Holding

Death caused by malaria contracted through a mosquito bite is not an accident within the meaning of a personal accident insurance policy, as an accident must be an unexpected, unnatural occurrence, not a disease arising in the normal course of events.

Summary

The insured, a manager who obtained a home loan with a personal accident insurance rider, died in Mozambique after contracting encephalitis malaria from a mosquito bite. His spouse and father claimed the death benefit, arguing that the bite was an unforeseen event constituting an accident. The insurer contended that death from malaria is a disease arising in the normal course of events and therefore not covered under the accident clause. The Supreme Court examined the meaning of "accident" in insurance contracts, emphasizing that an accident must be an unexpected, unnatural occurrence and cannot include diseases that are endemic to the area. Relying on Indian and foreign precedents, the Court held that malaria contracted via a mosquito bite is a natural disease, not an accident, and thus the policy does not cover the death. The appeal was allowed, setting aside the National Consumer Disputes Redressal Commission's order and denying the claim.

Issues considered

Whether death caused by malaria contracted through a mosquito bite qualifies as an "accident" under the personal accident insurance clause of the policy.
Whether the policy's exclusion of disease-related deaths applies to malaria in an endemic region.

Legislation cited

Constitution of Indias. Article 142
Consumer Protection Act, 1986

Subjects

accident insurancedefinition of accidentdisease vs accidentmalariapersonal accident policyconsumer protectioninsurance claimpolicy interpretationdeficiency of service

Judgment

46 [2019]
SUPREME COURT 5 S.C.R. 46
REPORTS [2019] 5 S.C.R.

A THE BRANCH MANAGER NATIONAL INSURANCE CO. LTD.
v.
SMT. MOUSUMI BHATTACHARJEE & ORS.
(Civil Appeal No 2614 of 2019)
B MARCH 26, 2019
[DR. DHANANJAYA Y CHANDRACHUD AND
HEMANT GUPTA, JJ.]
Consumer Protection Act, 1986 – Insurance policy claim –
Deficiency of service – Whether death due to malaria occasioned
C
by a mosquito bite in Mozambique constituted a death due to
accident – Insurance policy – Cover against accident – The insured
was working in Assam and thereafter took employment in
Mozambique where he was diagnosed with encephalitis malaria and
died due to multi-organ failure – Claim filed by spouse and father
D of the deceased – Plea of insurer was that death due to malaria
caused by a mosquito bite was a result of an infection or disease
and was not an accidental death under the terms of insurance policy
– All the Forums allowed the claim holding that the death was caused
due to accident – On appeal, held: To be bitten by a mosquito and
be imbued with a malarial parasite does involve an element of chance
E
– But the disease which is caused as a result of the insect bite in the
natural course of events cannot be regarded as an accident –
Malaria is most commonly transmitted to humans through malaria
virus infested mosquito bites, and when a virus is contracted through
normal means brought about by everyday life, it cannot be deemed
F to be an unexpected or unforeseen accident – In a policy of
insurance which covers death due to accident, the peril insured
against is an accident: an untoward happening or occurrence which
is unforeseen and unexpected in the normal course of human events
– The death of the insured in the instant case was caused by
encephalitis malaria – The insured was based in Mozambique –
G
According to the World Health Organization’s World Malaria Report
2018, Mozambique, with a population of 29.6 million people,
accounted for 5% of cases of malaria globally – One out of three
people in Mozambique is afflicted with malaria – In light of these
statistics, the illness of encephalitis malaria through a mosquito bite
H
46
BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 47
BHATTACHARJEE.

