Holding

The claim under the accident benefit clause is not payable because the death was not caused by a bodily injury resulting from an accident caused by outward, violent and visible means.

Summary

The appellant's spouse held three LIC policies that contained an accident benefit clause requiring a bodily injury caused solely and directly by an accident arising from outward, violent and visible means, leading to death within 180 days. The insured suffered chest pain, a heart attack and fell from his motorcycle, dying shortly thereafter. LIC paid the basic sum assured but denied the accident benefit, asserting death was due to a heart attack, not an accident. Consumer forums initially awarded the accident benefit, but the State Consumer Commission and later the National Consumer Disputes Redressal Commission set aside the award, finding no evidence of injury caused by outward violent means. The Supreme Court examined the policy language and the medical evidence, concluding that the death was not caused by a bodily injury resulting from such an accident and that the required proximate causal link was absent. Consequently, the appeal was dismissed.

Issues considered

Whether the death of the insured was due to a bodily injury resulting solely and directly from an accident caused by outward, violent and visible means.
Whether the injury, if any, was the proximate cause of death within the stipulated 180‑day period.
How the accident benefit clause of the insurance policies should be interpreted in light of the facts.

Legislation cited

Consumer Protection Act, 1986

Subjects

accident benefitinsurance policybodily injuryproximate causeoutward violent visible meansconsumer protectionclaim denialSupreme Court

Judgment

762 [2019]
SUPREME COURT 6 S.C.R. 762
REPORTS [2019] 6 S.C.R.

A SMT. ALKA SHUKLA
v.
LIFE INSURANCE CORPORATION OF INDIA
(Civil Appeal No. 3413 of 2019)
B APRIL 24, 2019
[DR. DHANANJAYA Y. CHANDRACHUD AND
HEMANT GUPTA, JJ.]
Insurance:
C Insurance policies – Stipulating accident benefit – Death of
assured – Insurer settled the claim in respect of basic cover, while
repudiated the claim under accident benefit on the ground that the
death had occurred due to heart attack and not due to an accident
– Consumer complaint – Allowed by District Forum – State Consumer
Commission affirmed the order of District Forum – National
D
Consumer Commission set aside the award of compensation in terms
of accident benefit because the death was not due to a bodily injury
resulting from an accident caused by outward, violent and visible
means as stipulated in the insurance policies – On appeal, held: In
order to sustain a claim under the accident benefit cover, it must be
E established that the assured has sustained a bodily injury which
resulted solely and directly from the accident – The accident must
be caused by outward violent and visible means – There must be
proximate relationship between the injury and the death to the
exclusion of all other causes – In the present case there is no
evidence to show that the accident took place as a result of any
F
outward, violent and visible means – The assured died as a result of
heart attack which was not attributable to accident.
Words and Phrases:
“Accident” – Meaning of.
G Dismissing the appeal, the Court
HELD: 1. An accident postulates a mishap or an untoward
happening, something which is unexpected and unforeseen. A
bodily injury caused by an accident is not limited to any visible

H
762
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 763
OF INDIA

physical marks in the form of lesions, abrasions or broken bones A
on the body. A bodily injury can be caused by violent means that
are external and relate to the use of strong physical force or even
threatening someone by the use of violent words or actions.
[Para 7][770-G; 771-A-B]
Union of India v Sunil Kumar Ghosh (1984) 4 SCC B
246 : [1985] 1 SCR 555 – referred to.
P Ramanatha Aiyar ’s Law Lexicon 3rd Edition;
MacGillivray on Insurance Law 12th Edition;
Colinvaux’s Law of Insurance 11th Edition; Black’s Law
Dictionary 10th Edition – referred to. C
2. There exists a divergence of opinion on whether
‘accidental means’ and ‘accidental death’ are to be read as similar
or whether in order for an accidental insurance claim to succeed,
the means causing the injury or death also have to be accidental
in nature. In order to sustain a claim under the accident benefit D
cover, it must be established that the assured has sustained a
bodily injury which resulted solely and directly from the accident.
There must, in other words exist a proximate causal relationship
between the accident and the bodily injury. Moreover, the accident
must be caused by outward violent and visible means. The
expression “outward violent and visible” signifies that the cause E
of the accident must be external. Moreover, the injury must be
the cause of the death within the period of 180 days. There has to
be proximate relationship between the injury and the death to
the exclusion of all other causes. [Para 9][779-A-C]
3. The clause of accident benefit cover of the present F
insurance policy postulates that the assured must sustain a bodily
injury; the injury must solely and directly result from an accident;
the accident must be caused by outward, violent and visible
means; the injury must solely, directly and independently of all
other causes result in the death of the assured; and death must G
ensue within a period of 180 days from the injury caused in the
accident. [Para 9][779-D-F]
Life Company Ltd and American Life Insurance
Company v Dorothy Martin [2003] 1 SCR 158 ;
H
764 SUPREME COURT REPORTS [2019] 6 S.C.R.

