Holding

The insurer is not liable because the death was not caused by an external violent accident and the claim was barred by undue delay.

Summary

The National Insurance Company Ltd. (appellant) entered into a Memorandum of Understanding with the Chief Electoral Officer of Bihar (respondent No.1) to provide group insurance for election workers in 2000. A constable died of sun stroke while on election duty, and his wife (respondent No.2) filed a claim for Rs.10 lakh under the policy only in 2008, more than seven years after the death. The High Court Division Bench had held the insurer liable, but the Supreme Court examined two key issues: the untimeliness of the claim and whether death due to sun stroke fell within the policy’s "scope of cover" which required death to arise "solely and directly" from an accident caused by external violent means. The Court held that the claim was barred by delay and that the cause of death did not meet the policy’s strict wording, so the insurer was not liable. The amount already paid by the Chief Electoral Officer to the claimant remains with her, and no recovery is permitted. Consequently, the appeal was allowed and the Division Bench judgment set aside.

Issues considered

The claim was filed beyond the reasonable time prescribed by the MoU; whether such delay bars the claim.
Whether death due to sun stroke qualifies as an "accident caused by external violent and any other visible means" within the policy’s scope of cover.
Whether the insurer is liable under the MoU and the agency principle under Section 182 of the Indian Contract Act.
The requirement of strict construction of insurance contract terms.

Legislation cited

Indian Contract Act, 1872s. 182

Subjects

insurance contractscope of coverdelay in claimstrict constructionagency principleelection dutysun strokeMoUproximate causeliability

Judgment

312 [2023]
SUPREME COURT 2 S.C.R. 312
REPORTS [2023] 2 S.C.R.

A NATIONAL INSURANCE COMPANY LTD.
v.
THE CHIEF ELECTORAL OFFICER & ORS.
(Civil Appeal No.4769 of 2022)
B FEBRUARY 08, 2023
[SANJAY KISHAN KAUL AND ABHAY S. OKA, JJ.]
Insurance – MOU entered into between Appellant-Insurance
company and Respondent No.1 to provide insurance cover to the
persons deployed for election related work for Bihar Legislative
C
Assembly Elections in 2000 – Respondent No.2’s husband, a
Constable died due to sun stroke while performing election duty –
Respondent No.2 sought compensation in 2008 – Respondent No.1
acknowledged the eligibility for payment, Single Judge assigned
the liability to pay the amount on the Respondent No.1 and the DM
D – Appeal filed by Respondent No.1, Division Bench fastened the
liability on the appellant – Held: Respondent No.2’s claim was
beyond reasonable time period – It was negligence of Respondent
No.1 in lodging the claim – If it was not admissible then there was
no reason to forward the claim to the Appellant – Further,
considering the Specific clause in the MoU governing the insurance
E
policy providing for payment of compensation in the event of death,
even in the event of a death, it is only in the scenario where it is
solely and directly from an accident caused by external violence –
However, the death of Respondent No.2’s husband was by sun stroke
– There was no semblance of any violence being the cause of death
F – A proximate causal relationship between the accident and the
body injury is a necessity – The cause arising from a sun stroke
cannot be included within the parameters of the ‘Scope of Cover’
in the insurance policy defining when such insurance amount would
become payable – Thus, Appellant is not liable – Impugned judgment
of the Division Bench set aside – However, the amount already stands
G
paid by Respondent No.1 to Respondent No.2 in pursuance of the
judgment of the Single Judge – It would not be appropriate to permit
Respondent No.1 to recover any amount from Respondent No.2 and
that aspect now stands closed.

H
312
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 313
ELECTORAL OFFICER & ORS.

