| CITATION | NCDRC 1794.REVISION PETITION NO. 3294 OF 20154 |
| DATE OF JUDGMENT | 28TH APRIL 2016 |
| COURT | NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION (NCRDC) |
| APPELLANT | LAKSHMI ROHIT AHUJA |
| RESPONDENT | SBI LIFE INSURANCE CO. LTD |
| BENCH | HON’BL JUSTICE V.K. JAIN |
INTRODUCTION
The case of “Lakshmi Rohit Ahuja vs SBI Life Insurance Company Limited, 2016” tries to resolve a complicated legal issue pertaining to liability of insurer to pay the benefit amount if the insured fails to meet the conditions of insurance and specifically it deals with what will amount to the state of intoxication under the influence of liquor. The case evolved when Late Mr. Rohit Ahuja who had a credit card of GE countrywide company died in 2009. As per the scheme of the credit card, in the event of death of the card holder the insurance company was required to pay the outstanding amount and accidental benefit amount of 3,00,00 to the NOK of the card holder. after the death of Mr. Rohit Ahuja in an accident insurance company denied the payment of accidental benefit to Lakshmi Rohit Ahuja the wife and NOK of Mr. Rohit Ahuja citing the reason that Her husband died being in the state of intoxication and thus it breaches our master policy and therefore claim could not qualify and payment couldn’t be made. Denial of the accidental benefit amount paved the way for this case up to NCDRC.
FACTS OF THE CASE
Late Rohit Ahuja, deceased husband of the appellant had a cash credit card of GE Countrywide consumer financial services ltd. Credit card. The company had the policy of paying all the outstanding dues and the compensation of Rs 3,00,00/- to legal heirs of the card holder in case of death of the card holder. Rohit Ahuja died on 24 April 2009 in an accident. An amount of 16,821/- being outstanding against him was paid by the insurance company but the accidental benefit amount of 3,00,000/- was not paid to the heirs of him citing that card holder breached the master policy clause 7.1.5 of the insurance company which says “SBI Life shall not be liable to pay the benefits if the death or as the case may be, the total and permanent disability of the life assured is caused by any of the following.
“Intentional self-injury, attempted suicide, insanity or immorality or whilst the life assured is under the influence of intoxicating liquor, drug or narcotic substance” and as at Late Rohit Ahuja was under the influence of intoxicating liquor at the time of accident which was confirmed by Lab reports after postmortem by the presence of 120mg of alcohol per 100 ml of blood.
Being aggrieved by the acts of the insurance company his wife approached the district forum in form of complaint, implementing the insurer as well as the G E Countrywide Consumer Financial Services Ltd. as respondents. District forum passed order in favour of complainant, being dissatisfied by the order of district forum insurance company approached the state consumer dispute redressal commission which reversed the order of district forum, being aggrieved by the order of state commission complainant filed revision petition before National consumer dispute redressal commission. NCDRC decided the case on pronouncement made in case of Baby Apoorva Rai Vs New India Assurance Co. Ltd & Anr. 2015
ISSUES RAISED
- whether a person having 120 mg of alcohol per 100 ml of his blood can be said to be under influence of intoxicating liquor?
- Whether the insurance company was liable to pay the accidental benefit amount?
CONTENTIONS OF APPEALENT (Baby Apoorva Rai Vs New India Assurance Co. Ltd & Anr. 2015)
- The appellant contended citing Modi’s Medical Jurisprudence and Toxicology, 24th Edition, that the presence of 103.14 mg/100 ml of the blood does not lead to the conclusion that the deceased was under the influence of intoxicating liquor.
- The appellant referring to the text of the above-mentioned book submitted that it is generally believed that a person with a concentration of 0.1 percent alcohol in the blood appears to be gay and vivacious, and those with a concentration of 0.15 percent alcohol in the blood are regarded as fit to drive a motor vehicle.
- The appellant described that alcohol acts differently on different individuals and on the same individual under different circumstances. The effect of alcohol is dependent on the environment and temperature of the individual and upon the degree of dilution of alcohol intake.
- The appellant thus emphasized that by referring to author if 0.15% of alcohol in body is fit to drive then it comes to be 150mg of alcohol/100 ml of blood and thus here in case where it is only 103.14gm/100ml of blood does not comes under the state of intoxication.
- Appellant also cited the decision of the commission in LIC of India & Anr Vs Ranjit Kaur III (2011) where the quantity of alcohol was 86.2 mg of alcohol/100 ml of blood and commissioned ruled in favour of the complainant.
