SMT. ALKA SHUKLA versus LIFE INSURANCE CORPORATION OF INDIA

Citation: [2019] 6 S.C.R. 762 · Decided: 24-04-2019 · Supreme Court of India · Bench: D.Y. CHANDRACHUD · Disposal: Dismissed
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Judgment (excerpt)

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SUPREME COURT REPORTS
[2019] 6 S.C.R.
SMT. ALKA SHUKLA
v.
LIFE INSURANCE CORPORATION OF INDIA
(Civil Appeal No. 3413 of  2019)
APRIL 24, 2019
[DR. DHANANJAYA Y. CHANDRACHUD AND
HEMANT GUPTA, JJ.]
Insurance:
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
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
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
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.
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
   [2019] 6 S.C.R. 762
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physical marks in the form of  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.
[Para 7][770-G; 771-A-B]
Union of India v Sunil Kumar Ghosh (1984) 4 SCC
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.
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
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
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
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
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 ;
SMT. ALKA SHUKLA  v. LIFE INSURANCE CORPORATION
OF INDIA
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SUPREME COURT REPORTS
[2019] 6 S.C.R.
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
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.
4. There is no material on record to indicate that the assured
sustained speci
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