cannot be considered as an accident – It was neither unexpected A
nor unforeseen – It was not a peril insured against in the policy of
accident insurance – The interpretation placed on the terms of the
insurance policy by the Forums below was manifestly incorrect.
Allowing the appeal, the Court
HELD: 1. In order to constitute an accident, the event must B
be in the nature of an occurrence which is unnatural, unforeseen
or unexpected. The instant case concerned death caused due to
a disease being contracted. Section II of the insurance policy
covers death caused by accident. Death or injury from accident
caused by insanity or venereal disease has been specifically C
excluded and not covered under the policy. [Para 14] [55-B]
Union of India v. Sunil Kumar Ghosh (1984) 4 SCC
246: [1985] 1 SCR 555; Regional Director, ESI
Corporation v. Francis De Costa (1993) 4 Suppl. SCC
100 : [1992] 3 SCR 23; Jyothi Ademma v. Plant D
Engineer, Nellore (2006) 5 SCC 513 : [2006] 3 Suppl.
SCR 400; Co-operators Life Insurance Company v.
Randolph Charles Gibbens 2009 SCC 59 – referred to
Lovelace v. Traveler’s Protective Association 47 Am.
St. Rep. 638; Sinclair v. Maritime Passengers Assurance E
(1861) 3 E&E 478; Fenton v. Thorley & Co. Ltd. (1903)
AC 443; Steel v. Cammel, Laird & Co. (1905) 2 K.B.
232; Gloria Wells v. Minnesota Life Insurance Company
No. 16-20831 (5th Cir. 2018) – referred to
P Ramanatha Aiyar’s Law Lexicon 3rd Edition, 2012; A F
W Baker Welford’s The Law Relating to Accident
Insurance 2 nd Edition, 1932; Colinvaux’s Law of
Insurance 10th Ed. by Robert Merkin; P Ramanatha
Aiyar’s Advanced Law Lexicon 3 rd Ed. (2005)
– referred to
G
2. As the law of insurance has developed, there has been
a nuanced understanding of the distinction between an accident
and a disease which is contracted in the natural course of human
events in determining whether a policy of accident insurance

H
48 SUPREME COURT REPORTS [2019] 5 S.C.R.

A would cover a disease. At one end of the spectrum is the theory
that an accident postulates a mishap or an untoward happening,
something which is unexpected and unforeseen. This
understanding of what is an accident indicates that something
which arises in the natural course of things is not an accident.
This is the basis for holding that a disease may not fall for
B
classification as an accident, when it is caused by a bodily infirmity
or a condition. A person who suffers from flu or a viral fever cannot
say that it is an accident. Of course, there is an element of chance
or probability in contracting any illness. Even when viral disease
has proliferated in an area, every individual may not suffer from
C it. Getting a bout of flu or a viral illness may be a matter of chance.
But a person who gets the flu cannot be described as having
suffered an accident: the flu was transmitted in the natural course
of things. [Para 18] [58-G-H; 59-A-C]
3. The death of the insured in the instant case was caused
D by encephalitis malaria. The claim under the policy is founded on
the hypothesis that there is an element of uncertainty about
whether or when a person would be the victim of a mosquito bite
which is a carrier of a vector-borne disease. The submission is
that being bitten by a mosquito is an unforeseen eventuality and
should be regarded as an accident cannot be accepted. The insured
E was based in Mozambique. According to the World Health
Organization’s World Malaria Report 2018, Mozambique, with a
population of 29.6 million people, accounts for 5% of cases of
malaria globally. It is also on record that one out of three people
in Mozambique is afflicted with malaria. In light of these statistics,
F the illness of encephalitis malaria through a mosquito bite cannot
be considered as an accident. [Para 20] [60-B-D]
Case Law Reference
[1985] 1 SCR 555 referred to Para 12

G [1992] 3 SCR 23 referred to Para 16
[2006] 3 Suppl. SCR 400 referred to Para 16
2009 SCC 59 referred to Para 17

H
BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 49
BHATTACHARJEE.

CIVIL APPELLATE JURISDICTION: Civil Appeal No. 2614 A
of 2019.
From the Judgment and Order dated 12.05.2016 of the National
Consumers Disputes Redressal Commission, New Delhi.
Madhvi Divan, ASG, Mansimran Singh, Ms. Vishakha Ahuja, Vishnu
Mehra, Ms. Manjeet Chawla, Advs. for the appellant. B