A Kamlawati Devi v State of Bihar (2002) 3 PLJR 450 ;
Branch Manager, United India Insurance Co v State of
Bihar (2003) 51 (2) BLJR 117 – referred to.
Clidero v Scottish Accident Insurance Co (1892) 19 R.
355 ; Landress v Phoenix Mutual Life Insurance 291
B US 491, 496 (1934) ; Dhak v Insurance Company of
North America (UK) Ltd [1996] 1 WLR 936 ; American
International Assurance Quek Kwee Kee Victoria v
American International Assurance Co. Ltd [2017] 1 SLR
461 – referred to.
C 4. There is no material on record to indicate that the assured
sustained specific injuries as a result of a fall from the motorcycle
or that the injuries were caused by outward, violent and visible
means, which was the sole and proximate cause of his death.
There is no direct nexus or causation between the assured
suffering a heart attack and injuries sustained in an accident by
D outward, violent and visible means. Nothing has been brought
on record to show that the injuries sustained by falling from the
motorcycle aggravated the assured’s condition that eventually
led to his death. In the absence of any evidence to the contrary,
the medical evidence on record is itself proof that the insured
E died due to a heart attack and not due to an accident of falling
from the motorcycle. The heart attack had a distinct effect of the
insured falling off from his motorcycle. [Para 11][780-D-F]
Life Insurance Corporation v Minor Rohini 2012 (1)
MWN (Civil) 740 – approved.
F LIC of India v Smt Mamta Rani II (2014) CPJ 624 (NC) :
RP No. 4468 of 2012 ; Swaranjit Kaur v ICICI Lombard
General Insurance Co Ltd 2015 SCC OnLine NCDRC
4168 ; Krishna Wati v LIC of India (2006) CPJ 21 (NC)
– referred to.
G Case Law Reference
[1985] 1 SCR 555 referred to Para 7
[2003] 1 SCR 158 referred to Para 8

H
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 765
OF INDIA

(2002) 3 PLJR 450 referred to Para 9 A
(2003) 51 (2) BLJR 117 referred to Para 9
(2014) CPJ 624 (NC) referred to Para 11
2012 (1) MWN (Civil) 740 approved Para 11
(2006) CPJ 21 (NC) referred to Para 11 B
CIVIL APPELLATE JURISDICTION : Civil Appeal No. 3413
of 2019.
From the Judgment and Order dated 29.04.2016 of the National
Consumer Disputes Redressal Commission, New Delhi in Revision
C
Petition No. 2427 of 2014.
Pawan Kumar Ray, R. Arora, Ms. Divya Roy, Advs. for the
Appellant.
S. Gurukishan Kumar, Sr. Adv., Mrs. Indra Sawhney, Adv. for the
Respondent. D
The Judgment of the Court was delivered by
DR. DHANANJAYA Y. CHANDRACHUD, J.
1. The present appeal arises from a judgement of the National
Consumer Disputes Redressal Commission1 which reversed the judgment E
of the Chhattisgarh State Consumer Disputes Redressal Commission 2.
The SCDRC had affirmed the view of the District Consumer Disputes
Redressal Forum, Durg3 allowing an accident insurance claim.
2. The spouse of the appellant obtained three insurance policies
from the Life Insurance Corporation of India4 : F
(i) New Bima Gold Policy;
(ii) LIC Jeevan Tarang Policy; and
(iii) Twenty Years Money Back Policy with profits and accident
benefit.
G
The details of the policies are tabulated below:

1
“NCDRC”
2
“SCDRC”
3
“the District Forum”
4
“LIC of India” H
766 SUPREME COURT REPORTS [2019] 6 S.C.R.

A Policy No Policy Date of Total Term Sum Premium
Number Commenceme Assured (in Rs)
nt (Rs)
1 Bima Gold 27.06.1992 75-20 50,000 3188/-
Policy yearly
370473369
2 LIC New 10.08.2006 178-10 2,00,000 21134/-
Bima Gold yearly
B Policy
384067139
3 Twenty 11.01.2008 179-12 2,00,000 7641/-
Years half-yearly
Money Back
Policy (with
accident
benefit)
C 385316764

Condition 10 (2) of the first policy, condition 10 (b) of the second
policy and condition 11(b) of the third policy contain a stipulation for
accident benefit, on which the controversy in the present case rests.
The stipulation in the New Bima Gold Policy in relation to accident benefit
D is extracted below, in so far as is material:
“(b) Death of Life Assured : In addition to sum assured under
Basic Plan, an additional sum equal to the Accident Benefit Sum
Assured shall be payable under this policy, if the Life Assured
shall sustain any bodily injury resulting solely and directly
E from the accident caused by outward, violent and visible
means and such injury shall within 180 days of its occurrence
solely, directly and independently of all other causes result in death
of the Life Assured.”
(Emphasis supplied)
F The stipulations in the other two policies are similar, where the
accident benefit was payable if the assured sustained any bodily injury
resulting solely and directly from the accident caused by “outward, violent
and visible means”, and that such injury “solely and directly and
independently of other causes” results in death. On 3 March 2012, the
G spouse of the appellant, while riding his motorcycle, experienced pain in
the chest and shoulder, suffered a heart attack and fell from the
motorcycle. He was attended to at 10:10 pm on 3 March 2012 by Dr
Ajay Goverdhan, a general physician. He was referred to Dr SS Dhillon
who diagnosed the mishap as having been caused by “a sudden fall from
the bike”. Dr Dhillon noted that the patient was experiencing pain in the
H left side of the chest and in the shoulder and there was a myocardial
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 767
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

