Court Affirms That Mere Alcohol Presence Insufficient to Deny Insurance Claim; Proximate Cause of Accident Validates Compensation
In a significant ruling, the Kerala High Court has dismissed a writ petition filed by the United India Insurance Company Ltd., affirming the decision of the Permanent Lok Adalat, Thiruvananthapuram, to award Rs. 15 lakhs as compensation to the legal heirs of a deceased individual. The court upheld the findings that the death, which occurred following a road accident, was indeed accelerated by the injuries sustained, despite the deceased's toxicology report indicating alcohol consumption.
The case stems from an incident on November 30, 2020, when Babu was found unconscious on a roadside and later succumbed to his injuries at a hospital on December 1, 2020. The insurance company had contested the compensation claim, arguing that the death was due to "occlusive coronary artery disease" and that the deceased was under the influence of alcohol, as indicated in the toxicology report.
Presiding Judge Mr. Harisankar V. Menon, referencing the post-mortem report, noted that the injuries from the accident could have precipitated or accelerated Babu's death. The court emphasized the need for a proximate causal relationship between the accident and the injuries sustained, citing principles from previous cases such as Alka Shukla v. Life Insurance Corporation of India and Oriental Insurance Company Ltd. v. Vineetha Nair.
The insurance company's assertion that the mere presence of alcohol was grounds to deny the claim was rejected, as the court reiterated that there was insufficient evidence to prove that Babu was under the "influence of alcohol" at the time of the accident. The judgment drew upon precedents that distinguish between the consumption of alcohol and being under its influence, a critical factor in insurance policy exclusions.
This decision underscores the judiciary's stance on interpreting insurance claims, particularly in cases involving allegations of alcohol consumption, and reinforces the necessity for clear evidence when invoking policy exclusions.
Bottom line:-
Insurance claim cannot be denied solely on the ground of consumption of alcohol unless it is proved that the deceased was under the "influence of alcohol" at the time of the incident.
Statutory provision(s): Insurance Law, Exclusion clause, Accident benefit cover, Proximate causal relationship, Influence of alcohol
United India Insurance Company Co. Ltd. v. Salpriya, (Kerala) : Law Finder Doc id # 2931834