Abhijit Kumar Chattopadhyay, Sachin Pawwa, Amit Singh Rawat,
Binay Kumar Das, Arun Aggarwal, Devesh Dubey, Ms. Anshika
Agarwal, Advs. for the Respondents.
The Judgment of the Court was delivered by C
DR DHANANJAYA Y CHANDRACHUD, J. 1. 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 D
Disputes Redressal Commission1, which upheld a decision of the State
Consumer Disputes Redressal Commission2. 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 E
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 term of 20 years commencing on 25 August F
2011. A single premium was paid against the policy. The policy was a
non-life insurance product intended to provide insurance security to a
person who obtains a loan for constructing, purchasing or repairing a
residential house, flat or apartment. Section I of the policy insured the
house against fire and allied perils, including earthquakes. Section II G
insured the borrower against personal accidents.
3. The insured was working as a Manager of a Tea Estate in
Assam. He thereafter took up employment in 2012 as a Manager of a
1
“National Commission”
2
“State Commission” H
50 SUPREME COURT REPORTS [2019] 5 S.C.R.

A Tea Factory at Cha-De-Magoma, District Gurue, Province-Zambezia,
Republic of Mozambique. During his stay in Mozambique, the insured
was admitted to the hospital on 14 November 2012. He was diagnosed
with encephalitis malaria and died on 22 November 2012 due to multi-
organ failure. His death certificate issued by the Republic of Mozambique
spelt out the conditions and causes of death thus:
B
“VII. Conditions and causes of death
56. Causes of the Death WRITE ONE DIAGNOSIS PER LINE
Direct cause a) Multi organ failure
Intermediary cause b) Encephalitis Malaria
Basic Cause c) Pnasituria – Malaria.”
C

4. The heirs of the deceased filed a complaint under the Consumer
Protection Act 1986 before the District Consumer Disputes Redressal
Forum3, North 24 PGS, Barasat alleging that the insurer had committed
a deficiency of service in not settling the claim under the insurance cover.
D In the written statement filed by the appellant, it set up the plea that
Section II of the policy insured the borrower of the loan against personal
accident. Death due to malaria caused by a mosquito bite was, in the
submission of the insurer, a result of an infection or disease and was not
an accidental death under the terms of the insurance policy.
E 5. By an order dated 28 February 2014, the District Forum allowed
the claim and called upon the insurer to pay the entire outstanding EMIs
in respect of the loan to the Bank of Baroda. A statutory appeal was
filed by the appellant before the State Commission 4. The State
Commission by its order dated 2 February 2016 affirmed the order of
F the District Forum, holding that a “sudden death due to mosquito bite in
a foreign land” was an accident; it would be rather silly to say that it was
a natural death. The order of the State Commission was assailed in
revision before the National Commission. The National Commission
observed thus:

G “The term “accident” has not been defined in the policy which
the deceased had taken and therefore contextual dictionary
meaning of the said term has to be taken for the purpose of deciding
whether the death of the deceased was due to an accident or not.
3
“District Forum”
4
“the “West Bengal State Commission”
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BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 51
BHATTACHARJEE. [DR. DHANANJAYA Y CHANDRACHUD, J.]

An accident is something that happens unexpectedly and is not A
planned in advance. It is defined as (i) as unpleasant event,
especially in a vehicle, that happens unexpectedly and causes injury
or damage, (ii) something that happens unexpectedly and is not
planned in advance, in the Oxford Advanced Learner’s Dictionary
(New 8th Edition). The word ‘accident’ is defined as (i) as accident,
B
an unforeseen injuries occurrence, something that does not come
in the usual course of event or that cannot be reasonably
anticipated, (ii) an unforeseen and injurious occurrence due to
mistake, negligence, neglect or misconduct; an unanticipated and
untoward event that cause(s) harm (In Black’s Law Dictionary
(Ninth Edition).” (sic) C
6. On whether a death as a result of encephalitis malaria was an
accident, the National Commission held:
“It can hardly be disputed that a mosquito bite is something which
no one expects and which happens all of a sudden without any
act or omission on the part of the victim. In Consumer Complaint D
No. 223 of 2006, Shri Matber Singh versus Oriental Insurance
Co. Ltd. decided on 05.09.2014, this Commission noted that as
per the information available on the website of the Insurance
Company, an accident may include events like snake bite, frost
bite and dog bite. Hence, it would be difficult to accept the E
contention that malaria due to mosquito bite is a disease and not
an accident.”
During the course of hearing Ms Madhavi Divan, learned
Additional Solicitor General submitted that:
(i) Among the perils which were insured against by the policy is F
‘death due to accident’;
(ii) Clause 3(A) of the conditions specified that the insured was
required to give immediate notice of any change of business or
occupation;
G
(iii) No intimation was furnished by the insured of having taken a
job in Mozambique which was a material breach of the policy
condition;
(iv) Malaria is a common occurrence in tropical countries, particu-
larly so in Mozambique;
H
52 SUPREME COURT REPORTS [2019] 5 S.C.R.

