What Is 'Accidental Death' In The Context Of Insurance Law?

Accidental death benefit clauses in life insurance policies are very common these days. This gives additional coverage, over and above the usual life insurance sum, if the death of the insured is caused due to an accident. Of course, one has to pay extra premium to avail this benefit. A standard phrase found in such clauses is "death due to accident caused by violent, visible and external means".Though sounding morbid, this phrase has been at the heart of fascinating judicial discussions on what exactly is an accident.Commonly understood, accident is an unforeseen incident which takes place not in the ordinary course of events, leading to unpleasant, tragic or startling results. In a judgment delivered last month in the case Smt.Alka Shukla vs Life Insurance Corporation of India, the Supreme Court has discussed this aspect in detail.The question in that case was whether a person who died of heart attack while riding a motor cycle can be said to have suffered 'accidental death'. The insurance company had repudiated the claim on the ground that death was not accidental. Challenging this, the wife of the deceased filed consumer complaint. Though the State Commission allowed the complaint, its decision was overturned by the National Commission in insurer's appeal. After that she approached the Supreme Court.As per medical records in the case, the cause of death was heart attack, and the fall from the scooter did not contribute to it. There was no 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. The bench of Justices D Y Chandrachud and Hemant Gupta found that the fall from the bike, which was taken as the accident in the case, did not contribute to death. Death was attributable to heart attack, which was not treated as an accident caused by 'violent, visible and external means'Accidental Means and Accidental ResultsWhile reaching its conclusions, the SC discussed the concepts of 'accidental means' and 'accidental results', which are used by Courts all over the world to deal with such situations.Justice Chandrachud said in the judgment that there was a divergence of opinion between courts across 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.As per the 'accidental means' approach, the mere fact that death was unexpected is not sufficient to classify it as 'accidental death'. It should have been caused by 'accidental means'. This approach draws support from the use of word 'means' in the phrase "violent, visible and external means".A 1934 judgment of the Supreme Court of the United States in the case Landress v Phoenix Mutual Life Insurance was regarding the claim of a person who died due to sunstroke while playing golf. The majority judgment upheld the repudiation of claim by observing "insurance is not against an accidental result" and that the policy need be honoured only if the accidental death is "effected by means which are external and accidental".Justice Cordozo however dissented from the majority. According to him, the distinction between 'means' and 'result' was artificial. If the death was an accidental result, it was caused by accidental means, he reasoned.The Canadian Supreme Court has taken a contrary view from the majority opinion of SCOTUS in Landress. In the case American International Assurance Life Company Ltd and American Life Insurance Company v Dorothy Martin, the insured died due to over dose of medicines injected by him. The insurance company rejected the claim saying that death was not due to violent, external accidental means and was caused by a deliberate act of the insured.The Canadian Court said that to ascertain whether a given means of death is "accidental", it must be considered 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", the Court observed, applying the reasoning of Justice Cordozo. According to Court, "accidental death" and "death by accidental means" have the same connotation and unintended results should be treated as accidental.Endorsing the Canadian view, the Singapore Supreme Court held in a case relating to unintended overdose of medicine that 'accidental means' test should not be used to deny insurance coverage to cases where the proximate cause of death was a voluntary act of the deceased, which had produced an unintended result.When death was caused by external attackIn Kamlawati Devi vs State of Bihar, the Patna High Court was grappled with the issue whether death of an officer while performing election due to attack by armed miscreants can be said to be "resulting solely and directly from accident caused by external violent and any other visible means"Justice Aftab Alam (later SC...

What Is 'Accidental Death' In The Context Of Insurance Law?

Manu Sebastian

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