infarction. He referred the patient to a specialist medical center. He A
was taken to the Chandulal Chandrakar Memorial Hospital at Bhilai.
The OPD card notes the following position at admission:
“Sweating, radiating to left shoulder and 2 episodes of vomiting
Following this patient was taken to Dhillon Nursing Home where
ECG taken showed Ant. Wall M1. He was given loading dose of B
Ant. Platelet and Referred. On his way to the hospital, Pt.
collapsed. On reaching here, on examination Pt. had so sign of
life.\HR, O/nil, BP-NR, Pupil B/L fixed.”
As the above diagnosis indicates, the patient had died by the time
that he had been admitted to the above hospital. The report of the C
physician indicates that death had occurred due to an acute myocardial
infarction.
3. Dr Ajay Goverdhan furnished his report in Claim Form B
indicating that: (i) the cause of death was an acute myocardial infarction;
and (ii) the symptoms of illness were pain in the chest and shoulder. The D
insurance claim was settled in respect of the basic cover of insurance.
However, the insurer repudiated the claim under the accident benefit
component of the insurance policy on the ground that the death of the
insured had occurred due to a heart attack and not due to an accident.
4. The appellant filed a consumer complaint under the Consumer E
Protection Act 1986 before the District Forum. On 2 May 2013, the
District Forum allowed the complaint and directed the respondent to pay
the accident benefit under the three policies together with interest at 6
percent per annum. The SCDRC by its judgment dated 14 March 2014
rejected the appeal of the insurer holding that:
F
(i) It appeared that the death of the insured was due to a fall
from the motorcycle; and
(ii) The main cause for the heart attack was the fall from a
motorcycle which was an accident under the terms of the
policy.
G
In a revision by the insurer, the NCDRC by its judgment dated 29
April 2016 reversed the judgment of the District Forum, which had been
affirmed by the SCDRC. The NCDRC held that in the terms of the
accident cover, the sum assured was payable in the event of an accident
caused by “outward, violent and visible means”. Adverting to the medical
H
768 SUPREME COURT REPORTS [2019] 6 S.C.R.

A evidence, the NCDRC held that the pain in the chest and shoulder and
the sudden fall from the motorcycle were not the result of an accident
caused by outward violent or visible means. The award of compensation
in terms of the accident benefit was accordingly set aside. Assailing the
decision of the NCDRC, the spouse of the insured has filed the present
appeal.
B
5. The issue before this Court is: (i) whether the assured’s death
was due to a bodily injury resulting from an accident caused by outward,
violent and visible means; and (ii) whether the injury was proximately
caused by the accident. It is only when both the questions are answered
in the affirmative that the complainant would be entitled to claim under
C the policy.
6. During the course of the hearing, learned counsel appearing
for the appellant argued that the assured suffered a heart attack as a
result of the injuries sustained due to a fall from the motorcycle, which
was within the purview of the policy. On the other hand, learned counsel
D for the respondent argued that the medical reports are indicative of the
fact that the death of the assured was due to a heart attack and not an
accident and therefore, no claim arises under the policy. It was also
argued that while determining the insurance cover for accidental death,
a distinction has to be made between ‘accidental means’ and ‘accidental
E result’. The distinction sought to be introduced is with a view to make
the application of the insurance cover more restrictive.
The rival submissions fall for our consideration.
7. The policy of insurance indicates that a claim on account of the
accident benefit is payable only if the following conditions are satisfied:
F (i) the assured sustained bodily injuries resulting solely and directly from
an accident; (ii) the accident was caused by “outward, violent and visible
means”; and (iii) that such injury “solely and directly and independently
of other causes” results in the death of the assured. These conditions
are cumulative. The terms “bodily injury” and “outward, violent and visible
G means” have not been defined in the policy. In Union of India v Sunil
Kumar Ghosh5, this Court dealt with the expression ‘accident’ and
held thus:
“13…An accident is an occurrence or an event which is unforeseen
and startles one when it takes place but does not startle one when
5
H (1984) 4 SCC 246
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 769
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