A (v) The death of the insured was hence not accidental, since the
expression ‘accident’ postulates an occurrence which is
unnatural, unforeseen or unexpected;
(vi) It is well established that the expression ‘accident’ does not
include disease and other natural causes;
B (vii) The insured died of multi-organ failure which may not
necessarily be a direct consequence of a mosquito bite;
(viii) The analogy drawn by the National Commission with a snake
bite or a scorpion bite is inapposite; and

C (ix) A variety of ailments can be caused on account of mosquito
bites such as Dengue, Chikungunya and Zika, which if
unattended can lead to complications and result in death, but it
would be absurd to term the cause of death as an accident.
7. On the other hand, learned Counsel appearing on behalf of the
D respondents supported the decisions of the District Forum, the State
Commission and the National Commission. Counsel submitted that
sustaining the mosquito bite is by its very nature a matter of chance or
accident since it is unforeseen. Malaria traces its origin to a mosquito
bite and hence, it was urged that a death which is caused as a result of
malaria must necessarily be construed to be accidental in nature.
E
8. The rival submissions fall for consideration.
9. Section II of the policy covered the following perils:
“Section II:
1. Death due to accident.
F
2. Accidental loss of two limbs, two eyes or one limb and one eye.
3. Permanent total disablement or injuries other than that named
above.”
10. The exclusions from Section II were:
G
“1. Loss of one limb or one eye
2. Any accidental injury or loss not mentioned under Section-II
above
3. Cumulative Bonus
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BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 53
BHATTACHARJEE. [DR. DHANANJAYA Y CHANDRACHUD, J.]

4. Education Fund A
5. Cost of transportation of the dead body
6. Persons below the age of 18 years at the time of disbursement
of loan, and above 60 years at the end of repayment period
7. People having Hysteria
B
8. Death or accidental resulting from intentional self injury, suicide
or attempted suicide
9. Death or injury from accident while under the influence of
intoxicating liquor or drug
10. Death or injury from accident caused by insanity or venereal C
disease
11.Death or injury from accident arising or resulting from the
insured committing any breach of law with criminal intent
12. War or war like operations
13. Lionising radiations or contamination by radioactivity D
14. Loss by delay, loss of market or any other consequential or
indirect loss or damage
15. Default in repayment of installments and or loan due to any
reason whatsoever except due to the occurrence of insured
peril.” E
In support of the submission that death due to malaria is a common
occurrence in Mozambique, Ms Divan has adverted to the World Health
Organization’s World Malaria Report 2018. According to it, in 2017, there
have been an estimated ten million cases of malaria in Mozambique and
an estimated 14.7 thousand deaths. According to the World Population F
Prospects 2017 Report published by the United Nations Department of
Economic and Social Affairs, Population Division, nearly one out of three
people in Mozambique contracted malaria.
11. In our view, it would be appropriate to approach the issue
which has been raised in the present case as a matter of interpreting the G
conditions contained in the insurance policy.
12. A line of precedents, both of this Court and international,
have dealt with the meaning of the expression ‘accident’. In Union of
India v Sunil Kumar Ghosh5,this Court held that:
5
(1984) 4 SCC 246 H
54 SUPREME COURT REPORTS [2019] 5 S.C.R.

