Augustine Paul JCA:

In this case the plaintiff (the appellant before us) brought an action against the defendant (the respondent before us) in the Sessions Court for the sum of RM122,000 with interest and costs arising from a personal accident insurance policy ( & the policy & ). The policy had been issued by the respondent to one Devia Nathan s/o Savarimuthu ( & the deceased & ) of whom the appellant is the legal representative. The policy guaranteed payment in the event of injury or death of the deceased arising from an accident except in cases where the exclusion clause applied. It was an agreed fact that the deceased died after attempting to put out a fire in his neighbour's house. The evidence showed that the cause of death was a heart attack suffered by the deceased. Upon a claim having been made under the policy by the beneficiary of the deceased the respondent repudiated the claim on the ground that the death was not caused by an accident.

The learned Sessions Court Judge was of the view that the exclusion clause did not apply in this case and thus allowed the appellant's claim. As he said in his judgment:

Di dalam kes ini, adalah fakta yang dipersetujui bahawa si mati meninggal dunia selepas cuba memadamkan satu kebakaran, membawa baldi air, di rumah jirannya. Dari keterangan SP1, terdapat calar-calar di bahu, muka dan badan si mati. Dari kecederaan tersebut, kemungkinan besar si mati telah terjatuh semasa membawa sebaldi air untuk cuba memadamkan kebakaran tersebut. Menurut SP1 lagi, tekanan fisikal itu bersama-sama dengan 'anxiety' dan kejatuhan boleh menyebabkan serangan jantung (triggered the heart attack). Saya berpendapat situasi ini termasuk dalam takrifan 'kemalangan'. Dan, bukan penyakit saluran darahnya yang menyebabkan kemalangan tersebut, malahan sebaliknya saya memutuskan klausa pengecualian polisi insuran tersebut tidak terpakai di dalam kes ini.

(English translation)

In this case, it is an agreed fact that the deceased died after attempting to put out a fire while carrying a bucket of water at his neighbour's house. From the evidence of PW1, there were scratches on the shoulder, face and body of the deceased. From the injuries, the deceased had probably fallen down while carrying the bucket of water in his attempt to put out the fire. According to PW1, physical tension together with anxiety and the fall could have triggered the heart attack. In my opinion, this situation falls within the definition of 'accident'. And it is not his blood vessel ailment which caused the accident. In fact on the contrary I find that the exclusion clause of the insurance policy is not applicable in this case.

The respondent appealed to the High Court. The learned High Court Judge ( & the learned judge & ), having said that the central issue in the appeal was whether the deceased's death was caused by an accident or resulted from a disease, then went on to say in his judgment:

To come within the policy it must be shown that the insured is injured by accident. The accident must be the proximate cause of the death. For example, where the assured by misadventure goes in front of a train and is run over (Lawrence v. Accidental Insurance Co Ltd [1881] 7 QBD 216); falls into a stream and is drowned (Reynolds v. Accidental Insurance Co [1870] 22 LT 820); slips on a step (Theobald v. Railway Passengers' Assurance Co [1854] 10 Exch 45); is thrown from a horse (Re Etherington and Lancashire and Yorkshire Accident Insurance Co [1909] 1 KB 591, CA); is suffocated by smoke from a burning house (Trew v. Railway Passengers' Assurance Co [1861] 6H & N839 at 844), the assured is entitled to recover under the policy, subject to any exception in the policy, by which liability in respect of the particular misadventure in question is excluded (see Personal Accident Insurance (I) in General (Vol 25) para 595 p 312). The exception may be so worded as to exclude disease, however caused, and then if the death is caused by an excepted dise