PER MR.B.S.WASEKAR, HON’BLE PRESIDENT
1) The present complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986. According to the complainant, her husband Shri Appa Bhagwan Nikam was an agriculturist holding Gut No.595 at village Washi, Taluka-Washi, District-Osmanabad. He died accidentally on 10th December, 2012. She submitted insurance claim under the Government scheme of Shetkari Apghat Vima Yojana. Her claim was not satisfied therefore she has filed this complaint for insurance claim of Rs.1 Lakh with interest.
2) The opponent appeared and filed written statement. It is submitted that the claim of the complainant was rejected vide letter dated 11th October, 2013 as the deceased had no valid driving license. There is no deficiency in service on the part of the opponent therefore the complaint is liable to be dismissed with cost.
3) After hearing the argument of the complainant and after going through the record, following points arise for our consideration.
POINTS
Sr.No. | Points | Findings |
1) | Whether there is deficiency in service ? | Yes |
2) | Whether the complainant is entitled for the relief as claimed ? | Yes |
3) | What Order ? | As per final order |
REASONS
4) As to Point No.1 & 2 :- The complainant has produced revenue record showing that her husband was holding agricultural land and he was farmer. The complainant also produced copies of F.I.R., Spot Panchanama, Inquest Panchanama, Post Mortem Report and Death Certificate. On going through all these papers, it is clear that the husband of the complainant died in the road accident. The complainant produced the information received under the Right to Information Act, 2005 showing that the insurance claim was submitted by the complainant and her claim was rejected as ‘deceased had no valid driving license’.
5) It is submitted by the learned advocate for the complainant that the accident took place due to the fault of the driver of the Tata Sumo vehicle and not of the deceased. Therefore, the defence of the opponent should not be accepted. For this purpose, he has placed reliance on the judgment of our State Commission in case of ICICI Lombard General Insurance Company Limited –Versus- Smt.Sindhubai Khanderao Khairnar in First Appeal No.1009/2007 dated 7th January, 2008 reported in 2008(2) All MR (Journal) 13. In para 8 of the judgment, the Hon’ble State Commission has held as under :
The Insurance Company insisted for driving license. In fact, driving license is not necessary. From the perusal of the F.I.R., it is revealed that one Hundai car gave dash to the motor cycle from behind, which was being driven by the deceased. In the said accident Shri Khanderao Krishna Khairnar sustained serious head injury and ultimately succumbed to the head injury in civil hospital on 7th June, 2005. He was not at the fault. He did not attribute for the commission of an accident. Therefore, driving license is not at all necessary to settle the insurance claim. In case of an accident on the road, information report, spot panchanama, inquiry report and post-mortem report are required as per the scheme. In fact, these documents were submitted to the Insurance Company. There is nothing on record to show that the deceased was under influence of any intoxication. Shri Khanderao Krishna Khairnar died because of head injury sustained in the road accident. Therefore, as per the scheme, widow of the deceased was one of the complainants. Widow stands at Serial No.1 in the list of claimants.
In the instant complaint before us also, as per police investigation papers, accident took place due to the fault of the driver of the Tata Sumo vehicle and not of the deceased. Therefore, the repudiation of claim by the opponent was not proper.
6) Thus, there is sufficient evidence on record to show that the deceased was the farmer holding agricultural land. He died accidentally. The complainant is a widow therefore, as per Agreement, the opponent is liable to satisfy the claim of the complainant. The complainant has complied all the formalities as required under Agreement and Government Resolution. As discussed above, the claim is wrongly repudiated by the opponent. As per the Government Resolution, it is binding on the opponent to take action on the claim within one month. On failure to take action for three months, the opponent will be liable to pay interest on claim.
7) As discussed above, the opponent has wrongly repudiated the claim. Therefore, the opponent is liable to pay interest at the rate of 12% per annum on the claim. Besides this, the opponent is liable to pay cost of this proceeding Rs.3,000/-. Hence, we proceed to pass the following order.
ORDER
1) Complaint is allowed.
2) The opponent is directed to pay Rs.1,00,000/- (Rs.One Lakh
Only) to the complainant with interest at the rate of 12% per
annum from the date of death of the insured i.e. 10th December, 2012 till its realization.
3) The opponent is further directed to pay Rs.3,000/- (Rs.Three Thousand Only) to the complainant as cost of this proceeding.
4) The above order shall be complied with within a period of one
month from today.
5) Copies of this order be sent to the parties free of cost.
Pronounced on 27th October, 2014
