Insurance Clauses Intending To Avoid Claims On Account Of Death Due To Self-Injury Or Disablement Under Influence Of Alcohol Not Arbitrary Or Capricious: Kerala HC

The petitioner is a widow who has approached the Court seeking insurance for the death of her husband by drowning after accidentally tripping into a well. She was denied insurance on the allegation that the husband was under the influence of alcohol at the time of death.

While denying the benefit of the claim under the Group Personal Accident Insurance Scheme, the Court stated that the petitioner's husband was under the influence of a large amount of liquor and could have tripped into the well under its influence.

“I deem it necessarily to peripherally say that the said clause cannot be found to be capricious because, it is intended to avoid any temptation from any person to cause self injury or disablement, solely for the purpose of the cover of insurance. The proviso does not really impose any unreasonable restriction but only stipulates that an injury or disablement, caused on account of an accident due to the influence of alcohol, or while under such influence, would stand excluded.”, stated Justice Devan Ramachandran

The petitioner had approached the Court claiming that she was entitled to an insurance payment of 10 lakh rupees since her husband was covered under the Group Personal Accident Insurance Scheme.

The counsel for the petitioner submitted that the cause of death was drowning and the insurance amount cannot be denied attributing death to the influence of alcohol. It was argued that any person could have accidentally tripped into a well with or without the influence of alcohol. Thus, it was stated that consumption of alcohol had no direct nexus to the cause of death and that she was entitled to the insurance amount.

On the other hand, the Government Pleader submitted that the object of the scheme was to cover deaths which are beyond the control of human intervention or action. He argued that as per Clause 6 of the Scheme, compensation could not be paid for death or disablement arising out of intentional self-injury, suicide, attempted suicide, death or disablement due to an accident, while under the influence of intoxicating liquor or drugs. It was also stated death or disablement while breaching the law with criminal intent would be covered under the scheme.

Further, the Government Pleader stated that the petitioner's husband had consumed a large amount of alcohol, was not in a state to control himself, and fell into the well and unfortunately died of drowning.

Relying upon the chemical analysis report, the Court found that the petitioner's husband was under the influence of alcohol indicative of not merely casual drinking, but of heavy indulgence. It found that the deceased would have been in an inebriated state when he tripped and fell.

The Court also took note of the fact that there was a protective wall around the well which makes it improbable for a person to fall into it except being intoxicated or external application of force.

“All the afore is suggestive of the fact that the death occurred unfortunately on account of the factum of the deceased having imbibed large volume of liquor; and hence the argument of the petitioner, that Clause 6 of the Scheme would not be attracted in this case, the death being not on account of consumption of liquor, cannot find my favour”, stated the Court.

On the above findings, the Court stated that going into Clause 6 of the Scheme would not be beneficial to the petitioner.

“This is because, even this Court is to read down the impugned proviso to hold that a case of death on account of an accident, which is not directly on account of the consumption of liquor, would not be attracted under its purlieu, it would not help the petitioner, since, in this case, it is without much of doubt that, unfortunately, the victim succumbed on account of the factum that he was unable to physically control himself”, it added.

Accordingly, the Court stated that such clauses in insurance schemes were meant to prevent persons from taking benefit of the scheme on sustaining injury or disablement on consumption of alcohol or under such influence and cannot be stated to be capricious. It left the issues open to be decided in future cases.

Counsel for the Petitioner: Advocates Lindons C.Davis , E.U.Dhanya, Swathy A.P.

Counsel for the Respondents: Government Pleader Rajeev Jyothish George

Citation: 2024 LiveLaw (Ker) 115

Case title: Sreedevi M v State Of Kerala

Case number: WP(C) NO. 6768 OF 2022

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