National Consumer Disputes Redressal
Shailendra Kumar Soni vs Sbi General Insurance Company Limited & ... on 30 March, 2026
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSIONHDCF NEW DELHI JUDGEMENT RESERVED ON: 22/01/2026 JUDGEMENT PRONOUNCED ON: 30/03/2026 REVISION PETITION NO. 744 OF 2022 (Against the Order dated 10" March 2022 in Appeal 164/2021 of the State Consumer Disputes Redressal Commission Chhattisgarh) Shailendra Kumar Soni S/o Shri PurshottamSoni, R/o Ward No. 19, Bemetra, Thana- Bemetra, District-Bemetra (Chhattisgarh) nae Petitioner Versus 1. SBI General Insurance Company Limited, Through- The Divisional Manager, Third and Fourth Floor, Lotus IT Park, Road No. 16, Plot No. B-18-19, Wagle industrial Estate, Thane West (Maharashtra) - 466604 2. SBI General Insurance Company Limited, Grievance Redressal Officer, 101, 201, 301, Natraj, Junction of Western Express Highway & Andheri Kurla Road, Andheri East. Mumbai (Maharashtra)- 400069 3. SBI General Insurance Company Limited, Branch- Fourth Floor, Pujari Chamber, Pachpedi Naka, Dhamtari Road, Raipur (N.H. 43) Chhattisgarh seseees Respondents BEFORE: HON'BLE MR. JUSTICE A.P. SAHI, PRESIDENT HON'BLE MR. BHARATKUMAR PANDYA, MEMBER For the Petitioner : Mr. Rajesh Kumar Bhawnani, Advocate For the Respondents :'Mr. D. Varadarajan, Advocate ORDER
PER BHARATKUMAR PANDYA, MEMBER
1. Heard Mr. Rajesh Kumar Bhawnani, Advocate learned counsel for the petitioner and Mr. D. Varadarajan, Advocate for Respondents.
2. The brief facts of the complainant's case, as pleaded before the learned District Commission, Durg, are that the complainant was the registered owner of a vehicle i.e. Swift Dzire bearing registration No. CG-07-AM-3270, which was duly insured with the Opposite Party insurance company under a valid motor insurance policy for the period 25.04.2018 to 24.04.2019, having an Insured Declared Value (IDV) of %3,21,033/-.It is the case of the complainant that during the subsistence of the said insurance policy, on 03.06.2018, the insured vehicle met with an accident near BTI College, Bemetra, when it collided with a truck bearing registration No. MP-16-H-1045, resulting in severe damage to the vehicle. The claim has been repudiated by the insurance company on the ground that the insured was under the Page 1 of 17 influencing under the intoxicating liquor resulting into violation of condition 2(c) of the policy. The complainant pleaded that he was driving the vehicle with a valid and effective driving licence and immediately informed both the police authorities as well as the insurance company about the said accident. It has further been pleaded that pursuant to the accident, an FIR was registered and proceedings were initiated by the police authorities. The complainant's vehicle suffered extensive damage and the estimated cost of repairs was assessed at %6,08,170/-, which was substantially higher than the IDV of the vehicle, thereby rendering the case that of total loss. Accordingly, the complainant lodged a claim with the Opposite Party insurance company and submitted all requisite documents in support thereof. However, to the utter shock and surprise of the complainant, the Opposite Party insurance company repudiated the claim vide letter dated 26.11.2018 (page no. 66), on the alleged ground that at the time of the accident, the complainant was under the influence of alcohol, which was stated to be in violation of the terms and conditions of the insurance policy. The complainant has specifically averred that the said repudiation | was arbitrary, illegal and without any cogent evidence, as there was no scientific or medical proof to establish that the complainant was under the influence of alcohol to the extent prohibited under law. It has been contended that mere mention of "smell of alcohol" in the MLC report does not establish intoxication nor does it constitute a breach of policy conditions. It is further pleaded that despite issuance of a legal notice dated 04.12.2018 to the insurance company calling upon it to settle the claim, the Opposite Party failed to redress the grievance of the complainant. The complainant filed the consumer complaint bearing Case No. CC/2019/68 on 18.01.2019 before the learned District forum, alleging deficiency in service and unfair trade practice on the part of the Opposite Parties and the complainant prayed that the Opposite Parties (insurance company) be directed to pay %6,08,170/- towards the damage/loss of the vehicle, =1,50,000/- as compensation for mental agony and harassment, along with amounts towards litigation and notice expenses, parking charges, and incidental expenses including travel and communication, and further sought interest on the total claimed amount aggregating to approximately %8,30,170/-.
