The Provisos of insurance policy specifically disclose that compensation will not be paid in respect of injury of the injured if he is under the influence of intoxicating liquor and the injured was not entitled to compensation since on facts it was proved that he was intoxicated and that was due to intoxication. This judgment was passed by the Hon’ble Justice MOHAN M. SHANTANAGOUDAR of the Supreme Court in the matter of NARBADA DEVI AND ORS. Vs. H.P. STATE FOREST CORPORATION & ANR. [CIVIL APPEAL NO. 6379 OF 2010].
This appeal arose out of order and judgement of the National Consumer Disputes Redressal Commission, New Delhi allowing Revision Petition filed by the Respondent, against the order dated 9.10.2006 passed by the Himachal Pradesh State Consumer Disputes Redressal Commission, Shimla (hereinafter ‘State Commission’) in Appeal No. 281/2004.
The factual data revealed that the deceased was returning from Banal Depot to Thundal along with one Chandermohan, the forest guard, on a stormy night where he was trapped and later recovered in a hapless condition around 9:00 AM, smelling of alcohol. After being recovered, he was given a hot water bath but he could not survive. Later the forest guard filed an FIR and the respondent issued a certificate that stated that the deceased died on duty during his working tenure. The post mortem reported asphyxia because of a choked food pipe due to intoxication. The deceased was enrolled in the Janta personal accident insurance scheme hence the decedents of the deceased were liable for the compensation from the scheme but the insurance company rejected to settle the compensation.
The court relied on the definition of asphyxia in the Medicolegal Manual by Dr K.S. Narayan Reddy states that “Asphyxia is a condition caused by interference with respiration, or due to lack of oxygen in respired due to which the organs and tissues are deprived of oxygen (together with the failure to eliminate CO2), causing unconsciousness or death.”
The court held that “The Insurance Policy only covers ‘bodily injury resulting solely and directly from an accident caused by outward, violent and visible means (including sterilization risks)’. Since there is no evidence to show that the deceased met with an accident and the PostMortem Report also shows that no bodily injury was caused to the deceased, the claim is not payable under the said Policy.”
The court pointed out that Proviso 4 to the Insurance Policy contains an exclusion clause and stated that “whereby it is clearly provided that if the insured dies whilst under the influence of intoxicating liquor or drug, claim under the Policy will not be payable.”
The appellants’ claim was not maintainable on the grounds stating that “The facts of the present case show that on the night before his death, the deceased was heavily drunk, and had gone and slept outside on a cold, rainy October night in Chopal. In case of excessive drinking and cold weather, asphyxia is the final medical complication”.
Also stating that “It was further pointed out that there is neither any direct evidence nor any bodily injury to prove the Appellants’ claim that the deceased died due to having suffered a fall during the storm.”
