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Ten passengers, including four women and a child, drowned when a private bus with about 40 persons on board plunged into the Meenachil river in Kerala's Kottayam district on Tuesday.
One person, who was engaged in rescue operations, also collapsed and died, police said.
The deceased included conductor of the bus, hospital sources said.
The bus was coming from Cherthala in Alappuzha district to Kottayam along the rural route when it fell into the river after hitting an electric pole, the police said.
Twenty persons, including the driver, were admitted in the Medical College hospital and district hospital in Kottayam.
Rescuers, including Naval divers from Kochi, were still searching in the river at Thazhathangadi to ascertain if more bodies were trapped in the slush, the police said.
The bus, portion of which got stuck in muddy river-bed, was lifted out after five hours using six cranes, but no body was found trapped inside the vehicle, as feared initially.
Some of the survivors said the bus had about 35 to 40 persons when the mishap occurred.
However, it was difficult to say exactly how many passengers were in the bus at the time of mishap as the conductor was among those who met with the watery grave. Last year, a boat had capsized at Thekkady lake claiming 45 lives. In 2002, in Kumarakom, which is close by the spot of Tuesday's mishap, 29 people had died in a boat mishap.