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DEVAN RAMACHANDRAN
Sreedevi M. , W/o. Late Vijayakumar – Appellant
Versus
State of Kerala, Represented by its Secretary, Finance Department – Respondent
JUDGMENT :
This is the second writ petition filed by the petitioner, after having obtained a judgment earlier in W.P.(C).No.12693/2020.
2. The petitioner is stated to be the wife of late Vijayakumar, who unfortunately died of drowning, after having accidentally tripped into a well on 18.10.2018. The petitioner says that her husband was covered by a Group Personal Accident Insurance Scheme ('Scheme' for short), namely Ext.P9; and thus that she was entitled to compensation to the sum of Rs.10 lakhs, but that this was denied on the allegation that her husband, at the time of death, was under the influence of alcohol. She says that this was irrelevant because, what is important as per Ext.P9 policy was the verified cause of death, which, according to her, cannot be attributed to the influence of alcohol – assuming that her husband was under such at the relevant time.
3. The petitioner says that she, therefore, had approached this Court through the aforementioned writ petition, namely, W.P.(C) No.12693/2020, which was disposed of, directing the competent Authority to reconsider the case, which has now entered in Ext.P8, wherein, it has been reiterated that, as per Ext.P9 policy, particular
The influence of alcohol at the time of death can justify the denial of a claim under a personal accident insurance scheme. The proviso to the insurance clause aims to prevent self-injury for insuran....
The main legal point established is that the insurance company is not liable to compensate if the deceased was under the influence of alcohol at the time of the accident, as per the terms of the poli....
(1) Failed to discharge the services – The insurer failed to discharge its service obligations by rejecting a genuine claim based on a Chemical Analysis report showing alcohol presence, while ignorin....
Accidental claims cannot be rejected solely on presumed intoxication without conclusive blood evidence.
The interpretation of exclusion clauses in insurance policies must be strict, and insurers bear the burden of proving that claims fall within such exclusions, particularly when ambiguities exist.
IMORTANT POINTS (1) Insurance policy - in the matter of Insurance claims, the Courts cannot adopt a beneficial/welfare approach, and have to go strictly by the words used in the concerned Insurance P....
Insurance claims must strictly adhere to policy terms; no liberal interpretations allowed.
Insured is not entitled to compensation when on facts it is proved that he was intoxicated and that his death was due to intoxication.
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