PER MR.B.S.WASEKAR, HON’BLE PRESIDENT

1)                The present complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986. According to the complainant, her husband Shri Jaysingh Shrirang Jagtap was an agriculturist holding Gut No.169 at village Kharphatne, Taluka-Mohol, District-Solapur. He died accidentally on 29^th May, 2012 in motor vehicle accident.  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/Insurance Company appeared and filed written statement. It is submitted that complete set of documents was not submitted within time as per Tripartite Agreement therefore she can not file claim before this Forum. 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 both the parties and after going through the record, following points arise for our consideration.

POINTS

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 Police Complaint, Spot Panchanama, Inquest Panchanama, Post Mortem Report and Information received under the Right to Information Act showing that claim was submitted.  On going through all these papers, it is clear that the husband of the complainant died in the motor vehicle accident.  According to the opponents, complete set of documents was not submitted. On perusal of the documents produced by the complainant, it is complete set as per requirement under the Agreement.  Under the Government Resolution, the beneficiary has to submit the claim to the concern agricultural department and the concern agricultural department has to comply all the formalities i.e. necessary documents and submit it to the opponents. Liability is fixed on the government agricultural department.  The beneficiary should not be suffered due to lack of the compliance within time by the government machinery. According to the complainant, the claim was submitted to the opponent government office within time.  The opponents had produced copy of repudiation letter dated 13^th May, 2013 showing that claim was repudiated as the deceased was under influence alcohol. On perusal of Post Mortem Report on record, there is nothing to show that the deceased had consumed alcohol.  There is absolutely no evidence on record to show that the deceased had consumed alcohol and he was under influence of alcohol at the time of accident.  Therefore, the defence taken by the opponent can not be accepted.  It is clear that the opponent has wrongly repudiated the claim. 

5)                The learned advocate for the complainant has placed reliance on the judgment of our State Commission reported in 2008(2) All MR (Journal) 13 in the case of ICICI Lombard General Insurance Company Limited –Versus- Smt.Sindhubai Khanderao Khairnar, decided on 7^th January, 2008. In para 9 of the judgment, the Hon’ble State Commission has observed as under :

The Government declares various benevolent schemes for Agriculturists and person coming from lower strata of society. For effective implementation of the claim, Govt. prescribed simple procedure. Taking into consideration, the illiteracy in the rural areas, the liability is imposed on the Village Revenue Officer and Tahsildar for purpose of collection of necessary documents and submission of the claim to the insurance company. The success of benevolent scheme depends as to how and in what manner such schemes are implemented. Unfortunately, because of lukewarm and obstructive attitude of insurance company, genuine and honest claim of widow is defeated for no fault of her.

In the instant complaint before us also, claim form was immediately submitted to the government office. Therefore, the claim of the complainant can not be repudiated. 

6)                Thus, there is sufficient evidence on record to show that the deceased was the farmer holding agricultural land. He died accidentally in the motor vehicle accident.  The complainant is a widow therefore, as per the Agreement, the opponent is liable to satisfy the claim of the complainant. The complainant has complied all the formalities as required under the Agreement and the Government Resolution. 

         As discussed above, the complainant is entitled for the relief as prayed. Hence, we proceed to pass the following order.

ORDER

1. Complaint is allowed.
2. The Opponent/Insurance Company 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. 29^th May, 2012 till its realization.
3. The Opponent/Insurance Company 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 13^th February, 2015