it does not take place. It is the happening of the unexpected, not A
the happening of the expected, which is called an accident. In
other words an event or occurrence the happening of which is
ordinarily expected in the normal course by almost everyone
undertaking a rail journey cannot be called an “accident”. But the
happening of something which is not inherent in the normal course
B
of events, and which is not ordinarily expected to happen or occur,
is called a mishap or an accident.”
P Ramanatha Aiyar’s Law Lexicon6, defines the expression
‘accident’ as:
“an event that takes place without one’s foresight or expectation; C
and event that proceeds from an unknown cause, or is an unusual
effect of a known cause, and therefore not expected, chance,
causality, contingency.”
The expression ‘accident’ in the context of an accident insurance
policy has been explained in MacGillivray on Insurance Law 7: D
“In the context of an accidental insurance policy the word is usually
contained in phrases such as “injury by accident”, “accidental
injury”, “injury caused by or resulting from an accident” or “injury
caused by accidental means” and in each of these phrases it has
the connotation of an unexpected occurrence outside the normal E
course of events.”
Colinvaux’s Law of Insurance8 explains the expression ‘bodily
injury’ thus:
“It is usual for the policy to require an accident to manifest itself
as “bodily injury” to the assured. The most obvious form of bodily F
injury is external trauma causing physical injury, but the phrase is
not limited to injury to the exterior of the body: the term “bodily
injury”, when used in a personal accident policy, is not limited to
lesions, abrasions or broken bones. Nor is it essential that there
should be an external mark of injury on the assured’s body…”
G
The word ‘violent’ according to Black Law’s Dictionary9 means:
6
3rd Edition
7
12th Edition
8
11th Edition - See pg. 1133 for case laws relied upon.
9
10th Edition H
770 SUPREME COURT REPORTS [2019] 6 S.C.R.

A “1. Of, relating to, or characterised by strong physical force
<violent blows to legs>. 2. Resulting from extreme or intense force
<violent death>. 3. Vehemently or passionately threatening <violent
words>.”
The word ‘visible’ according to Black Law’s Dictionary10 means
B something which is:
“1. Perceptible to the eye; discernible by sight. 2. Clear, distinct,
and conspicuous.”
A passage from Colinvaux’s Law of Insurance11 discusses the
effect and the impact of the expressions “violent, external and visible”:
C
“”Violent”. The notion of violence... is not limited to the situation
where another person does violence to the assured, and it has
been said that the word is used simply as the antithesis of “without
any violence at all”. “Violent means” include any external,
impersonal cause, such as drowning, or the inhalation of gas. Thus,
D ‘violent’ does not necessarily imply actual violence, as where the
assured is bitten by a dog… The element of violence will obviously
be present where the injury is inflicted by a third party or by some
natural phenomenon, since there could otherwise be no effect
upon the body of the assured.”
E “”External”. It is the means of causing the injury which must be
external, rather than the injury itself. Thus, a rupture or other
internal injury is quite capable of falling within the ambit of a
personal accident policy. Given this distinction, it appears that the
word “external” in these policies merely serves to reiterate the
F general principle that the injury must not be attributable to natural
causes. It will therefore be obvious that a given type of injury
may fall within or without the policy according to the event which
caused it, and it is this cause which must always be examined.”
“”Visible”. It is probable that this word adds nothing to the policy
coverage, since every external cause must also be visible. It
G
appears to be included merely for purposes of emphasis.”
An accident postulates a mishap or an untoward happening,
something which is unexpected and unforeseen. A bodily injury caused
10
10th Edition
11
H 11th Edition - See pg. 1126 for case laws relied upon.
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 771
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

by an accident is not limited to any visible physical marks in the form of A
lesions, abrasions or broken bones on the body. A bodily injury can be
caused by violent means that are external and relate to the use of strong
physical force or even threatening someone by the use of violent words
or actions.
8. There is a divergence of opinion between courts across B
international jurisdictions - including the UK, US, Canada and Singapore
on whether a distinction should be maintained between ‘accidental means’
and ‘accidental result’ while deciding accidental insurance claims. The
distinction was laid out in Clidero v Scottish Accident Insurance
Co12, where the Scottish Court of Session (First Division) unanimously
held that the injury suffered by the insured to his colon on slipping while C
putting on his stocking, which then led to his death was not caused by
“violent, accidental, external and visible means” because the insured’s
conduct in putting on his stockings was intentional and voluntary and
there was no other external factor that affected the insured’s movement
which resulted in the injury. It was held thus: D
“…The death being accidental in the sense in which I have
mentioned, and the means which lead to the death as accidental,
are to my mind two quite different things. A person may do certain
acts, the result of which acts may produce unforeseen
consequences, and may produce what is commonly called E
accidental death, but the means are exactly what the man intended
to use, and did use, and was prepared to use. The means were
not accidental, but the result might be accidental…”
The above distinction was applied by the US Supreme Court in
Landress v Phoenix Mutual Life Insurance13, where the insured F
while playing golf suffered a sunstroke and died. The complainant sought
recovery of the amounts stipulated in one policy, to be paid if death
resulted “directly and independently of all other causes from bodily injuries
effected through external, violent and accidental means, and not directly
or indirectly, wholly or partly from disease or physical or mental infirmity,”
and, in the other policy, if death resulted “from bodily injuries effected G
directly and independently of all other causes through external, violent
and accidental means.” The majority, while denying the insurance claim,
laid down a strict test which differentiated between ‘accidental means’
12
(1982) 19 R. 355
13
291 US 491, 496 (1934) H
772 SUPREME COURT REPORTS [2019] 6 S.C.R.

