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2025 Supreme(Online)(Ker) 49272

KERALA HIGH COURT
Sushrut Arvind Dharmadhikari, *Syam Kumar V. M., JJ.
National Insurance Co. Ltd. Kochi v. State of Kerala
W. A. No. 476 of 2023



1. This appeal is filed challenging the judgment dated 14.10.2022 of the learned Single Judge in W.P.(C) No.21669 of 2012. Appellant was the petitioner in the said W.P.(C), and respondents were the respondents therein.

2. The Writ Petition was filed seeking to quash Ext.P9 award dated 03.01.2012 of the Insurance Ombudsman, Kochi, in Complaint No.IO / KCH / GI / 11-003-986/2010-11. The Ombudsman vide the said order directed the appellant Insurance Company to pay an amount of Rs.7,00,000/- to the 4th respondent, towards the sum insured under a group insurance policy covering her husband, who had died in an accident.

3. The brief facts pertaining to the subject matter are as follows :
The husband of the 4th respondent, K. S. Shibu, was a Lascar in the Irrigation Department of the Government of Kerala. He had been covered under a Group Personal Accident Policy (GPA policy) issued by the appellant Insurance Company to cover Government employees and teachers. On 19.05.2009, the petitioner's husband died of injuries suffered in a motor vehicle accident involving a collision between the motorcycle driven by him and a tourist bus. The 4th respondent preferred a claim with the appellant insurer invoking the policy. The claim was rejected by the appellant insurer, stating that the same is hit by a clause in the policy which stipulated that death occurred while the deceased was under the influence of intoxicating liquor or drugs will be an exclusion of liability. The repudiation of the claim was challenged by the 4th respondent before the Insurance Ombudsman. After hearing both sides, the Ombudsman rendered the impugned order inter alia holding that the 4th respondent is entitled to an amount of Rs.7,00,000/- from the appellant insurer. Challenging the said order of the Ombudsman, the appellant Insurance Company had preferred the Writ Petition, which was dismissed by the learned Single Judge by the judgment impugned in this appeal.

4. Heard Sri. George A. Cherian, Senior Advocate, instructed by Smt. Susan George, Advocate, for the appellant and Sri. Sunil Kumar Kuriakose, learned Senior Government Pleader for R1 and R3. Notice to the 2nd respondent, Insurance Ombudsman, was dispensed with. Though service was completed against the 4th respondent, there was no appearance on her behalf.

5. Learned Senior Counsel appearing for the appellant contended that the learned Single Judge had erred in dismissing the Writ Petition and had failed to properly appreciate the law governing the terms of the policy of the insurance. It is contended that the rights and liabilities under an insurance policy are determined based on the terms of the policy and that such terms are to be strictly construed. The terms of the policy (Ext.P1), as well as the relevant Memorandum of Understanding (Ext.P2) clearly excluded any liability to pay under the policy when death or disability arises whilst under the influence of intoxicating drugs or alcohol. The learned Single Judge had erred in taking note of the same. It is contended that while interpreting a contract of insurance, the terms and conditions thereof are to be interpreted strictly. The words in an insurance contract must be given paramount importance and should be interpreted as expressed without any addition, deviation or substitution. The learned Single Judge, following the said settled legal position, ought to have set aside the order of the Insurance Ombudsman. The policy having specifically excluded compensation for death or disability arising out of or whilst under the influence of intoxicating drugs or alcohol, no amount could have been directed to be paid. Based on Ext.P5 chemical analysis report, it is further submitted that the blood sample collected contains ethyl alcohol 154.79 mgs. per 100 ml. blood. Based on S.185 of the Motor Vehicles Act, 1988, it is contended that driving a vehicle by a drunken person is an offence and that as per Ext.P5 chemical analysis report, the deceased had more than five


















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