Positive Alcohol Test Alone Cannot Defeat Accident Insurance Claim: Kerala High Court

Justice Harisankar V. Menon was delivering the judgment in a writ petition filed by United India Insurance Company challenging an award of the Permanent Lok Adalat directing payment of ₹15 lakh to the legal heirs of a deceased policyholder.

The deceased, Babu met with an accident while riding a motorcycle, and later passed away in the hospital while undergoing treatment. His legal heirs filed for an insurance claim before the permanent lok adalat and Rs. 15 lakh was awarded as the claim. The appeal was filed against this award.

The Insurance company contended that the toxicology report of the deceased tested positive for alcohol and that the postmortem report stated the cause of death as 'occlusive coronary artery disease'.

The Court examined whether a positive toxicology report showing the presence of alcohol is, by itself, sufficient to invoke an insurance policy exclusion applicable when the insured was "under the influence of intoxicating liquor or drugs."

It also examined whether the death could be treated as resulting from an accident where the post-mortem attributed death to coronary artery disease but also recorded that the injuries sustained in the accident could have accelerated or precipitated death.

The Court drew a distinction between consumption of alcohol and being under its influence.

The Court noted that while the toxicology report merely confirmed the presence of alcohol, there was no evidence whatsoever demonstrating that the deceased's faculties were impaired or that he was under the influence of alcohol at the time of the accident.

“True, the toxicology report at Ext.P6 makes reference to the existence of “alcohol” in the sample collected on 01.12.2020. However, the question is as to whether merely because the person is said to have consumed alcohol, can it be concluded that he was under the “influence of alcohol”.” the Court urged.

Relying on the decision in Oriental Insurance Co. Ltd. v. Vineetha Nair [2016 (4) KHC 392] and the Supreme Court's decision in IFFCO Tokio General Insurance Co. Ltd. v. Pearl Beverages Ltd., [2021 KHC OnLine 6232], the Court reiterated that denial of an insurance claim requires evidence regarding the circumstances of the accident, which includes the extent of alcohol consumption, its impact on the driver, and other surrounding facts. It noted that merely a positive toxicology result cannot be used to deny the insurance claim.

“In the case at hand, as already noticed, the reference made by the petitioner in the writ petition is only to the toxicology report. There is no evidence on record to show that the deceased was under the influence of alcohol.” Court noted.

The Court further held that although the post-mortem identified coronary artery disease as the cause of death, it expressly recorded that the injuries sustained in the accident "could have accelerated or precipitated death." Reading the report as a whole, including the multiple injuries noted therein, the Court concluded that the accident had a proximate causal connection with the death.

The Court also referred to the Supreme Court's decision in Alka Shukla v. LIC of India [2019 (2) KLT 3098], observing that accident benefit claims require a proximate causal relationship between the accident, the bodily injuries, and the death. The Court noted that such a relationship could be found in the present case and hence the decision of the Lok Adalat in granting the claim was correct.

The Court thus dismissed the writ petition.

Case Title: United India Insurance Company Co. Ltd. v Salpriya and Ors.

Case No: WP(C) 16379/ 2023

Citation: 2026 LiveLaw (Ker) 348

Counsel for Petitioner: S. Arun Raj, C. T Suja, Arjun S. Raj

Counsel for Respondents: R. T. Pradeep, Niranjan T. Pradeep