Decided on June 22,2015

Valsala Devi Appellant
Divisional Manager, Kottayam And Ors. Respondents


- (1.) The issue arising in the above writ petition, filed impugning the award of the Ombudsman, is whether the petitioner is entitled to the additional benefit of 'death by accident' as covered in Ext. P1 policy. The policy is said to be one which indemnifies the death and death by accident, the latter entitling double benefit to the beneficiary. With respect to death by accident, the nominee is entitled to Rs. 5 lakhs as indemnity for the death caused and an additional Rs. 5 lakhs as indemnity if such death is caused by an accident. The petitioner, the nominee of the policy holder-who died by reason of a fall from a height, was granted the death benefit, but was declined the accident benefit for reason of the death having not been caused by an "outward, violent and visible means". This is the exact words used in Clause 10(b) of Ext. P1 which refers to the entitlement of an "additional sum equal to the sum assured under this policy, if the life assured shall sustain any bodily injury resulting solely and directly from the accident caused by outward, violent and visible means and such injury shall within 120 days of its occurrence solely, directly and independently of all other causes result in the death of the life assured".
(2.) The learned Counsel for the petitioner would Ambalal Lallubhai Panchal (Ranerwala) v. L.I.C. of India, 1999 AIR(Guj) 280 and United India Insurance C. Ltd. v. State of Bihar,2003 3 KerLT 316 to contend that, the repudiation made on the ground of the accident itself having been caused by Diabetes Mellitus and Hypertension cannot be sustained. The learned Counsel would also take me through the 4th edition of Halsbury's Laws of England, 4th edition, 2013 (Vol. 25) in which the concept of injuries resulting from accident by violent, external and visible means has been dilated upon on the strength of judicial precedents.
(3.) The learned Standing Counsel appearing for the respondent Insurance Company however, would urge that, a strict interpretation is necessary in the case of the policies governing the indemnification of death and accident, as has been consistently held by the Hon'ble Supreme Court in Life Insurance Corporation of India and Another v. Dharam Vir Anand, 1998 7 SCC 348, Amravati District Central Cooperative Bank Limited v. United India Fire and General Insurance Company Limited, 2010 5 SCC 294 and Export Credit Guarantee Corporation of India Limited v. Garg Sons International, 2014 1 SCC 686.;

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