Insurance company

The insurance company is not exempted simply because the driver has consumed alcohol in excess of the prescribed limit, except in cases of proven contributory negligence: Kerala HC

The Kerala High Court recently ruled that just because a person has consumed alcohol in excess of the limit prescribed by the criminal provisions of the Motor Vehicles Act 1988, it cannot be said that she was “under the influence of alcohol”, and the insurance company cannot be exempted from making right to the loss when the person himself has in no way contributed to the occurrence of the accident.

Judge Shaji P. Chalywhile supporting it, proceeded to the interpretation of the term “influence of alcohol” and observed that,

“The influence of alcohol on the senses and faculties varies from person to person. The influence of alcohol, in my opinion, would mean that due to the consumption of alcohol, the senses and the person’s normal faculties should have been overpowered by alcohol and thus lost the average mind temporarily; or that he was unable to control himself; or a state of intoxication prevailed over the person, losing thus the ability, strength and ability to control and ride the motorcycle by himself and thus wholly or partially contributed to the accident”.

The brief facts of the case show that the deceased who was the husband of the 4th respondent in this case, died in an accident on May 19, 2009, when the motorcycle he was riding collided with a tourist bus.

The deceased was covered by a group personal accident insurance policy, and so the 4th defendant filed a claim with the insurance company (the claimant here) for the death benefit under the policy. This was however rejected by the latter, on the grounds that the death occurred while the deceased was under the influence of alcohol or intoxicating drugs, thus rejecting the request of the 4th defendant.

Before the Ombudsman, the 4th defendant argued that the repudiation of the claim was not lawful and proper and that the deceased was not negligent in riding the motorcycle. It was also pointed out that an FIR and an indictment have been filed against the bus driver. The petitioner however argued before the Ombudsman that the presence of alcohol content exempted the claim under clause 5(b) contained in the insurance conditions.

The Ombudsman found that the accident occurred when the tourist bus overtook a car and, in doing so, hit the motorcycle of the deceased. It was further found that the deceased had stood on the correct side of the road, while it was the tourist bus that had passed on the wrong side. The Ombudsman further observed that, “The simple consumption of alcohol is quite different from the stage under the influence of alcohol”, and the instant accident had happened entirely due to the negligence of the bus driver. As a result, the Ombudsman ordered the insurance company to pay an amount of Rs. 7,00,000/- to the 4th sponsor.

It is against this order that the present motion was filed by the Petitioner-Insurance Company.

In the High Court he was supported by Lawyer Rajan P. Kaliyath on behalf of the Claimant that the Company’s liability was contractual and that the Mediator’s decision was clearly contrary to the terms of the contract. It was argued that the insurance contract, together with the memorandum of understanding on the basis of which the insurance contract is issued, governs the rights and liabilities of the parties, which specifically excludes compensation for death or injury. disability resulting from “under the influence of intoxicating drugs or alcohol” under the exclusion clause of 5(b) of the insurance contract and clause 4 of the memorandum of understanding. deceased had consumed alcohol in excess of the limit of 30mg per 100ml of blood prescribed under section 185 of the Motor Vehicles Act 1988 as revealed by the chemical analysis report, he was argued that the insurance company was excluded from liability for compensation.

Lawyer Ajaya Kumar G.and Joby Joseph, senior government official on the other hand, maintained that the accident was solely due to the reckless and negligent driving of the tourist bus driver, and that the deceased had in no way contributed to it.

In this case, the Court found that there was no instance of contributory negligence on the part of the deceased in the accident, despite the presence of alcohol.

“The only case projected by the insurance company is on the basis of the chemical analysis report that the alcohol content in the blood exceeds the limit prescribed in section 185 of the 1988 act, which in itself does not is not sufficient to benefit from the exclusion clause in favor of the insurer”, Court observed.

Accordingly, the Court found no evidence that the Ombudsman’s decision suffered from arbitrariness, illegality, injustice or any other legal invalidity justifiable to be interfered with in a proceeding under Article 226 of the Constitution, and accordingly dismissed the writ.

Case title: National Insurance Co. Ltd. vs. State of Kerala & Ors.

Quote: 2022 LiveLaw (Ker) 531

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