2.2. The Opposite Parties, in their Written Statement filed before the learned District Commission (pp. 49-83), raised preliminary objections that the complaint is not maintainable either in law or on facts and is liable to be dismissed, as there is no Page 2 of 17 deficiency in service on their part and the complainant has suppressed material facts. While admitting the issuance of the insurance policy, its validity, and the occurrence of the accident, Insurer categorically denied any liability on the ground that the complainant had committed a fundamental breach of the terms and conditions of the policy by driving the vehicle under the influence of alcohol at the time of the accident. In this regard, strong reliance was placed on the MLC report which recorded the presence of "smell of alcohol" in the breath of the complainant, contending that such presence clearly establishes consumption of alcohol and impairment of driving ability, thereby attracting the exclusion clause of the policy which absolves the insurer from liability where the insured or driver is under the influence of intoxicating liquor or drugs. The Opposite Parties further submitted that a proper investigation was conducted and all relevant documents, including medical records and police papers, supported their conclusion, and they also relied upon the police charge-sheet filed under Sections 279, 337 and 304A of the IPC to contend that the accident occurred due to rash and negligent driving on the part of the complainant, allegedly under the influence of alcohol. On these grounds, they justified the repudiation of the claim vide letter dated 26.11.2018 as being legal, valid and in strict accordance with the policy conditions, and denied all allegations of arbitrariness, deficiency in service or unfair. trade practice, asserting' that the complainant is not entitled to any compensation, insurance amount or other reliefs as Claimed in the complaint.
3. After hearing the submissions of both parties and carefully examining the material on record, the learned District Commission held that although the insurance policy was valid and the occurrence of the accident and damage to the vehicle were not in dispute, the complainant had violated the terms and conditions of the insurance policy by driving the vehicle under the influence of alcohol at the time of the accident, as was evident from the MLC report which recorded the presence of smell of alcohol in his breath. The Commission further observed that such presence of alcohol-smell was sufficient to attract the exclusion clause of the policy which disentitles the insured from claiming any amount if the vehicle is driven by a person under the influence of intoxicating liquor. Relying upon the said medical evidence along with the surrounding circumstances and record, District Forum concluded that | the repudiation of the claim by the Opposite Parties vide letter dated 26.11.2018 was justified and did not amount to deficiency in service or unfair trade practice, and é Page 3 of 17 accordingly, the complaint being devoid of merit was dismissed. The order of District forum is reproduced herein below:
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4. The appellant/complainant, being aggrieved by the impugned order dated 03.11.2021 passed by the District Forum, Durg, Chhattisgarh, preferred First Appeal before the State Commission, Chhattisgarh at Raipur, being First Appeal No. FA/2021/164, challenging the findings of the District Commission and seeking setting aside of the said order and allowance of the complaint and reiterating that the repudiation of the insurance claim by the Opposite Party was arbitrary, illegal and not supported by any cogent evidence, as mere mention of "smell of alcohol" in the 7 \ Page 7 of 17 MLC report does not establish that the complainant was driving under the influence of alcohol so as to constitute a breach of the policy conditions, and further that the District Commission failed to properly appreciate the facts, evidence and applicable law while dismissing the complaint. After hearing the learned counsel for the parties and examining the record, the State Commission held that the complainant had failed to make out any case warranting interference with the order passed by the District Commission, and that the material on record, including the MLC report indicating presence of smell of alcohol and the police record showing rash and negligent driving, clearly established that the complainant was driving the vehicle under the influence of alcohol in violation of the terms and conditions of the insurance policy; accordingly, it upheld the repudiation of the claim by the insurance company as justified and dismissed the appeal at the admission stage, finding no merit in the same. The order of State Commission is reproduced herein below:
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5. The appellant/complainant, being aggrieved by the impugned order dated 10.03.2022 passed by the State Commission, Chhattisgarh at Raipur, in First Appeal No. 164/2021, preferred the present Revision Petition under Section 58(1)(b) of the Consumer Protection Act, 2019 before this Commission on 10.06.2022, challenging the concurrent findings of the District Forum and the State Commission as being erroneous, perverse and contrary to the material on record, on the ground that both the fora below failed to properly appreciate the evidence and law, wrongly concluded that the complainant was driving under the influence of alcohol merely on the basis Page 10 of 17 of smell of alcohol in the MLC report, ignored the absence of any scientific or legal proof of intoxication or being under the influence while driving, and thereby erroneously upheld the repudiation of the insurance claim by the Opposite Party. In the Revision Petition, the petitioner raised detailed grounds inter alia that:
