National Insurance Company Ltd. vs. The Chief Electoral Officer & Ors. (Civil Appeal No. 4769 of 2022)
Background
For the 2000 Bihar Legislative Assembly elections, the Chief Electoral Officer, Bihar entered into a group insurance MoU with National Insurance Company to cover election-duty personnel for death "solely and directly from accident caused by external violent and any other visible means." A police constable on election duty died of heat/sun stroke during the extended (by-poll) policy period. His wife raised a compensation claim only in 2008, over seven years later. A Patna High Court Single Judge held the State authorities liable since the claim was not lodged with the insurer in time; the Division Bench reversed this and fastened liability on the insurance company instead, applying an "agency" principle from an unrelated line of cases. The insurance company appealed to the Supreme Court.
Decision Breakdown
The Supreme Court held that the claim was raised after an unreasonably long delay (seven and a half years) and that if the Chief Electoral Officer believed the claim was valid, it was its own duty to lodge it with the insurer promptly per the MoU's "immediate intimation" clause: its failure to do so could not be used to shift liability onto the insurer. On merits, the Court also held the policy's "external violent and any other visible means" clause, read strictly (as insurance contracts must be), did not cover death by heat stroke, since that is not "accidental means" caused by external violence, relying on the accidental-means vs. accidental-result distinction from Alka Shukla v. LIC. The Division Bench's judgment was set aside and the appeal allowed, though the Court declined to let the money already paid to the widow be recovered back from her.
Lesson Learnt
Insurance policy terms must be read strictly as written. Courts will not expand "accident" to cover a natural physiological event like heat stroke unless the policy's language covers it. Claims should be lodged with insurers promptly per policy terms; unreasonable delay in claiming can itself defeat entitlement, regardless of which party is ultimately liable.