A and an ‘accidental result’. This distinction emerges from the following
extract:
“Petitioner argues that the death, resulting from voluntary exposure
to the sun’s rays under normal conditions, was accidental in the
common or popular sense of the term, and should therefore be
B held to be within the liability clauses of the policies. But it is not
enough, to establish liability under these clauses, that the death or
injury was accidental in the understanding of the average man—
that the result of the exposure ‘was something unforeseen,
unexpected, extraordinary, an unlooked-for mishap, and so an
accident,’ see Lewis v. Ocean Accident & Guarantee Corp., 224
C N.Y. 18, 21, 120 N.E. 56, 57, 7 A.L.R. 1129; see, also, AEtna Life
Insurance Co. v. Portland Gas & Coke Co. (C.C.A.) 229 F. 552,
L.R.A. 1916D, 1027, for here the carefully chosen words
defining liability distinguish between the result and the
external means which produces it. The insurance is not
D against an accidental result. The stipulated payments are
to be made only if the bodily injury, though unforeseen, is
effected by means which are external and accidental. The
external means is stated to be the rays of the sun, to which the
insured voluntarily exposed himself. Petitioner’s pleadings do not
suggest that there was anything in the sun’s rays, the weather, or
E other circumstances external to the insured’s own body and
operating to produce the unanticipated injury, which was unknown
or unforeseen by the insured.”
(Emphasis supplied)

F However, Justice Cardozo in his dissenting opinion warned about
the inherent problem in creating a distinction between ‘accidental means’
and ‘accidental result’:
“The attempted distinction between accidental results and
accidental means will plunge this branch of the law into a Serbonian
G Bog. …
…
When a man has died in such a way that his death is spoken of as
an accident, he has died because of an accident, and hence by
accidental means …
H …
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 773
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

The insured did not do anything which in its ordinary consequences A
was fraught with danger. The allegations of the complaint show
that he was playing golf in the same conditions in which he had
often played before. The heat was not extraordinary; the exertion
not unusual. By misadventure or accident, an external force, which
had hitherto been beneficent, was transformed into a force of
B
violence, as much so as a stroke of lightning. The opinion of the
court concedes that death ‘from sunstroke, when resulting from
voluntary exposure to the sun’s rays,’ is ‘an accident.’ Why? To
be sure, the death is not intentional, but that does not make it an
‘accident,’ as the word is commonly understood, any more than
death from indigestion or pneumonia. If there was no accident C
in the means, there was none in the result, for the two were
inseparable. No cause that reasonably can be styled an
accident intervened between them. The process of
causation was unbroken from exposure up to death. There
was an accident throughout, or there was no accident at
D
all.”
(Emphasis supplied)
In a decision of the Court of Appeal in UK in Dhak v Insurance
Company of North America (UK) Ltd14, the insured to relieve herself
of backpain started consuming alcohol and died due to acute alcoholism. E
The accidental insurance policy provided for benefits payable for “bodily
injury resulting in death or injury within 12 months of the accident occurring
during the period of insurance and caused directly or indirectly by the
accident.” The term “bodily injury” was defined as one “caused by
accidental means.” The court held that the words “caused by accidental
means” were a clear indication that the terms of the policy required the F
court to concentrate on the cause of the injury and to inquire whether it
was by accidental means. It held thus:
“I have come to the conclusion, however, that it has not been
established that the bodily injury to the deceased was “caused by
accidental means” within the meaning of the policy. In reaching G
this conclusion I have been persuaded that the words “caused by
accidental means” are a clear indication that it is the cause of the
injury to which the court must direct its attention.

14
[1996] 1 WLR 936 H
774 SUPREME COURT REPORTS [2019] 6 S.C.R.

A …
In my judgment, however, whatever the position may be in some
other jurisdictions, the terms of this policy require a court in this
country to concentrate on the cause of the injury and to inquire
whether the injury was caused by accidental means…
B …
…the deceased must have been well aware of the consequences
and dangers of drinking alcohol to excess and that she must be
taken to have foreseen what might happen in the event of someone
drinking to excess… I am satisfied that there must have been a
C point at which she would have realised that any further drinking
would be dangerous and that vital bodily functions might be impaired
or interrupted.”
The Canadian Supreme Court, in American International
Assurance Life Company Ltd and American Life Insurance
D Company v Dorothy Martin15, has taken a contrary view and moved
away from the distinction laid out in Landress (supra). This case dealt
with the interpretation of an accidental death benefit provision, which
stipulated that “the Company will pay the amount of
the Accidental Death Benefit … upon receipt of due proof that the Life
E Insured’s death resulted directly, and independently of all other causes,
from bodily injury effected solely through external,
violent and accidental means”. The insured in the course of treating a
peptic ulcer, developed an addiction to opiate medications and died due
to high levels of Demerol in his body. The insurers challenged the claim
on the ground that the death was not through “accidental means” and
F that self-injection of Demerol was a deliberate act making the death a
foreseeable consequence. Chief Justice McLachlin, speaking for the
Bench held thus:
“The first question to be considered is whether deaths caused
by accidental means form a subclass of accidental deaths. To put
G the question another way, is the category of deaths caused
by accidental means narrower than that of accidental deaths?
The insurers argue that… a death is only caused
by accidental means when both the death and the actions
that are among its immediate causes are accidental.
H 15
[2003] 1 SCR 158
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 775
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