(i) the appeal before the State Commission, having not been decided within the statutory period of 21 days, stood deemed admitted and could not have been dismissed at the admission stage thereafter;
(ii) | the State Commission failed to consider and decide the application filed under Order XL] Rule 27 CPC seeking to place on record additional evidence in the form of MACT settlement awards, which were material for proper adjudication of the case;
(iii) | the reliance placed on the police charge-sheet was erroneous as the same does not constitute proof of guilt and, in any event, did not establish intoxication;
(iv) the provisions of Sections 279, 337 and 304A IPC do not imply driving under the influence of alcohol, and no offence under Section 185 of the Motor Vehicles Act was registered against the petitioner;
(v) the MLC report merely recorded smell of alcohol and did not indicate the quantity or level of alcohol so as to conclude that the petitioner was under the influence of intoxicating liquor;
(vi) the insurance policy does not exclude liability in cases of rash or negligent driving and, therefore, even assuming negligence, the claim could not have been repudiated;
6. Mr. Bhavnani, on behalf of the petitioner has argued that the there is material irregularity in appreciation of the evidence on record in as much as a subjective noting or observation of "smell of alcohol" has been read as evidence of the appellant "having driven the vehicle under the influence of intoxicating liquor or drugs" firstly by the insurance company, which perverse view has been illegally thereafter also approved by both the fora below. As per Mr. Bhawnani, the ratio of Supreme Court decision in Pearl Beverages has wrongly been read and applied by the fora below, because in the present case, the charge of rash and negligent driving has not been established and further the insurance company, in the repudiation letter, has relied neither on any other circumstance except the "smell of alcohol in the breath" not has established in other circumstance to even indicate that the accident itself can be taken to be the evidence of influence of intoxication as was the case in Pearl Beverages. As such there is no cogent material on record at all which Page 11 of 17 supports the gro 'ati .
ground of repudiation which, alongwith the relevant poli 43 reproduced as under; nt policy condition is "SECTION i --
LOSS OR DAMAGE TO THE VEHICLE INSURED:
-
seeeee 1
2) The Compa pany shall not be Liable to make any payment r mt in respect
a) consequenti nitial lo -
electrical b ss, depreciation, we reakdown, fatlures or breakages and tear, mechanical or It cas ei i og) any accidental ! bs oss or ad person drivin damage suffered iis ' insured is iving the vehicle with the pred sonst the Insured or any influence of intoxicating We we ar msent of the rugs."
Subieck- Repudiation letter of tiaum Near Sr Date of Loss. oals 201 3 Ref: Claim no. 521469 unde Sub: Ciaim Declinatian r Policy no. 8949568 We. draw your attention to the clairn intimation lodged win our company on 15/06/2038. The insured gan Chopra at Ais. Sparsh yehicke was inspected by IRDAI acensed independent surveyor Mr Ga futomobdite. Raipur.
We hed also sought services of Mis National Claims Bureau. Inc. to collect facts & add tonal docamenis wilh regards to the subject claim We have received survey reports, lnvestigation Reoort and elairn documents submitted by yeu On seniliny of the same, We nouced fallowing anomalies.
.
u supported! his coport by Charge sheer copy ot! ik No Sem MLC teport stated tia' > Investigator Mis National Claim Burea influence at
-
302 and MLC copy oi wir Shaitandra Soni S/o Purusotiam la "gmett of alcoholic present from mouth breath. Person is under the alcohol.
the claim has led to violation of policy terns ang Que to the above observed and mentioned facts for your kind reference condition -Drivers Clause, which #s reproduced below ®ONDITION NO.2(CH OF SECTION -7 OF POLICY
2."Tne Company shall not be liable to make any payment in respect of Insured or any person driving the vehicle ntal loss or damage suffered whilst the der the influence of intoxicating liquor or C) Any accide ledge and consent of the Insured is un with the Know drugs.
onaitions of the policy.
Hence the reported clairn is Hot admissible as per the terms and ¢ Page 12 of 17 The foregoing repudiation by us on fiability is issued based on the facts as at present. We reserve ine aghl to extend or modify this repudiation in the event of new/additional facts or circumstances brought io our Knowledge, We regral, consequently, that we are unable to consider this claim Should ycu believe that we have overlooked any matenai fact or circumstance or should you wish to present an atermaty, interpretation of any relevanl policy provision, please draw the same to our attention for our furthe:
consideration by contacting SBI GIC GRIEVANCE REDRESSAL COMMITTEE, address of whith ys gven hereunder, with detads for resolution.
