Mere Presence Of Alcohol In Accident Victim's Blood Not Enough To Exclude Liability, Insurer Must Show Evidence Of Impairment: Kerala High Court

In a recent judgment, the Kerala High Court has held that evidence of the mere presence of alcohol in the victim's blood is not enough for an insurer to exclude liability in accidental deaths when the exclusion clause specifically excludes deaths caused under the influence of alcohol.

It further observed that the insurer must prove that the accident occurred while the victim was under the influence of intoxicating liquor to trigger the exception clause.

The Division Bench of Justice Sushrut Arvind Dharmadhikari and Justice Syam Kumar V.M. laid down the position of law while considering an appeal preferred by National Insurance Company.

The company had filed the writ petition to quash the Insurance Ombudsman's award directing it to pay Rs. 7 lakhs to the wife of the deceased, who was insured under a group insurance policy. When the Single Bench dismissed the same, the insurance company filed a writ appeal.

The deceased was employed in the Irrigation department of the Government of Kerala and was covered under the Group Personal Accident (GPA) Policy of the appellant company to cover government employees. He died in a motor accident when the motorcycle driven by him collided with a tourist bus.

His wife (4th respondent) made a claim with the appellant invoking the policy but the same was rejected stating that the exclusion clause is triggered since the deceased was under the influence of alcohol. This was challenged before the Ombudsman, which awarded in favour of 4th respondent.

The Court noted that the policy did not specifically state "presence of alcohol in blood" was sufficient to trigger the exception clause but had mentioned that insurer would not be liable if the death or disablement of insured person occurred while he was "under the influence of intoxicating liquor/alcohol".

It found that a chemical analysis report pointing to the content of alcohol in blood sample is not sufficient to prove that the deceased was intoxicated. It also remarked that the appellant's argument that the report pointed to the commission of offence under the Motor Vehicles Act do not apply while considering the insurer's liability.

The Court also went on to state that the precedents relied on by the appellant do not apply in the present case considering the specific wordings of the policy. 

The Bench, therefore, refused to interfere with the judgment of the Single Judge and observed:

"When an insurer proceeds to include an exception clause in the policy to exclude coverage for accidents occurring under the influence of intoxicating liquor/ alcohol, the onus is on the insurer to demonstrate the actual impairment of faculties due to intoxication. That alone would trigger the exception clause. It has to be proved through a process known to law that the insured was intoxicated and that the incident happened due to intoxication. Evidence regarding the mere presence of alcohol would not suffice to exclude the insurer from liability."

Thus, the Court dismissed the writ appeal.

Case No: WA No. 476 of 2023

Case Title: National Insurance Co. Ltd. v. State of Kerala and Ors.

Citation: 2025 LiveLaw (Ker) 623

Counsel for the appellant: George A. Cherian, Jacob Mathew Kaithalil, George Cherian (Sr.)

Counsel for the respondents: Ajaya Kumar G - R4, Sunil Kumar Kuriakose - Government Pleader

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