‘Crash after one or two drinks can’t block insurance’

permissible.

“Any person who may take a drink or two will smell of alcohol,but that person cannot be termed as being under the influence of alcohol. Unless the reasoning power of a person is undermined to such an extent that he does not know what he is doing,he cannot be held under the influence of liquor,” said Commission’s President Justice J D Kapoor,who retired last month.

According to the Commission,refusing insurance claim on the vague accusation that the insurer’s breath smelt of alcohol was not justified,as there were numerous medical yardsticks to decide if the person lost his sense of judgement because of drinking.

Recording that hundreds of such claims are repudiated by insurance companies,the Commission said had there been no distinction between taking alcohol and getting drunk,the companies could have inserted a clause that as soon as the driver consumes liquor,the policy holder would not get the claim.

The Commission’s remarks came in a case in which a US-based NRI,Ashminder Pal Singh,was refused insurance claim by the New India Assurance Company Ltd. — Singh’s Mitsubishi Lancer car had met with an accident on December 23,2000.

The company had thrown out his claim on the ground that the doctor who examined him after the accident had specifically mentioned that his breath smelt of alcohol.

Countering the company’s claim,Singh had said the smell was because of the homeopathic medicines he had taken,and that had he been drunk,the police would have booked him for drunken driving.

Analysing their contentions,Justice Kapoor perused other medial reports and noticed they indicated that there was no perceptible change in Singh’s behaviour.

“Suspicion can never take the place of proof. If such standards are applied by the insurance companies,we are sure each and every claim,including medical insurance aims,will be rejected,” said the

Commission.

Terming the rejection as “untenable,illegal and arbitrary,” the Commission directed the insurance company to pay Rs 7 lakh as insurance cover and another Rs 50,000 as damages to Singh within a month.

Similar order on medical insurance ,/b>
In an earlier order,the Consumer Commission had noted that medical insurance could not be denied to moderate drinkers: “They (companies) are under a misconception that to take liquor in moderation every day was tantamount to being alcoholic.”

If reimbursements to the insured will be denied in such a manner then more than 90 per cent population would be out of their net,and the companies would be out of business in the backdrop of modern lifestyle,the Commission had observed in the January 2007 order. — ENS