IMPORTANT POINT
Alcohol concentration up to 50 mg per 100 ml of blood is tolerable, such person will not show signs of intoxication.

Relevant facts in brief are that Sri Madhu Reddy (since deceased) obtained Personal Accident Policy from the OP-The Bajaj Allianz General Insurance Co. Ltd., Pune, Branch, (Maharashtra) valid from 25.01.2010 till 17.01.2015 for a sum of Rs.10,00,000/- where nominee was his wife Smt. Sujata. During the subsistence of the said policy; Madhu Reddy died in a motor vehicle accident on 21.3.2010. The nominee had filed a claim before the OP, but the OP repudiated the claim as the Policy holder was under the influence of alcohol while driving the car at the time of accident. Hence, Complaint No.23/2011 was filed by Smt. Sujatha (wife of deceased) before the District Consumer Disputes Redressal Forum, (in short, ‘District Forum’) Nizamabad for claiming the accident benefit and proper compensation.

2. The District Forum, Nizamabad allowed the complaint and directed the OP to deposit Rs.10,00,000/- with interest @ 9% per annum from the date of repudiation i.e. from 07.07.2010, the OP is further directed to pay Rs.20,000/- towards compensation for deficiency of service and negligence, and Rs.2,000/- as costs.

3. Against this order, the OP filed the First Appeal No.450 of 2012 before the State Consumer Disputes Redressal Commission, (in short, ‘State Commission’) of Andhra Pradesh at Hyderabad. The State Commission reversed the order and dismissed the complaint. Hence, aggrieved by the order of the State Commission, the complainant/petitioner filed the present revision petition.

4. We have heard the learned counsel for the parties. The counsel for the complainant vehemently argued that there is no proper evidence regarding consumption of alcohol. The FSL report is inconclusive, while the Medical Superintendent of District Hospital, Nizamabad issued certificate for cause of death as “Head injury and intracranial bleed under Ethyl Alcohol intoxication”.

5. The learned counsel for the OP vehemently argued that, after thorough enquiry the OP repudiated the claim on the ground that the deceased was under the influence of alcohol. As the Complainant has violated the policy conditions, she is not entitled to claim any amount; hence, the OP has rightly repudiated the claim. FIR, Charge-sheet, PM & FSL Report prove that he expired due to head injury and intracranial bleed under ethyl alcohol intoxication and claim towards death under the influence of alcohol is standard exclusion clause B1(b) of the policy. Clause B 1 (b) of the insurance policy states that, the amount will not be paid, if the death is due to accidental bodily injury while under the influence of liquor or drugs. Therefore, OP prayed for dismissal of the revision.

6. The counsel for OP admitted that, the FSL report did not show any quantification or concentration of Alcohol but, the counsel vehemently argued that the report mentions about presence of Ethyl Alcohol in the organs (Item 1 and 2 of the viscera from post mortem). He further contended that the provision laid down in Motor Vehicles (MV) Act, about alcohol concentration, is not applicable in this case. It has vitiated the terms and conditions of the policy. Therefore, the claim should not be allowed.

7. On careful perusal of FSL report, it is very surprising to note that the doctor who performed PM had not sent the blood sample from the dead body for analysis and to know Blood Alcohol Concentration (BAC). He took only samples as Item 1- the stomach and a piece of intestine and as Item-2 piece of liver and kidney which were sent to the FSL. The FSL report given after analysis is reproduced as below:

“Item 1 and 2 are analysed and Ethyl alcohol is found in both of them. No other poisonous substance is found in them”

8. In our view, it was not a conclusive report from the FSL, it leads us nowhere. There was no mention of any alcohol concentration, by which we can decide whether the person was Intoxicated or not? We have perused several literature and medical texts in Medical Jurisprudence and Toxicology, which clearly define a