an accident under an accident insurance policy?

What is the remedy or outcome when an insurer disputes a claim under an accident policy for death due to a vector-borne disease contracted abroad?

Cases Referred (4)

D.Y.CHANDRACHUD, HEMANT GUPTA
Branch Manager National Insurance Co. Ltd. – Appellant
Versus
Mousumi Bhattacharjee – Respondent