Insurance – Insurance contracts – Held: Words used in a A
contract of insurance must be given paramount importance and it
is not open for the Court to add, delete or substitute any words.
Insurance – Law governing insurance contracts – Discussed.
Insurance – Insurance claims – Distinction between
“accidental means” and “accidental result” – Discussed. B

Allowing the appeal, the Court
HELD: 1.1 On consideration of the rival contentions, there
are two aspects which needs to be flagged: firstly, the
consequences of delay in claiming the amount from the Appellant C
insurance company; secondly, whether at all the insurance policy
covered the scenario of the death of the constable. On the first
aspect, the admitted position is that Respondent No.2 never
raised a claim even on the Chief Electoral Officer seeking an
entitlement of the claim till the letter dated 21.11.2008 after seven
and a half years. Thus, by any standards this claim was beyond D
any reasonable time period. Even if the wife had not claimed and
the Appellant insurance company were of the view, that the case
was covered by the policy, then it was the bounden duty of
Respondent No. 1 to have lodged that claim. It cannot countenance
the submission that while on one hand the claim made by the wife E
was initially rejected, subsequently, it is re-examined, almost as
if making it a pre-condition to fasten the liability on the Appellant
insurance company. The conditions of the MoU required the claim
to be made immediately on the occurrence. It appears that in
their own wisdom Respondent No.1 never thought that it was a
case for which claim should be lodged with the Appellant F
insurance company. Thus, whether the claim was admissible under
the insurance policy or not, the conduct of Respondent No.1 would
not entitle them to fasten the liability on the Appellant and would
have to be borne by them if they are of the view that such an
amount ought to have been made. It would be negligence of G
Respondent No.1 in lodging the claim. If it was not admissible
then there is no reason to forward the claim to the Appellant.
Respondent No.1 has been actually playing ducks and drakes
with this issue for reasons best know to them. [Para 21-24][321-
D-H; 322-B-D]
H
314 SUPREME COURT REPORTS [2023] 2 S.C.R.

A 1.2 Now turning to the specific clause in the MoU, which
would govern the insurance policy providing for payment of
compensation in the event of death (only) resulting “solely and
directly” from the accident caused by external violent and any
other visible means. On a plain reading itself, leave aside the
question of strict interpretation of the clauses, it is quite apparent
B
that the admissibility of the claim is in the event of death. The
second part of the same sentence begins with “only”. Thus, even
in the event of a death, it is only in the scenario where the
consequent situation arises, i.e., it has to be solely and directly
from an accident caused by external violence. Here the death is
C by sun stroke. There was no semblance of any violence being
the cause of death. The last aspect which reads as “any other
visible means” would be an expression to be read in the context
of ejusdem generis with the external violent death and cannot be
read in isolation itself. [Para 31][323-E-G; 324-A]
D 1.3 The cause arising from a sun stroke cannot be included
within the parameters of the ‘Scope of Cover’ in the insurance
policy defining when such insurance amount would become
payable. Thus, on the second account also, the Appellant
insurance company is not liable. [Paras 34 and 35][324-F-G]
E Alka Shukla v. Life Insurance Corporation of India
(2019) 6 SCC 64 : [2019] 6 SCR 762 – relied on.
1.4 The impugned judgment of the Division Bench of the
High Court is clearly unsustainable and is set aside. In fact, the
order passed by the Single Judge was predicated on the own
F admission of Respondent No.1, which is now sought to be resiled
from by giving a slightly different interpretation but then if the
claim was not admissible, there was no reason for Respondent
No.1 to forward the claim to the Appellant insurance company
merely because it was made and with the objective of somehow
benefiting Respondent No.2 at the cost of the Appellant. That
G being the position, this Court is quite cognizant of the fact that
the amount already stands paid by Respondent No.1 to
Respondent No.2 wife in pursuance of the judgment of the learned
Single Judge. De hors the complexity of any legal issue,
Respondent No.2 having enjoyed the benefit for so many years,
H
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 315
ELECTORAL OFFICER & ORS.

the stand as taken by Respondent No.1 qua the liability to pay A
Respondent No.2, it would not be appropriate to permit
Respondent No.1 to recover any amount from Respondent No.2
and that aspect should now stand closed. [Para 36][324-G-H; 325-
A-C]
Suraj Mal Ram Niwas Oil Mills (P) Ltd. vs. United India B
Insurance Co. Ltd. 2010 SCC OnLine SC 1148; Export
Credit Guarantee Corporation of India Limited vs. Garg
Sons International (2014) 1 SCC 686 : [2013] 1 SCR
336; Vikram Greentech India Ltd. v. New India
Assurance Co. Ltd. (2009) 5 SCC 599 : [2009] 5 SCR
437 – relied on. C