… A
This view seems to me, however, to be problematic. Almost
all accidents have some deliberate actions among their
immediate causes. To insist that these actions, too, must
be accidental would result in the insured rarely, if ever,
obtaining coverage. Consequently, this cannot be the B
meaning of the phrase “accidental means” in the policy.
Insurance policies must be interpreted in a way that gives
effect to the reasonable expectations of the parties: Reid
Crowther & Partners Ltd.v. Simcoe & Erie General Insurance
Co., [1993] 1 S.C.R 252, at p. 269. A policy that seldom applied to
what reasonable people would consider an accidental death would C
violate this principle.
In my view, the phrase “accidental means” conveys the idea that
the consequences of the actions and events that produced death
were unexpected.
D
It follows that to ascertain whether a given means of death
is “accidental”, we must consider whether the
consequences were expected. We cannot usefully separate
off the “means” from the rest of the causal chain and ask
whether they were deliberate. Cardozo J. emphasized in his
dissenting judgment in Landress v. Phoenix Mutual Life Insurance E
Co., 291 U.S 491 (1934), at p. 501, that “[i]f there was no accident
in the means, there was none in the result”. The converse is
equally true: if there was no accident in the result, there
can be none in the means. As Cardozo J. went on to say, either
“[t]here was an accident throughout, or there was no accident at F
all”. Hence, to determine whether death occurred by accidental
means, we must look to the chain of events as a whole, and we
must consider whether the insured expected death to be a
consequence of his actions and circumstances.
...Usually we intend the consequences of our actions. However, G
sometimes our actions have unintended or unexpected
results. When death is the unexpected result of an action,
we say that the death was “accidental”, or that it was
brought about by “accidental means” as opposed to
“intentional means”. In ordinary language, then, “death
H
776 SUPREME COURT REPORTS [2019] 6 S.C.R.

A by accidental means” and ”accidental death” have the same
meaning.
…
I conclude that the phrase “accidental means” in this insurance
policy does not refer to a narrow subclass of the broader category
B of “accidental deaths”. “Accidental death” and ” death
by accidental means” connote a death that was in some
sense unexpected. The two phrases have essentially the
same meaning.”
(Emphasis supplied)
C
The Court of Appeal of Singapore in Quek Kwee Kee Victoria
v American International Assurance Co. Ltd16, agreed with the
Canadian Supreme Court in Dorothy Martin (supra) and noted that
the courts in many jurisdictions have moved away from the distinction
laid out in Landress (supra):
D
“… we prefer the view that the use of phrases such as “accidental
means” would not restrict the situations covered by a personal
accident insurance policy to those where the proximate cause of
the insured’s injury or death was not a deliberate or voluntary
action on the part of the insured. For example, if a person injures
E himself by driving off a cliff in the mistaken belief that the road
continued, that person would have met with an “accident” just as
much as one who slips and fractures his leg while walking on a
slippery surface. It would, in our view, accord with ordinary
experience to hold that the injury suffered by an insured in such
F cases would be a result of “accidental means”. In this regard, we
find ourselves in agreement with the observations of McLachlin
CJ in Martin…
…
…courts in the Commonwealth have moved away from this
G distinction between intended means and unintended results.
Although this still appears to be good law in England (see, for
example, Dhak v Insurance Co of North America [1996] 1 WLR
936 (“Dhak”) at 949), the distinction has been rejected in New
Zealand (see Groves at 127–128), the United States (see Wickman
16
H [2017] 1 SLR 461
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 777
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

v Northwestern National Insurance Co 908 F 2d 1077 (1st Cir A
1990) (“Wickman”)), Scotland (see MacLeod v New Hampshire
Insurance Co Ltd 1998 SLT 1191), Australia (see the judgment of
Wilson, Deane and Dawson JJ in Australian Casualty Co Ltd v
Federico [1986] HCA 32 at [18]–[20]) and Canada (see Martin v
American International Assurance Life Co [2003] SCC 16
B
(“Martin”) at [10]–[13])…”
9. The respondent has placed reliance upon a decision of a Single
Judge of the Patna High Court in Kamlawati Devi v State of Bihar17,
where the deceased who was on election duty was threatened by armed
miscreants while relieving himself which triggered a heart attack. Justice
Aftab Alam (as his Lordship then was) while discussing precedent from C
other jurisdictions and authorities on Insurance Law noted that there
exists a divergence of opinion about whether a distinction exists between
an ‘accidental result’ and ‘accidental means’ while assessing a claim
under an accident insurance policy. The court while holding that the act
of threatening by armed miscreants was covered by the expression D
“external violent and any other visible means”, held thus:
“A plain reading of the cover clause in the M.O.U. would make it
clear that it is intended to impose a twofold limitation. A death in
order to qualify for the insurance cover must not only be accidental
but the accident causing death must itself result from some E
external, violent and other visible means. This two fold limitation
is based on what is called, in the Law of Insurance, the distinction
between ‘accidental result’ and ‘accidental means’. An
unexpected and unforeseen consequence or result from a normal
or routine activity may constitute an accident but it would not
qualify as ‘accidental means’. Thus, if a person suffers a fatal F
heart attack while dancing (considered to be a normal activity)
the death may be called ‘accidental’ but it would fail to attract the
insurance cover because it was not due to ‘accidental means’.
On the other hand, if a person dies due to heart attack suffered as
a result of over-exertion on being chased by a ferocious dog (an G
unintended occurrence, and not a normal activity) the death might
attract the insurance cover as it was caused by ‘accidental
means’.
…
17
(2002) 3 PLJR 450 H
778 SUPREME COURT REPORTS [2019] 6 S.C.R.