Aue et SE 6.1. Mr. Bhawnani further emphasized that: (i) The appeal has wrongly been rejected by the State Commission in limine at the admission stage (ii) The third party MACT claims have been duly settled by the insurer which would imply that the technical objection raised by the insurer in this own-damage vehicle policy is misconceived, which the State Commission failed to appreciate as the relevant documents were not even taken on record by the State Commission (iii) The fora below have wrongly based findings on the irrelevant consideration of the criminal proceedings and chargesheet while overlooking the most relevant consideration as ~ to whether the ground raised in the repudiation letter is based on cogent evidence or not (iv) The petitioner was not "under influence of the intoxicating liquor or drug"
while driving the vehicle and that there was no violation of policy condition as alleged
(v) The reliance by the fora below on the ratio of Pear! Beverages is misconceived in the facts of the case, whereas on the other hand the facts are squarely covered by the decision of this Commission in the case of Neelam Deshmukh v. SBI and Others in NC/RP/1100/2022 dated 23.10.2025. (iv) Even if there is violation of some policy condition, the claim should have been processed at least on non-standard basis at 75% in light of the existing guidelines and this commission's decision in New India Assurance Co. Ltd. v. Narayan Prasad (2006) CPJ 144. On the other hand, Mr. Varadrajan on behalf of the insurance company has strongly supported the orders of the fora below and emphatically submitted that absolutely no interference in the flawless concurrent findings and decisions of the fora below is called for. There is neither any error nor irregularity nor any jurisdictional error nor any perversity in the order of the State Commission and hence the petition deserves to be rejected. The ratio in Pearl Beverages has rightly been followed, the circumstances like the collision with a parked stationary truck from behind, the death of the co-passengers due to severe injury in the accident, the charges of rash and negligent driving, the alcohol content as recorded in the PM report of the co-passengers coupled with the Page 13 of 17 finding of smell of alcohol in the breath of the driver are all relevant circumstances which led to a factual finding by the investigator and insurer that the driver was under the influence of intoxication of liquor and therefore repudiation based thereon when upheld by the fora below by concurrent finding of fact the same cannot and should not be interfered with.
7. After hearing the learned counsels for the parties at length and upon careful perusal of the entire record including the orders passed by the learned District Commission dated 03.11.2021 and the State Commission dated 10.03.2022, it is seen that the core issue is the repudiation of the insurance claim on the ground that the complainant was allegedly driving the insured vehicle under the influence of alcohol at the time of the accident. It is not in dispute that the vehicle in question was duly insured, the policy was valid on the date of the accident i.e. on 03.06.2018, and that the accident did occur resulting in substantial damage to the vehicle. The only basis on which the claim was repudiated by the Respondent/OP insurance company as recorded in the repudiation letter is the conclusion of presence of smell of alcohol in breath/mouth of the petitioner, as recorded in the MLC report. However, it has emerged from the investigator's report that the said MLC report merely mentions the "smell of alcohol" in the breath of the complainant and does not indicate the quantity or level of alcohol in the blood, nor does it establish that the complainant was in such a state so as to be designated or labelled as "under the influence of intoxication of liquor or drugs" at the time of accident. We are therefore of the considered view that mere presence or smell of alcohol cannot be equated with or be deemed to be evidence of the driver of the vehicle being "under the influence of intoxicating liquor"
so as to be hit by the clause 2(c) as contemplated under the terms and conditions of the insurance policy. In the absence of any scientific or medical evidence such as a blood alcohol concentration (BAC) test, breath analyzer report, or any material indicating that the alcohol level exceeded the permissible limits prescribed under law, or the tolerable limits within which, even after consumption, one can remain "uninfluenced", it cannot be conclusively held that the complainant was driving under the influence of alcohol, more so, when no other attending circumstance has been referred to or relied upon in the letter of repudiation. Significantly, no offence under Section 185 of the Motor Vehicles Act, 1988 has been registered against the complainant, which further supports the case of the insured. There are of course other grave circumstances leading to the death of the co-passengers as also oN Page 14 of 17 collision with a stationary vehicle from behind, which leads to a strong suspicion that the driver could be under the influence of intoxicating liquor'. However, we are unable to agree with the fora below that the evidence of "smell" and "circumstances"
together is sufficient in the facts of the present case for the fora below to have come to a factual finding of "driving under influence of intoxicating liquor' so as to uphold the repudiation within the policy clause relied upon by the insurer. In our considered view, both the fora below have erred in law in drawing an adverse inference solely on the basis of the MLC report without there being any substantive proof of intoxication or influence thereof. Such an approach is contrary to settled legal principles and amounts to perverse finding and gross misappreciation of relevant evidence. As rightly submitted by Mr. Bhawnani, the ratio of Pear! Beverages has also been wholly mechanically and wrongly applied by the fora below in as much as apart from "smell in breath" and the collision with a stationary vehicle, there are no other circumstances like the excessive speed of the vehicle or the high force of impact etc., to otherwise establish the apparent influence of intoxication on the driving skills of the driver. In our considered opinion the ratio of this commission's order in Smt. Neelam Deshmukh v. State Bank of India in RP No. 1100 of 2022 pronounced on 23.10.2025, would more aptly apply. Para 11 of the said decision is reproduced as under:
11. We have considered the submissions raised and we find that the conclusion drawn by the State Commission is not supported by any cogent evidence. In our opinion, a mere recital in the history sheet that the insured deceased was brought in an intoxicated condition to the hospital, does not establish that the intoxication was due to alcohol or any such other substance. It is well known that intoxication can be very easily analysed either through a breathalyser or through a blood test. None of these processes have been undertaken and from the history sheet, it appears that the injured was straight away kept on a ventilator in view of the serious heavy head injuries suffered by him.