Delhi Electric Supply Undertaking v. Basanti Devi &
Anr. (1999) 8 SCC 229 : [1999] 3 Suppl. SCR 219;
Oriental Insurance Co. Ltd. v. Sony Cheriyan (1999) 6
SCC 451 : [1999] 1 Suppl. SCR 622; Polymat India
(P) Lid. v. National Insurance Co. Ltd. (2005) 9 SCC D
174 : [2004] 6 Suppl. SCR 535; Sumitomo Heavy
Industries Ltd. v. ONGC Ltd. (2010) 11 SCC 296 : [2010]
9 SCR 176; RashtriyaIspat Nigam Lid. v. Dewan Chand
Ram Saran (2012) 5 SCC 599; Lilawanti Devi v. The
State of Bihar & Ors. 1998 (2) PLJR 692; Kamlawati E
Devi v. The State of Bihar & Ors. (2002) 3 PLJR 450 –
referred to.
Justice K Kannan, Principles of Insurance Law Chapter
3 (Volume 1, 10th ed. 2017, pg. 31); Colinvaux’s Law
of Insurance (11th Edn.) discusses the effect and the F
impact of the expressions “violent, external and visible
– referred to.
Case Law Reference
[1999] 3 Suppl. SCR 219 referred to Para 11
G
[2013] 1 SCR 336 relied on Para 28
[2009] 5 SCR 437 relied on Para 29
[1999] 1 Suppl. SCR 622 referred to Para 30
[2004] 6 Suppl. SCR 535 referred to Para 30
H
316 SUPREME COURT REPORTS [2023] 2 S.C.R.

A [2010] 9 SCR 176 referred to Para 30
(2012) 5 SCC 599 referred to Para 30
[2019] 6 SCR 762 referred to Para 32
CIVIL APPELLATE JURISDICTION : Civil Appeal No.4769
B of 2022.
From the Judgment and Order dated 03.10.2017 of the High Court
of Judicature at Patna in LPA No.1049 of 2011.
Ms. Shantha Devi Raman, Garvesh Kabra, Arihant Jain, Advs.
for the Appellant.
C
Amit Sharma, Dipesh Sinha, Ms. Pallavi Barua, Advs. for the
Respondents.
The Judgment of the Court was delivered by
SANJAY KISHAN KAUL, J.
D 1. The non-application of the general strict liability principle, in
case of an insurance policy, is sought to be questioned, where an expanded
meaning has been given to the relevant term of the insurance policy in
order to grant insurance claim, now assailed before us by the insurance
company, the Appellant herein, in view of the order dated 03.10.2017
E passed by the Division Bench of Patna High Court in favour of
Respondent No. 1 herein. The original claim was made by a writ petition
filed by the prospective beneficiary i.e. Respondent No.2 herein, but
while granting the benefits to the beneficiary, a liability was placed on
Respondent no.1 and not on the insurance company, which aspect was
reversed by the Division Bench vide its judgment dated 03.10.2017
F fastening the liability on the insurance company.
Facts:
2. The Appellant, insurance company, and Respondent No.1, the
Chief Electoral Officer, Bihar, Patna, entered into a Memorandum of
G Understanding (hereinafter referred to as ‘MoU’) on 09.02.2000 to
provide insurance cover to the persons deployed for election related
work for Bihar Legislative Assembly Elections in the year 2000. The
relevant Clause in question of the MoU is Clause 3, which reads as
under:

H
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 317
ELECTORAL OFFICER & ORS. [SANJAY KISHAN KAUL, J.]

“Scope of Cover A
The insurance is intended to provide for the payment of
compensation in the event of death only resulting solely and directly
from accident caused by external violent and any other visible
means.”
On the MoU being executed, the State Government opted for a B
Group Insurance Scheme vide letter dated 10.02.2000 to cover its
premium paying employees, who were appointed for election related
activities. It appears that keeping in mind the period of the by-polls, the
duration of the insurance scheme was extended from 24.05.2000 to
23.06.2000 by way of a supplementary policy. The incident, we are C
concerned with, was during these by-poll elections.
3. The husband of Respondent No.2, late Deval Ravidas,
Constable, Shivhar District Force, was a member of the Static Armed
Force, posted at Booth no.67, Primary School, Mathura Sultanpur, Police
Station Bidupur, District Vaishali, who died due to a sun stroke/heat stroke D
while performing election duty for the Bihar Legislative Assembly. As
stated, this was during the extended period of the insurance policy. It
appears that the matter rested at that for a fairly long time and it is only
in the year 2008 that Respondent No.2, wife of the deceased Constable
Deval, sought to raise the issue of compensation vide her letter dated
21.11.2008. E