CONTENTIONS OF REPONDENT (Baby Apoorva Rai Vs New India Assurance Co. Ltd & Anr. 2015).
- The respondents contended by relying upon the information published in Lyons’s Medical Jurisprudence and Toxicology. They cited that American Medical Association and the national safety council of USA have adopted the policy that Blood alcohol of 0.10% can be accepted as prima facie evidence of alcoholic intoxication. Recognising that many individuals are under the influence of liquor in range 0.05% to 0.10% The Uniform Vehicle code has accepted that blood alcohol of 0.10% or more will be presumed as subject was under the influence of alcoholic beverage.
- The respondents asserted that the different countries have prescribed permissible limits of blood alcohol like India has a limit of 30mg% and USA as discussed above is having 100mg %, Australia is having 40mg%.
- The respondents referring to Lyons’s Medical Jurisprudence stated that Even USA being the most liberal country with respect to the quantity of alcohol in blood while driving, permits only 100 mg alcohol/100 ml of blood.
- The respondents cited the decision of the NCDRC in the case of LIC of India & Anr. Vs. Priyanka Singh (Appeal no. 368 of 2004 decided on 14.10.2005) where the commission dismissed the complaint citing the presence of 109.92mg alcohol per 100ml of blood.
JUDGEMENT
The National Consumer Dispute Redressal commission opined that the state commission decision to overturn the district forum order was valid and dismissed the revision petition. The commission relying upon the pronouncement made in Consumer complaint Baby Apoorva Rai Vs New India Assurance Co. Ltd & Anr. 2015 in which the medical literature HWV COX “ Medical jurisprudence and Toxicology”, seventh edition PC Dikshit” was brought on record which stated that “considering the opinion expressed in the manual issued by All India Institute of Medical Sciences, which is premier most medical institution in this country, we are not inclined to accept the opinion expressed in Modi’s Medical Jurisprudence and Toxicology, particularly when the opinion of AIIMS also find the corroboration from the opinion expressed in Lyons’s Medical Jurisprudence and Toxicology.” The quantity of alcohol allowed to the driver in any country is not more than 100mg/100ml of alcohol blood ratio. In the case of India it is only 30mg/100ml of blood only. Thus the commission considered the presence of 103.14mg of /100ml of blood would be said to be under the intoxication of liquor.
Relying upon the judgement of Baby Apoorva (Supra) Commission was of opinion that late Rohit Ahuja was intoxicated under the influence of liquor and hence breached the master policy clause of 7.15. Hence Insurer is not liable to pay the accidental benefit amount.
ANALYSIS
- State of Intoxication under the influence of liquor. – The case looked upon the policies of several countries and referred many texts including Manual from AIIMS and tried to draw comparison between accepted norms for ratio of alcohol/100 ml of blood to decide what will constitute into state of intoxication and lastly referring to the pronouncement made in Baby Apoorva case (supra) it concluded that 30Mg of alcohol/100 ml of blood will result into unfitness to drive as it comes under the purview of intoxication.
- Liability of insurer on breach of policy – The pivot question was whether the insurer was liable to pay the accidental benefit amount and commission held that if the insured has breached the policy of insurance, he is disqualified to get benefit out of the insurance.
- Reason behind Exclusion of Intoxication under the influence of Liquor – Commission stated that the main reason behind such exclusion is to discourage the people to drive after consumption of alcohol as it leads to accident and consequently disability or death and that too without any benefit from the insurance company to the insured.
- Court’s Final Verdict – The case ultimately held that the decision of the SCDRC was correct in deciding the case. NCDRC absolving the liability of insurer to pay the accidental benefit amount dismissed the petition
CONCLUSION
In conclusion, the case of Lakshmi Rohit Ahuja Vs SBI Life Co. Ltd., Maharashtra 2016, reaffirms a crucial legal precedent in the realm of determining the state of intoxication and the liability of the insurer to pay the accidental benefit amount. It clarifies the liabilities of the insurer if the insured breaches the policy of the insurance contract. Commission’s ruling in this case cements the view that the purpose of the insurer to exclude the cases of accident under the influence of intoxicating liquor is to ensure that consumption of liquor does not lead or contribute to occurrence of accident. Thus, consumption of liquor beyond the prescribed limit shall disqualify the insured from benefiting from the insurance policy.
REFERENCES
This Article is written by Dhirendra Singh student of PES Modern Law College, Pune ; Intern at Legal Vidhiya.
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