Mere alcohol presence isn't intoxication

The National Commission decided a person can be said to be intoxicated only when blood alcohol level is 100 mg per 100 ml or more

Narinder Kumar's son had purchased a with-profit Jeevan Anand Policy from Life Insurance Corporation of India (LIC). The policy also came with an accident benefit. The total sum assured was Rs 4,70,000: Rs 2,35,000 on account of the sum assured of the main policy and Rs 2,35,000 on account of the accident benefit.

On June 8, 2014, the insured died due to accidental drowning in a river. When a claim was lodged, LIC paid only the sum assured of Rs 2,35,000. The accident benefit was not paid. Upon representation, LIC replied that the accident benefit was repudiated on the ground that the deceased was under the influence of alcohol when the incident occurred. Hence, it said that the claim was not payable as it violated policy conditions.

Narinder Kumar filed a complaint before the Solan District Consumer Commission. The insurer contested the complaint. The district commission observed that there were certain material lapses in conducting the post mortem and forensic examination. Even though the alcohol level found in the blood was 59.45 mg per 100 ml of blood, the post mortem did not study the urine sample. The Commission concluded that in the absence of a urine sample being examined, it would not be correct to jump to the conclusion that the insured was intoxicated at the time of death. The Commission concluded that death had occurred due to asphyxiation and not due to intoxication.

The district commission allowed the complaint and directed LIC to pay Rs 2,35,000 towards the accident benefit component which had been wrongly repudiated. In addition, it awarded 9 per cent interest from the date of the complaint, Rs 25,000 as compensation for mental harassment, and Rs 5,000 towards litigation costs.

LIC appealed to the Himachal Pradesh State Commission, which observed that a person is considered intoxicated if his blood alcohol level exceeds 50 mg per 100 ml of blood. Since the insured’s alcohol level was 59.45, the state commission concluded that the insured was intoxicated at the time of his death, and that the repudiation of the accident benefit claim was justified.

Narinder Kumar then approached the national commission. The latter scrutinised the post mortem and forensic laboratory reports. It observed that the post-mortem report did not contain any evidence to prove that the stomach contents had the smell of alcohol. It was also silent on whether blood and urine samples had been collected.

The commission observed that according to the forensic laboratory report, the blood alcohol concentration (BAC) was 59.45 mg. It questioned whether this amounted to intoxication. It relied on standard medical textbooks on forensic examination to determine this issue. According to Modi’s Jurisprudence and Lyon’s Medical Jurisprudence & Toxicology, as also AIIMS Manual for Physicians in National Drug Dependence Treatment Centre, a person having 100 mg or more per 100 ml of blood will be said to be under the influence of alcohol.

The national commission concluded that even though there were lapses in conducting the post-mortem and forensic examination, the evidence was absolutely clear that the insured was not intoxicated, and that death had occurred due to drowning and asphyxiation.

By its order of September 14, 2022, delivered by S M Kantikar along with Dinesh Singh, the national commission castigated LIC for mechanically repudiating the accident benefit claim without applying its mind and ignoring the documents available. The order of the state commission was set aside, and LIC was ordered to settle the claim along with interest, compensation and costs, as directed by the district forum.

The writer is a consumer activist