4. The Assistant Election Officer, Bihar-cum-Under Secretary to
the Government, vide letter dated 20.11.2009 addressed to the Under
Secretary to the Lokayukta, Patna, Bihar, noted that the death of the
deceased Constable had occurred on account of heat stroke on
26.05.2000 during election duty and had not occurred on account of any F
external violent activity/accident. Thus, compensation to Respondent No.2
could not be found admissible for payment.
5. Respondent No.2 wife filed a Writ Petition, being CWJC
No.1781/2011, before the High Court of Judicature at Patna for quashing
the aforementioned letter dated 20.11.2009 and sought payment of G
compensation amount of Rs.10 lakhs as per the insurance policy since
her husband had died while performing election duty. Apparently, on
account of some directions of the learned Single Judge, the District
Election Officer placed a notice of claim dated 24.04.2011 to the Appellant
H
318 SUPREME COURT REPORTS [2023] 2 S.C.R.

A insurance company regarding the claim for insurance. This was,
however, not accepted.
6. The learned Single Judge in the Writ Petition, CWJC No.1781/
2011, decided not to go into the issue whether the accidental death was
in terms of the policy because the Chief Electoral Officer in a
B supplementary counter affidavit had already acknowledged the eligibility
for payment to the wife of the deceased police official. The Court, relying
on the judgment in Lilawanti Devi v. The State of Bihar & Ors1, opined
that after the expiry of a given policy, no direction could be given for
payment of insurance amount. The claim was required to be lodged
within the duration of the policy, i.e., 24.05.2000 to 23.06.2000. Thus,
C the Court opined that the primary responsibility to raise the claim under
the policy was with the officials of the State Government and that they
did not raise the claim within the duration of the policy and permitted the
policy to lapse. Therefore, the liability to pay the amount to the deceased
wife was assigned to the Chief Electoral Officer and the District
D Magistrate, Vaishali.
7. The Chief Electoral Officer, preferred an appeal before the
Division Bench of the High Court against the order dated 17.05.2011,
which is the subject matter of the impugned judgment dated 03.10.2017.
The controversy debated before the Division Bench:
E
8. In LPA No.1049/2011 in so far as the insurance company is
concerned, it washed its hands of the liability relying on the judgment in
Lilawanti Devi2 case. Thus, primarily, the defence was raised on the
absence of any claim being lodged in time, though the death of the Police
Constable during the election period of by-poll was not disputed.
F
9. The appeal filed by the Chief Electoral Officer was premised
on the plea to burden the liability to pay the insurance amount on the
Appellant insurance company, as the insurance policy was stated to be
subsisting on the relevant date. The entitlement of the family of the
deceased officer to receive the amount and that to as claimed, however,
G was not disputed and it was stated that the family had already been paid
the amount by Respondent No.1 during the pendency of the appeal before
the High Court. The grievance was solely assigning the liability on the
Chief Electoral Officer and the District Magistrate, Vaishali. In this behalf,
1
1998 (2) PJLR 692
2
H (supra)
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 319
ELECTORAL OFFICER & ORS. [SANJAY KISHAN KAUL, J.]

reliance was placed, inter alia, on a judgment of this Court in Delhi A
Electric Supply Undertaking v. Basanti Devi & Anr.,3 opining that
the employer of the deceased had assumed the role of an agent of the
insurance company under Section 182 of the Indian Contract Act because
the employer had the responsibility of deducting the premium from the
monthly salary of the deceased and remitting it to the insurance company.
B
Therefore, on account of the employer’s failure, as an agent, to remit
the premium amount, the insurance company, as the principal, will still
have the liability to make payment of the insured amount.
10. We may observe, at this stage itself, that the factual controversy
and the legal controversy in this case are quite different. We really do
not see how it was relevant for the issue being debated. C

