The Kerala High Court has ruled that an insurance company cannot reject an accident insurance claim merely because alcohol was detected in the deceased's body. The Court held that unless there is evidence showing the person was actually under the influence of alcohol, the policy exclusion cannot be invoked. It also found that injuries suffered in the accident had contributed to the death, making the legal heirs eligible for compensation.
Background of the Case
The case arose after Babu was found unconscious on the roadside on November 30, 2020, and was taken to a hospital, where he died the following day. His wife and daughters sought compensation under a personal accident insurance policy issued by United India Insurance Company.
The insurer denied the claim before the Permanent Lok Adalat, arguing that Babu had died due to occlusive coronary artery disease rather than the accident. It also relied on a toxicology report showing the presence of alcohol in his body and claimed that the policy excluded such cases. Despite these objections, the Permanent Lok Adalat awarded ₹15 lakh to the family. The insurance company then challenged that award before the High Court.
Court's Observations
Justice Harisankar V. Menon examined the post-mortem report and noted that although the immediate cause of death was recorded as coronary artery disease, the report also clearly stated that the injuries sustained in the accident "could have accelerated or precipitated death."
The Court observed,
"Postmortem findings are consistent with death due to occlusive coronary artery disease and injuries could have accelerated or precipitated death."
The Court said this finding could not be ignored. It further noted that the deceased had suffered multiple injuries in the accident and that these injuries had a direct connection with his death. Therefore, the insurer's argument that the accident was unrelated to the death was not accepted.
On the issue of alcohol consumption, the Court made an important distinction between the mere presence of alcohol and being under its influence.
The bench observed,
"Merely because the person is said to have consumed alcohol, can it be concluded that he was under the 'influence of alcohol'."
Justice Menon pointed out that the insurance policy excluded claims only where the rider was under the influence of intoxicating liquor. Since the insurer relied only on a toxicology report and produced no evidence proving impairment at the time of the accident, the exclusion clause could not be applied. The Court also referred to earlier decisions of the Supreme Court and the Kerala High Court supporting this principle.
Decision
Finding no legal error in the Permanent Lok Adalat's award, the Kerala High Court dismissed the writ petition filed by United India Insurance Company and upheld the direction to pay ₹15 lakh as compensation to the deceased's legal heirs.
Case Details
Case Title: United India Insurance Company Co. Ltd. v. Salpriya & Others
Case Number: WP(C) No. 16379 of 2023
Judge: Justice Harisankar V. Menon
Decision Date: 8 June 2026
-300x169.webp)
