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M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

PLOT NO.76, ARERA HILLS, BHOPAL

FIRST APPEAL NO.906 OF 2013

(Arising out of order dated 04.05.2013 passed in Case.No.181/2012 by

District Commission, Rewa)

SBI LIFE INSURANCE COMPANY

LIMITED,

THROUGH HEAD LEGAL,

KAPAS BHAWAN, PLOT NO.3-A,

SECTOR NO.10, CBD BELAPUR,

NAVI MUMBAI. … APPELLANT.

Versus

1. SMT.VEENA PATEL,

R/O SAMAN NAKA, PATELJI

COMPLEX, SAMAN,

REWA.

2. STATE BANK OF INDIA,

UJJAIN BRANCH,

SBI MAIN BRANCH CAMPUS,

BUDHVARIYA, UJJAIN. .… RESPONDENTS.

BEFORE :

HON’BLE JUSTICE SMT.SUNITA YADAV, PRESIDENT

HON’BLE DR. (MRS) MONIKA MALIK, MEMBER

COUNSEL FOR PARTIES :

Shri Nitin Jain, learned counsel for the appellant.

None present for respondent no.1.

Shri Yash Vidhyarthi, learned counsel for respondent no.2.

O R D E R

(Passed on .01.2026)

The following order of the Commission was delivered

by Dr.(Mrs) Monika Malik, Member :

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This is an appeal by the opposite party no.2 /

appellant – SBI Life Insurance Company Limited (hereinafter

referred to as ‘Insurance Company’) directed against the order

dated 04.05.2013 passed by the District Consumer Disputes

Redressal Commission, Rewa (for short ‘District Commission’) in

complaint case no. 181/2012, whereby the District Commission

has partly allowed the complaint and has directed the Insurance

Company to deposit the claim amount towards car loan account

situated in opposite party no.1 – State Bank of India (hereinafter

referred to as ‘bank’) and pay cost of Rs.1,000/- to the

complainant.

2. Brief facts of the case are that the late husband of the

complainant – Bhuvaneshwar Prasad Patel (hereinafter referred

to as ‘deceased / insured’) had obtained car loan from the bank.

He had also obtained insurance policy bearing no.83001001708

under the loan scheme plan from the Insurance Company. It is

submitted that on 13.05.2009 the deceased / insured had went

alongwith his colleagues for a picnic. When he went for urination

at night he fell in a dry well, which was without platform and

sustained severe head injuries due to which he died. It is alleged

that when the claim alongwith requisite documents was presented

to the Insurance Company the same was denied on 19.09.2009.

Therefore she filed complaint before the District Commission,

seeking relief.

3. Heard.

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4. Learned counsel for the Insurance Company argued

that the Insurance Company enquired into the matter and found

that death of the deceased/ insured was due to severe head

injuries sustained when he fell into dry well under the influence of

intoxicating liquor. Therefore the death claim was repudiated by

the Insurance Company on the grounds of exclusion clause as

per terms and conditions of the policy. The chemical analysis

revealed that the blood samples of the deceased / insured

contained 226 mg / 100 g of ethyl alcohol in the viscera which

proves that the deceased / insured was heavily drunk. Hence

repudiation of the claim by the Insurance Company was fully

justified, as under intoxication there is poor motor coordination

alongwith poor judgment which increases the likelihood of

accidental injury and may be fatal in many cases. He therefore

prayed that the impugned order be set aside. He referred

judgments passed by the Hon’ble National Commission in

Consumer Case no.401/2014, Baby Apoorva Rai Vs. New

India Assurance Co.Ltd. & Anr, decided on 03.09.2015 and

case of Sushila Chouhan Vs. National Insurance Co.Ltd.,

(2015) 04 NCDRC CK 0164 in support of his arguments.

5. Learned counsel for the bank argued that the

deceased / insured had obtained car loan from the bank which

was covered by insurance policy issued by the Insurance

Company. There is no liability of the bank regarding payment of

claim amount. He prayed that in case the claim is allowed the

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claim amount be directed to be deposited towards the loan

account of the deceased / insured. He also prayed that the

appeal against the bank be dismissed.

6. Exhibit D-9 is the test report prepared by the Regional

Forensic Science Laboratory, Jhumarghat, Rau and reveal