11. The Division Bench, however, distinguished the instant case
from Lilawanti Devi4 predicated on the premise that the Constable had
died while the insurance cover existed, unlike in Lilawanti Devi5. The
factum of death, occurring during the existence of the policy, was not
disputed, which was before the expiry of the insurance policy and D
surprisingly, in our view, applied the ratio of Basanti Devi6 on the agency
principle. To support its view, the Court made the following observations:
Firstly, the net premium for the policy was paid to the insurance
company by the Headquarters directly after deducting from the salaries
of the police personnel; E

Secondly, insurance was taken on behalf of the police personnel
under the signature of Director General and Inspector General of the
Police or their name nominee;
Thirdly, the police personnel was prohibited under rules from F
making any direct contact with the insurance company and all
communications were restricted between the Headquarters and the
insurance company;
Fourthly, the police personnel did not have an individual right to
take out the policy.
G
12. On the issue of time for raising the insurance claim, it was
opined that no time limit was prescribed and since all pre-requisites to
3
(1999) 8 SCC 229
4
(supra)
5
(supra)
6
(supra) H
320 SUPREME COURT REPORTS [2023] 2 S.C.R.

A the claim for the insurance policy were available, it was the exclusive
liability of the insurance company to pay the insured amount.
13. The insurance company but naturally came into appeal before
this Court.
Appellant’s contentions:
B
14. The Appellant contended before us that the Assistant Election
Officer had actually rejected the claim vide letter dated 20.11.2009 but
subsequently sought to admit their liability in the writ petition and paid
the claim to Respondent No.2. The endeavour thereafter was to somehow
fasten the liability on the Appellant.
C
15. The policy was also stated to have expired by efflux of time
on 23.06.2000. Learned counsel for the Appellant also sought to contend
that the cause of death was due to a sun stroke/heat stroke and was not
even covered within the scope of the policy as the ‘Scope of Cover’ of
the MoU required it to be “external violent and any other visible
D means.”
16. On the issue of time period within which the claim was to be
made, the terms of the MoU were referred to, requiring the claim to be
made and notified immediately to the Appellant, which had admittedly
not been done. In fact, it was notified to the Appellant insurance company
E on 24.04.2011 i.e. after eleven years and after the Respondent No. 2
had filed the writ petition before the High Court of Patna.
17. The crucial issue, emphasised before us, was that the terms
of the insurance policies are to be strictly construed and undisputedly
accepted.
F Respondent No.1’s case:
18. On behalf of the Chief Electoral Officer, a slightly divergent
case as apparent from the impugned order was sought to be made before
us countering any admission of liability to pay the insurance amount in
the supplementary counter affidavit. It was submitted that the
G Supplementary Counter Affidavit in the Writ petition only stated that it
was a fit case to be recommended for payment in view of the judgment
in Kamlawati Devi v. The State of Bihar & Ors.7
19. The letter dated 10.02.2000 issued by the Chief Electoral
Officer had clarified that the primary burden to file the claim for
7
H (2002) 3 PLJR 450
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 321
ELECTORAL OFFICER & ORS. [SANJAY KISHAN KAUL, J.]

insurance amount before the Appellant insurance company was on the A
wife of the deceased. It is mentioned that there was also an inordinate
delay in the representation made by Respondent No.2 wife and that it
was made for the first time on 21.11.2008, almost seven and a half years
after the death of the police official.
20. It had been clarified that the death of the police official was B
caused by a heat stroke and his death was not covered under the MoU
and, thus, delay in raising claim was not exclusively driven by the Chief
Electoral Officer.
The role of the Chief Electoral Officer was limited to forwarding
the recommendation, which it duly did. The husband of Respondent No.2 C
died during the currency of the insurance policy and, thus, it was pleaded
that the Appellant insurance company as the insurer was under an
obligation to honour the promise of paying the insured amount in case of
death of an employee while on election duty during the sustenance of
the insurance policy.
D
Our view:
21. On consideration of the rival contentions, there are two aspects
which needs to be flagged: firstly, the consequences of delay in claiming
the amount from the Appellant insurance company; secondly, whether
at all the insurance policy covered the scenario of the death of the E
constable.
22. On the first aspect, the admitted position is that Respondent
No.2 never raised a claim even on the Chief Electoral Officer seeking
an entitlement of the claim till the letter dated 21.11.2008 after seven
and a half years. Thus, by any standards this claim was beyond any F
reasonable time period.
23. Let us say that even if the wife had not claimed and the
Appellant insurance company were of the view, that the case was
covered by the policy, then it was the bounden duty of Respondent No.
1 to have lodged that claim. It cannot countenance the submission that
G
while on one hand the claim made by the wife was initially rejected,
subsequently, it is re- examined, almost as if making it a pre-condition to
fasten the liability on the Appellant insurance company. The conditions
of the MoU required the claim to be made immediately on the occurrence.
The relevant clause is as under:
H
322 SUPREME COURT REPORTS [2023] 2 S.C.R.