A On examining this branch of the law of insurance one finds a
series of decisions which tend to do away with the distinction
between ‘accidental result/death’ and ‘accidental means’. One
also finds another set of decisions which though maintaining the
formal distinction between ‘accidental result’ and ‘accidental
means’ have so interpreted the key words in the restrictive clause
B
(e.g. accident, external, violence and any other means etc.) as to
greatly relax the rigours of the ordinary meanings of those words.”
On the facts of the case, the High Court held:
“In the light of the above there can be no denying that the death
C of Parshuram Singh was an accidental death caused by accidental
means. If the view expressed in the book, the Law of Insurance
that the words “by violent, external and visible means” add little if
anything to an accident policy is to be accepted, then his death
would attract the insurance cover without anything else. But even
if the applicability clause in the M.O.U. is to be given a literal
D interpretation and the distinction between accidental result and
accidental means is to be maintained, I come to the unescapable
conclusion that the act of threatening by the armed miscreants
was plainly covered by the expression “external, violent and any
other visible means” and the deceased encountering those threats
E while he had gone to relieve himself was clearly an accident that
triggered off the heart attack and, thus, resulting solely and directly
into his death. It appears to me, therefore, that the death of the
petitioner’s husband was fully covered by the cover clause in the
M.O.U.”

F In a Letters Patent Appeal, the Division Bench of the Patna High
Court in Branch Manager, United India Insurance Co v State of
Bihar18 affirmed the aforesaid judgment and held thus:
“... In the present matters, it appears that the Insurance Companies
are belabouring under misapprehension that unless the person
G suffers an external visible injury by external visible means the
Insurance Company would not be answerable to it. In our opinion,
the phraseology used in the cover does not have the scope to read
external visible injury. The phrase simply says—”in the event of
death only resulting solely and directly from accident caused by
external violent and any other visible means.””
H 18
(2003) 51 (2) BLJR 117
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 779
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

There exists a divergence of opinion on whether ‘accidental A
means’ and ‘accidental death’ are to be read as similar or whether in
order for an accidental insurance claim to succeed, the means causing
the injury or death also have to be accidental in nature. For the purposes
of this case, it is not necessary to conclusively decide this question. In
order to sustain a claim under the accident benefit cover, it must be
B
established that the assured has sustained a bodily injury which resulted
solely and directly from the accident. There must, in other words exist a
proximate causal relationship between the accident and the bodily injury.
Moreover, the accident must be caused by outward violent and visible
means. The expression “outward violent and visible” signifies that the
cause of the accident must be external. Moreover, the injury must be the C
cause of the death within the period of 180 days. There has to be
proximate relationship between the injury and the death to the exclusion
of all other causes. The outcome of the present case involves
interpretation of the accident benefit cover. Breaking down the clause
into its components, what it postulates is that:
D
(i) The assured must sustain a bodily injury;
(ii) The injury must solely and directly result from an accident;
(iii) The accident must be caused by outward, violent and visible
means;
E
(iv) The injury must solely, directly and independently of all other
causes result in the death of the assured; and
(v) Death must ensue within a period of 180 days from the injury
caused in the accident.
What needs to be determined is whether the insured suffered a F
heart attack as a result of the injuries sustained from the fall from the
motorcycle or whether the fall was a result of the assured suffering a
heart attack in the first place.
10. The plain reading of the policy is to be accepted as our guide.
Under the policy, in order for the complainant to prove her claim, she G
must show direct and positive proof that the accident of the assured
falling from his motorcycle caused bodily injury by external/outward,
violent and visible means. The complainant will have to prove that the
accident and the injuries sustained as a result were a direct or proximate
cause of her husband’s death.
H
780 SUPREME COURT REPORTS [2019] 6 S.C.R.

A 11. In the present case, no post mortem of the deceased or police
investigation was conducted. In the absence of a post mortem report
indicating the nature of injuries sustained by the insured, we would have
to rely upon the medical report that indicates the exact cause of death.
The medical report of Dr Ajay Goverdhan who examined the assured
on the date of the accident indicated that the insured suffered shoulder
B
and chest pain and that the exact cause of death was an acute myocardial
infraction. The insured was referred to a specialist, Dr SS Dhillon, who
also recorded in his report that the diagnosis did not show the cause of
death to be accidental. Dr S S Dhillon noted that the insured was
experiencing pain in the left side of the chest and in the shoulder and
C there was a myocardial infarction. The insured was referred to Chandu
Lal Memorial Hospital, a specialist medical center, where the OPD
records noted that an ECG was taken at Dhillon Nursing Home and the
insured was sweating and that he had chest pain, radiating to the left
shoulder along with two episodes of vomiting. He died before he reached
the hospital. There is no material on record to indicate that the assured
D
sustained specific injuries as a result of a fall from the motorcycle or
that the injuries were caused by outward, violent and visible means,
which was the sole and proximate cause of his death. There is no direct
nexus or causation between the assured suffering a heart attack and
injuries sustained in an accident by outward, violent and visible means.
E Nothing has been brought on record to show that the injuries sustained
by falling from the motorcycle aggravated the assured’s condition that
eventually led to his death. In the absence of any evidence to the contrary,
the medical evidence on record is itself proof that the insured died due to
a heart attack and not due to an accident of falling from the motorcycle.
The heart attack had a distinct effect of the insured falling off from his
F
motorcycle.
In a case decided by the NCDRC - LIC of India v Smt Mamta
Rani19 - clause 10.2 of the insurance policy provided an accident benefit
cover if the assured sustained any bodily injury resulting solely and directly
from the accident caused by outward, violent and visible means. The
G assured died of a heart attack. The district and state forums allowed the
claim of the complainant for accidental benefit. However, the NCDRC
rejected the claim and held thus:

