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The Kerala High Court has delivered a powerful judgment that is a massive win for insurance policyholders, specifically those dealing with motor and personal accident claims. Insurers can no longer use the mere presence of alcohol in an accident victim's blood as a quick excuse to reject a claim.

This ruling fundamentally changes the game by placing the burden of proof squarely on the insurance company.

🛑 The New Rule: Proof of Impairment is Mandatory

For years, insurance companies often repudiated claims by relying on a chemical analysis report showing traces of alcohol (Blood Alcohol Concentration or BAC) in the deceased or injured person’s system. They would cite the exclusion clause for death/injury occurring "whilst under the influence of intoxicating liquor."

The Kerala High Court has now drawn a crucial legal line:

• Mere Presence $\neq$ Under the Influence: The court ruled that the simple detection of alcohol in the bloodstream is not sufficient proof. The presence of alcohol, even above the limit specified by the Motor Vehicles Act, does not automatically equate to being "under the influence."
• Insurer Must Prove Impairment and Causation: To legally deny a claim, the insurer must provide unequivocal evidence proving two things:
1. The insured person’s faculties (mental and physical) were actually impaired due to the alcohol consumed.
2. This impairment caused or significantly contributed to the accident itself.

Know This: This shifts the onus from the grieving family or injured policyholder to the mighty insurer. They must now investigate beyond a lab report to prove intoxication was the cause, not just a co-existing factor.

🔑 Why This Ruling Empowers You (The Policyholder)

This judgment sets a binding precedent, giving you a strong legal shield when fighting a wrongful claim rejection:

• Challenging Repudiation: If your claim is denied solely based on the BAC report, you have the legal right to challenge the insurer. Demand they furnish clear proof of impaired faculties and the causal link to the accident.
• Strict Construction of Exclusion Clauses: Courts strictly interpret exclusion clauses (which limit the insurer’s liability) against the party that drafted them—the insurer. This ruling reinforces that narrow, technical readings cannot be used to defeat the main purpose of the policy: providing compensation.
• Beyond the MV Act: The court clarified that violating Section 185 of the Motor Vehicles Act (drunken driving) is a penal matter, but it does not automatically void an insurance contract unless the policy clearly requires the insurer to prove the impairment caused the accident.

🛡️ Bimacure Action Plan: How to Fight a Wrongful Rejection

If an insurer tries to deny your accident claim based on alcohol, follow these steps:

1. Request the Rejection Letter: Get the repudiation in writing, noting the specific clause cited (usually the "under the influence" exclusion).
2. Demand Evidence: Formally write to the insurer referencing the Kerala High Court ruling and demanding the specific, objective evidence that proves both impairment and causation. Do not accept the BAC report as sufficient proof.
3. Escalate to the Ombudsman/Consumer Forum: If the insurer fails to provide the required evidence or maintains the rejection, immediately file a complaint with the Insurance Ombudsman or the appropriate Consumer Disputes Redressal Commission.

This landmark decision ensures that insurance remains a contract of protection, not a tool for arbitrary denial. Know your rights, and don't let an insurer use a simple blood test to walk away from their liability!

⚖️ Source of the Judgment

This ruling was delivered by a Division Bench of the Kerala High Court in an appeal filed by the insurance company against an order of the Insurance Ombudsman, Kochi.

• Case Title: National Insurance Co. Ltd. vs. State of Kerala and Others. (The case involves the death of one K.S. Shibu.)
• Court: High Court of Kerala, Ernakulam.

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