A “INVOICE OF CLAIM
The claim will be intimated to the National Insurance Co. Ltd.
immediately on its occurrence at its Regional office, Sone Bhawan,
Birchand Patel Marg, Patna (Phone: 220979, 223103 Fax: 0612-
220973). On receipt of the intimation, the local office at the place
B of occurrence shall be liasioning with the govt. Agencies in getting
the desired papers completed in all respect.”
24. It appears to us that in their own wisdom Respondent No.1
never thought that it was a case for which claim should be lodged with
the Appellant insurance company. Thus, whether the claim was admissible
C under the insurance policy or not, the conduct of Respondent No.1 would
not entitle them to fasten the liability on the Appellant and would have to
be borne by them if they are of the view that such an amount ought to
have been made. It would be negligence of Respondent No.1 in lodging
the claim. If it was not admissible then there is no reason to forward the
claim to the Appellant. Respondent No.1 has been actually playing ducks
D and drakes with this issue for reasons best know to them.
25. The aforesaid could actually end the discussion before us but
since the issue of the liability of Respondent No.1 has in turn raised the
question about the incident being covered by the insurance policy, we
consider it appropriate to even answer that question.
E
26. We would first like to elucidate the principles on which a claim
under any insurance policy is examined. It is trite to say that the terms of
the insurance policy are to be strictly construed.
27. The insurance contracts are in the nature of special class of
F contracts having distinctive features such as utmost good faith, insurable
interest, indemnity subrogation, contribution and proximate cause which
are common to all types of insurances. Each class of insurance also has
individual features of its own. The law governing insurance contracts is
thus to be studied in three parts, namely, (1) general characteristics of
insurance contracts, as contracts; (2) special characteristics of insurance
G contracts, as contracts of insurance, and (3) individual characteristics of
each class of insurance8.
28. Now turning to some of the judicial pronouncements, wherein
it has been opined that the words used in a contract of insurance must
8
Justice K Kannan, Principles of Insurance Law Chapter 3 (Volume 1, 10th ed. 2017,
H pg. 31)
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 323
ELECTORAL OFFICER & ORS. [SANJAY KISHAN KAUL, J.]

be given paramount importance and it is not open for the Court to add, A
delete or substitute any words (Suraj Mal Ram Niwas Oil Mills (P)
Ltd. vs. United India Insurance Co. Ltd9.). Insurance contracts are
in the nature where exceptions cannot be made on ground of equity and
the Courts ought not to interfere with the terms of an insurance agreement
(Export Credit Guarantee Corporation of India Limited vs. Garg
B
Sons International10).
29. This Court in Vikram Greentech India Ltd. v. New India
Assurance Co. Ltd.11 reiterated that the insured cannot claim anything
more than what is covered by the insurance policy. The terms of the
contract have to be construed strictly, without altering the nature of the
contract as the same may affect the interests of the parties adversely. C
The clauses of an insurance policy have to be read as they are.
Consequently, the terms of the insurance policy, that fix the responsibility
of the insurance company must also be read strictly.
30. In several other judgements12, this court has held that the
insurance contract must be read as a whole and every attempt should be D
made to harmonise the terms thereof, keeping in mind that the rule of
contra proferentem does not apply in case of commercial contract, for
the reason that a clause in a commercial contract is bilateral and has
mutually been agreed upon.
31. Now we turn to the specific clause in the MoU, which would E
govern the insurance policy providing for payment of compensation in
the event of death (only) resulting “solely and directly” from the accident
caused by external violent and any other visible means. On a plain reading
itself, leave aside the question of strict interpretation of the clauses, it is
quite apparent that the admissibility of the claim is in the event of death. F
The second part of the same sentence begins with “only”. Thus, even in
the event of a death, it is only in the scenario where the consequent
situation arises, i.e., it has to be solely and directly from an accident
caused by external violence. Here the death is by sun stroke. There was
no semblance of any violence being the cause of death. The last aspect
G
9
2010 SCC OnLine SC 1148
10
2014 1 SCC 686
11
(2009) 5 SCC 599
12
Oriental Insurance Co. Ltd. v. Sony Cheriyan (1999) 6 SCC 451,Polymat India (P)
Lid. v. National Insurance Co. Ltd. (2005) 9 SCC 174, Sumitomo Heavy Industries Ltd.
v. ONGC Ltd. (2010) 11 SCC 296 and RashtriyaIspat Nigam Lid. v. Dewan Chand
Ram Saran (2012) 5 SCC 599. H
324 SUPREME COURT REPORTS [2023] 2 S.C.R.

