NATIONAL INSURANCE COMPANY LTD. versus THE CHIEF ELECTORAL OFFICER & ORS.

Citation: [2023] 2 S.C.R. 312 · Decided: 08-02-2023 · Supreme Court of India · Bench: SANJAY KISHAN KAUL · Disposal: Appeal(s) allowed

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Judgment (excerpt)

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SUPREME COURT REPORTS
[2023] 2 S.C.R.
   [2023] 2 S.C.R. 312
312
NATIONAL INSURANCE COMPANY LTD.
v.
 THE CHIEF ELECTORAL OFFICER & ORS.
(Civil Appeal No.4769 of 2022)
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
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
– 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
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
– 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
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.
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Insurance – Insurance contracts – Held: Words used in 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.
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
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
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
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
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
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]
NATIONAL INSURANCE COMPANY LTD. v. THE CHIEF
ELECTORAL OFFICER & ORS.
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SUPREME COURT REPORTS
[2023] 2 S.C.R.
1.2 Now turning to the specific cla

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