A “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
it does not take place. It is the happening of the unexpected, not
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
B
undertaking a rail journey cannot be called an “accident”. But the
happening of something which is not inherent in the normal course
of events, and which is not ordinarily expected to happen or occur,
is called a mishap or an accident.”
13. In a subsequent decision in Regional Director, ESI
C Corporation v Francis De Costa6, the expression ‘accident’ was
defined as follows:
“4…The popular and ordinary sense of the word ‘accident’ means
the mishap or an untoward happening not expected and designed
to have an occurrence is an accident. It must be regarded as an
D accident, from the point of view of the workman who suffers
from it, that its occurrence is unexpected and without design on
his part, although either intentionally caused by the author of the
act or otherwise.”
The same principle was adopted in Jyothi Ademma v Plant
E Engineer, Nellore7, where this Court held:
“7…the expression accident means an untoward mishap which is
not expected or designed.”
P Ramanatha Aiyar’s Law Lexicon8, defines the expression
F ‘accident’:
“an event that takes place without one’s foresight or expectation;
and event that proceeds from an unknown cause, or is an unusual
effect of a known cause, and therefore not expected, chance,
causality, contingency.”
G The above Law Lexicon, relying on Lovelace v Traveler’s
Protective Association9, defines the expression ‘death by accident’
as:
6
1993 Supp (4) SCC 100
7
(2006) 5 SCC 513
8 rd
3 Edition, 2012
H 9
47 Am. St. Rep. 638
BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 55
BHATTACHARJEE. [DR. DHANANJAYA Y CHANDRACHUD, J.]

“Death from any unexpected event, which happens, as by chance, A
or which does not take place according to the usual course of
things.”
14. In order to constitute an accident, the event must be in the
nature of an occurrence which is unnatural, unforeseen or unexpected.
The present case concerns death caused due to a disease being B
contracted. Section II of the insurance policy covers death caused by
accident. Death or injury from accident caused by insanity or venereal
disease has been specifically excluded and not covered under the policy.
The issue is whether death caused by any other disease not specifically
excluded under the policy, is be covered. The issue whether a disease
can be covered under the ambit of the expression ‘accident’ has been C
analysed in A W Baker Welford’s The Law Relating to Accident
Insurance10, where it was stated:
“The word “accident” involves the idea of something fortuitous
and unexpected, as opposed to something proceeding from
natural causes; and injury caused by accident is to be D
regarded as the antithesis to bodily infirmity caused by
disease in the ordinary course of events.” (emphasis supplied)
Colinvaux’s Law of Insurance11 elucidates on the ambit of the
expression ‘accident’:
E
“Accident excludes disease.It follows from the above principle
that a disease cannot be classified as an accident. Although disease
proximately caused by an accident, in the absence of any exclusion
for disease will be covered by a personal accident policy,it is well
established that the word “accident does not include disease and
other natural causes, and implies that intervention of some cause F
which is brought into operation by chance and which can be
described as fortuitous.” (emphasis supplied)
The expression ‘accidental death insurance’ has been explained
in P Ramanatha Aiyar’s Advanced Law Lexicon12:
G
“Insurance that provides coverage in the event of death due to
accidental injuries, but not illness. In the event of death, payment
10
2nd Edition, 1932
11
10th Ed.by Robert Merkin
12 rd
3 Ed. (2005)
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56 SUPREME COURT REPORTS [2019] 5 S.C.R.

A is made to the insured’s beneficiary. If bodily injury occurs (e.g.,
the loss of a limb), the insured receives a sum specified by the
contract. (insurance)”
The treatises extracted above construe accidents and diseases as
distinct concepts. Baker Welford regards ‘accident’ as a term which
B does not include disease in the ordinary course of events. Colinvaux
acknowledges that a disease caused as a proximate cause of an accident
will be covered by a policy for personal accident, in the absence of an
exclusion. But then it is also argued that the term accident does not
include disease.
C 15. Courts across international jurisdictions - including in the UK,
US and Canada have interpreted the term ‘accident’. There is a fine
distinction between the occurrence of a disease which may be considered
as an accident and a disease which occurs in the ‘natural course of
events’. In 1861, the Queen’s Bench Division13 in the UK was called
upon to consider whether a sunstroke suffered by a person while on
D board a ship in the course of performing his ordinary duties would amount
to an accident. Cockburn C.J., delivering the judgment of the court held:
“It is difficult to define the term “accident”, as used in a policy of
this nature, so as to draw with perfect accuracy a boundary line
between injury or death from accident, and injury or death from
E natural causes; such as shall be of universal application. At the
same time we think we may safely assume that, in the term
“accident” as so used some violence, casualty, or vis major, is
necessarily involved. We cannot think disease produced by the
action of a known cause can be considered as accidental. Thus
F diseases or death engendered by exposure to heat, cold, damp,
the vicissitudes of climate, or atmosphere influences, cannot, we
think properly be said to be accidental; unless at all events, the
exposure is itself brought about by circumstances which may give
it the character of accident. Thus (by way of illustration), if, from
the effects of ordinary exposure to the elements, such as is
G common in the course of navigation, a mariner should catch cold
and die, such death would not be accidental; although if, being
obliged by shipwreck or other disasters to quit the ship and take to
13
Sinclair v Maritime Passengers Assurance (1861) 3 E&E 478
H
BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 57
BHATTACHARJEE. [DR. DHANANJAYA Y CHANDRACHUD, J.]