The Insurance Company has not been able to collect any other evidence to corroborate the recital of intoxication. The recital in the history sheet on an information by the relative of the insured that he was an alcoholic, does not prove that the insured was under the influence of alcohol as on the date and the time when the accident took place. The post mortem report is also not indicative of any presence of alcohol in the body of the insured. The patient was very much in the hospital for three days and there is no diagnosis recorded or any such material which may even remotely connect the allegation of the insured being under the influence of alcohol on the date of the accident.
12. The State Commission therefore, has presumed the presence of alcohol without any confirmatory report or any clinching evidence to Page 15 of 17 that effect. We therefore, find that the State Commission has erred in proceeding to interfere with the findings recorded by the District Commission that was based on evidence and therefore, the impugned order suffers from an error by applying the law in the case of Iffco Tokio General Insurance Company Ltd. (supra) and reversing the order of the District Commission.
8. Furthermore, the reliance placed by the State Commission on the police charge-sheet under Sections 279, 337 and 304A of the Indian Penal Code is also misplaced. A charge-sheet is merely an accusation and does not constitute proof of the guilt unless established through trial. Moreover, the said provisions relate to rash and negligent driving which aspect, even if established, does not entitle the insurer to repudiate under the policy, (and in any case, this has not been taken as a ground of repudiation), and which does not ipso facto establish that the driver was under the influence of alcohol. It is also pertinent to note that the accident involved a collision with a parked truck, and even the truck driver was charge-sheeted under Section 283 IPC, indicating that negligence was not perhaps in the initial estimation solely attributable to the complainant. In any case, the insurance policy does not exclude liability on the ground of rash or negligent driving; the exclusion is limited only to cases where the driver is proved to be under the influence of intoxicating liquor or drugs. Thus, even assuming negligence, the repudiation of the claim would not be justified in the absence of credible proof of influence of intoxication.
9. In conclusion, we find that the findings recorded by the District Commission and affirmed by the State Commission are perverse in as much as the conclusion of upholding the repudiation is not based entirely on cogent and conclusive evidence, The repudiation of the insurance claim by the insurer is not supported by any cogent or reliable evidence and is therefore unsustainable and, therefore, amounts to deficiency in service. Accordingly, the impugned orders dated 03.11.2021 and | 10.03.2022 are set aside, the repudiation is also held to be illegal and to be based on no cogent evidence and is therefore set aside, and thus, the insurer is held liable for deficiency in service in wrongfully repudiating the claim. The respondent-insurers are, therefore, directed to pay to the complainant the Insured Declared Value (IDV) of the vehicle, i.e., 3,21,033/- alongwith simple interest at the rate of 6% from the date of repudiation till the date of payment. The insurer shall also pay litigation cost of Rs. 25000/-. The payment shall be made within three months from today failing Page 16 of 17 _ & which the interest shall be payable at the enhanced rate of 9% from 30.06.2026 on the amount remaining unpaid on that date.
10. Revision petition is thus allowed in terms of the order as above:
( A.P. SAHI, J. ) PRESIDENT Pawan/aj . f BHARATKUMAR PANDYA ) _ MEMBER Mosfe lie. war Se Se NS Ree 2 Page 17 of 17,