19
H II (2014) CPJ 624 (NC) : RP No. 4468 of 2012
SMT. ALKA SHUKLA v. LIFE INSURANCE CORPORATION 781
OF INDIA [DR. DHANANJAYA Y. CHANDRACHUD, J.]

“… it is clear that in case of death of life assured, the additional A
accident benefit equal to the sum assured is payable only if the
life assured dies because of any bodily injury resulting solely and
directly from an accident by outward, violent and visible means.
In the instant case, as per the record, the life assured died on
01.07.2002 due to heart attack. There is no evidence on record to
B
indicate that the life assured died because of some injury suffered
in an accident. Thus, the fora below have committed a material
illegality in awarding the accident benefit to the respondents against
the terms and conditions of the insurance contract.”
Similarly, in Swaranjit Kaur v ICICI Lombard General
Insurance Co Ltd20, the assured while travelling on his scooter, suffered C
a heart attack and fell from his scooter. The claim for accidental benefit
cover was repudiated on the ground that the insured had died a natural
death because of heart attack. The state commission set aside the order
of the district forum allowing the claim. The NCDRC while upholding
the state commission’s judgment, noted that the onus to prove that the D
insured had died as a result of an accident and not a heart attack was on
the claimant. It held thus:
“…On perusal of the copy of repudiation letter, it is clear that the
respondents repudiated the insurance claim on the ground that
cause of death of insured was heart attack. On perusal of the E
report of the investigator, we find that the stand of the petitioners
in the statement made before the investigator on 17.8.2006 was
that while driving the scooter insured suffered a heart attack,
consequently, he fell down from the scooter and died. From this, it
is clear that the accident took place after the insured had suffered
heart attack. Otherwise also, in order to succeed in the insurance F
claim, the onus of proving that the insured had died as a result of
accident was on the petitioners. Undisputedly, incident was not
reported to the police nor post mortem to establish cause of death
was done. No evidence has been produced by the petitioners to
prove the cause of death of the insured. There is nothing in the G
statement of the petitioners as recorded by the investigator that
the insured had suffered any bodily injuries due to fall from the
scooter. Thus, under the circumstances, the conclusion of the State

20
2015 SCC OnLine NCDRC 4168 H
782 SUPREME COURT REPORTS [2019] 6 S.C.R.

A Commission that cause of death of the insured was heart attack
and not an accident cannot be faulted…”
The High Court of Madras held in Life Insurance Corporation
v Minor Rohini21 that in the absence of any evidence that the assured
had sustained any bodily injury resulting solely and directly from the
B accident caused by outward, violent or visible means, it cannot be said
that the death due to a heart attack would amount to an accident for the
purposes of accidental insurance claim under the policy.
In Krishna Wati v LIC of India22, the NCDRC had to deal with
whether the accidental injuries which resulted in the death of the assured
C due to a heart attack after three days of the accident could be termed as
an accidental death or a natural death. The assured while riding his
bicycle was attacked by a cow and upon arriving at the hospital complained
of pain in the legs and in the chest, because of a fall from his bicycle.
The NCDRC relied on the investigation report and the allowed the claim
for accident insurance. It held thus:
D
“… In our view, from the record as it is, it is apparent that first the
accident took place, resulted in injuries and chest pain which
ultimately resulted in ‘death’. May be, the death in the medical
terms be described as ‘due to heart-attack, but the main cause
for leading to heart-attack was injury caused due to accident.
E Accident is the basis for causing chest pain and thereafter heart-
attack…”
12. In the present case, there is no evidence to show that any
bodily injuries were suffered due to the fall from the motorcycle or that
they led to the assured suffering a heart attack. There is no evidence to
F show that the accident took place as a result of any outward, violent and
visible means. The assured died as a result of a heart attack which was
not attributable to the accident.
13. For the above reasons, we are of the view that the judgment
of the NCDRC dated 29 April 2016 does not suffer from any error. The
G appeal shall accordingly stand dismissed. There shall be no order as to
costs.

Kalpana K. Tripathy Appeal dismissed.
21
2012 (1) MWN (Civil) 740. Also see New India Assurance Company Limited v.
K. Thilagam 2009 (2) TN MAC 197
H 22
1 (2006) CPJ 21 (NC)