the sea in an open boat, he remained exposed to wet and cold for A
some time, and death ensued therefrom, the death might properly
be held to be the result of accident. It is true that, in one sense,
disease or death through the direct effect of a known natural
cause, such as we have referred to, may be said to be accidental
inasmuch as it is uncertain beforehand whether the effect will
B
ensue in any particular case. Exposed to the same malaria or
infection, one man escapes, another succumbs. Yet diseases thus
arising have always been considered, not as accidental, but as
proceeding from natural causes.”
The Court contrasted the term ‘accident’ with an event that occurs
naturally and held that death due to a sunstroke was not an accident: C

“In the present instance, the disease called sunstroke, although
the name would at first seem to imply something of external
violence, is, so far as we are informed, an inflammatory disease
of the brain, brought on by exposure to the too intense heat of the
sun’s rays. It is a disease to which persons exposing themselves D
to the sun in a tropical climate are more or less liable, just as
persons exposed to the other natural causes to which we have
referred are liable to disastrous consequences therefrom. The
deceased, in the discharge of his ordinary duties about his ship,
became thus affected and so died. E
“We think, for the reasons we have given, that his death must be
considered as having arisen from a “natural cause,” and not from
“accident,” within the meaning of this policy.”
16. In Fenton v Thorley & Co. Ltd.14,the House of Lords held
that a rupture caused by an act of over-exertion would not fall within the F
ambit of the term ‘injury by accident’. Lord Macnaughtenspeaking for
the House of Lords held thus:
“Now the expression “injury by accident” seems to me to be a
compound expression. The words “by accident” are, I think,
introduced parenthetically as it were to qualify the word “injury,” G
confining it to a certain class of injuries, and excluding other classes,
as, for instance, injuries by disease or injuries self-inflicted by
design.”
14
(1903) AC 443
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58 SUPREME COURT REPORTS [2019] 5 S.C.R.

A The Court of appeal followed this decision in Steel v Cammel,
Laird & Co.15,Cozens Hardy L.J. observed:
“The doctor called as a witness by the workman said that the
paralysis was an “occupation” disease, which he should expect in
a certain number of cases to follow on the work on which the
B workman was engaged. It was not unforeseen; it was not
unexpected…
Injury by disease alone, not accompanied by an accident, is
expressly excluded, as pointed out by Lord Macnaughten in Fenton
v Thorley & Co.”
C (emphasis supplied)
17. In Co-operators Life Insurance Company v Randolph
Charles Gibbens16, the Supreme Court of Canada was tasked with
determining whether contracting a rare complication of herpes that
resulted in paralysis caused due to engagement in unprotected sex would
D be covered under the definition of ‘accident’. The Court held thus:
“59. In the present case the evidence is that genital herpes is a
sexually transmitted virus that spreads by sexual intercourse. Sex
is its normal method of transmission. As such, unlike for example an
internally developing condition leading to an aneurysm, its transmission
E requires an outsider’s participation. But the same could be said of
infectious diseases generally. Viruses and bacteria pass, directly or
indirectly, from person to person, and occasionally across species.
In the “ordinary language of the people”, an individual would not say
on coming down with influenza that “I had an accident”. We come down
F with the flu “in the ordinary course of events.”
(emphasis supplied)
18. As the law of insurance has developed, there has been a
nuanced understanding of the distinction between an accident and a
disease which is contracted in the natural course of human events in
G determining whether a policy of accident insurance would cover a disease.
At one end of the spectrum is the theory that an accident postulates a
mishap or an untoward happening, something which is unexpected and
unforeseen. This understanding of what is an accident indicates that
15
(1905) 2 K.B. 232
16
H 2009 SCC 59
BRANCH MANAGER NATIONAL INSURANCE CO. LTD. v. MOUSUMI 59
BHATTACHARJEE. [DR. DHANANJAYA Y CHANDRACHUD, J.]