A which reads as “any other visible means” would be an expression to be
read in the context of ejusdem generis with the external violent death
and cannot be read in isolation itself.
32. We have benefit of elucidation in this behalf arising from the
judgment of this Court in Alka Shukla v. Life Insurance Corporation
B of India13. The Court noted the divergence of opinion of courts between
courts across international jurisdictions making a distinction between
“accidental means” and “accidental result” while deciding insurance
claims. Thus, an unexpected accident and unforeseen consequence or
result from a normal or routine activity may constitute an accident but it
would not qualify as “accidental means”. Two illustrative examples given
C are: (a) a fatal heart attack while dancing would be called “accidental”
but would fail to attract insurance cover as not due to “accidental means”;
(b) heart attack suffered as a result of over-exertion on being chased by
a ferocious dog the death might attract the insurance cover as it was
caused by “accidental means”. In the first example it was a normal
D activity while in the second it was an unintended activity and not a normal
activity. The given type of injury may thus, fall within or outside the
policy according to the event which led to the death and it is this particular
cause which is required to be examined.14 The accident, thus, per se
postulates a mishap or untoward happening, something which is
unexpected or unforeseen.
E
33. The aforesaid judgment also emphasises the importance of a
plain reading of the policy as a guiding principle. A proximate causal
relationship between the accident and the body injury is a necessity.
34. If in the aforesaid context, the policy is analysed, the cause
arising from a sun stroke cannot, in our view, be included within the
F
parameters of the ‘Scope of Cover’ in the insurance policy defining
when such insurance amount would become payable.
35. Thus, on the second account also we are of the view that the
Appellant insurance company is not liable.
Conclusion:
G
36. We have, thus, no hesitation in concluding that the impugned
judgment of the Division Bench of the Patna High Court is clearly
unsustainable and is set aside. In fact, the order passed by the learned
13
(2019) 6 SCC 64
14
Colinvaux’s Law of Insurance (11 th Edn.) discuses the effect and the impact of the
H expresions” violent, external and visible:
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF 325
ELECTORAL OFFICER & ORS. [SANJAY KISHAN KAUL, J.]

Single Judge was predicated on the own admission of Respondent No.1, A
which is now sought to be resiled from by giving a slightly different
interpretation but then if the claim was not admissible, there was no
reason for Respondent No.1 to forward the claim to the Appellant
insurance company merely because it was made and with the objective
of somehow benefiting Respondent No.2 at the cost of the Appellant. B
That being the position, we are quite cognizant of the fact that the amount
already stands paid by Respondent No.1 to Respondent No.2 wife in
pursuance of the judgment of the learned Single Judge. We do believe
that de hors the complexity of any legal issue, Respondent No.2 having
enjoyed the benefit for so many years, the stand as taken by Respondent
No.1 qua the liability to pay Respondent No.2, it would not be appropriate C
to permit Respondent No.1 to recover any amount from Respondent
No.2 and that aspect should now stand closed.
37. The appeal is accordingly allowed leaving the parties to bear
their own costs.
D

Divya Pandey Appeal allowed.
(Assisted by : Roopanshi Virang, LCRA)

E

F

G

H