something which arises in the natural course of things is not an accident. A
This is the basis for holding that a disease may not fall for classification
as an accident, when it is caused by a bodily infirmity or a condition. A
person who suffers from flu or a viral fever cannot say that it is an
accident. Of course, there is an element of chance or probability in
contracting any illness. Even when viral disease has proliferated in an
B
area, every individual may not suffer from it. Getting a bout of flu or a
viral illness may be a matter of chance. But a person who gets the flu
cannot be described as having suffered an accident: the flu was
transmitted in the natural course of things. To be bitten by a mosquito
and be imbued with a malarial parasite does involve an element of chance.
But the disease which is caused as a result of the insect bite in the C
natural course of events cannot be regarded as an accident. Particularly,
when the disease is caused in an area which is malaria prone. On the
other hand, there may well be instances where a bodily condition from
which an individual suffers may be the direct consequence of an accident.
A motor car accident may, for instance, result in bodily injuries, the
D
consequence of which is death or disability which may fall within the
cover of a policy of accident insurance. Hence, it has been postulated
that where a disease is caused or transmitted in the natural course of
events, it would not be covered by the definition of an accident. However,
in a given case or circumstance, the affliction or bodily condition may be
regarded as an accident where its cause or course of transmission is E
unexpected and unforeseen.
19. Recently, in Gloria Wells v Minnesota Life Insurance
Company17, the United States Court of Appeals, Fifth Circuit, dealt
with a case where the question of law before the court was whether
death caused by a bite of a mosquito carrying West Nile Encephalitis F
virus in Texas was covered under an accidental death insurance policy.
The Court while remanding the case to the lower court on the disputed
issue of facts, observed that the determinate, single act of a mosquito
bite was not incidental to a body process and the mosquito, an external
force produced an unforeseen result. However, this may be distinguished
from the facts in the present case. Malaria is most commonly transmitted G
to humans through malaria virus infested mosquito bites, and when a
virus is contracted through normal means brought about by everyday
life it cannot be deemed to be an unexpected or unforeseen accident.
17
No. 16-20831 (5th Cir. 2018)
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60 SUPREME COURT REPORTS [2019] 5 S.C.R.

A 20. In a policy of insurance which covers death due to accident,
the peril insured against is an accident: an untoward happening or
occurrence which is unforeseen and unexpected in the normal course of
human events. The death of the insured in the present case was caused
by encephalitis malaria. The claim under the policy is founded on the
hypothesis that there is an element of uncertainty about whether or when
B
a person would be the victim of a mosquito bite which is a carrier of a
vector-borne disease. The submission is that being bitten by a mosquito
is an unforeseen eventuality and should be regarded as an accident. We
do not agree with this submission. The insured was based in Mozambique.
According to the World Health Organization’s World Malaria
C Report 2018, Mozambique, with a population of 29.6 million people,
accounts for 5% of cases of malaria globally. It is also on record that
one out of three people in Mozambique is afflicted with malaria. In light
of these statistics, the illness of encephalitis malaria through a mosquito
bite cannot be considered as an accident. It was neither unexpected nor
unforeseen. It was not a peril insured against in the policy of accident
D
insurance.
21. We are hence of the view that the interpretation placed on the
terms of the insurance policy was manifestly incorrect and that the
impugned order of the National Commission is unsustainable.
E 22. We have been informed during the course of the hearing that
the claim under the insurance policy has been paid by the insurer. We
direct in exercise of our jurisdiction under Article 142 of the Constitution
that no recoveries shall be made. We have embarkedon the present
exercise since the issue raised in the present case will have a bearing on
similar questions of interpretation in policies of insurance envisaging an
F accident cover.
23. The appeal is allowed and the impugned judgment and order
of the National Commission shall stand set aside. There shall be no
order as to costs.

G
Devika Gujral Appeal allowed.

H