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 Shivaji Jyotiram Dadas was an agriculturist holding Gut No.100 at village Vithobanagar, Taluka-Man, District-Satara. He died accidentally on 21^st March, 2011 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 O.P.No.1 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)                The O.P.No.2 appeared and filed written statement and submitted that the claim was not filed by the complainant.

4)                The O.P.No.3 appeared but failed to file written statement.

5)                After hearing all the parties and after going through the record, following points arise for our consideration.

POINTS

REASONS

6) 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 has also produced copies of F.I.R., Police Complaint, Inquest Panchanama, Spot Panchanama, Post Mortem Report and Copy of claim form.  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 within time limit therefore the present complaint is not maintainable. On the other hand, it is submitted by the learned advocate for the complainant that claim form was submitted directly to the O.P.No.1. The complainant has produced postal receipts and acknowledgement dated 27^th October, 2012.  As there was no response, reminder was issued on 2^nd March, 2013.  Postal Acknowledgement is produced on record. On going through the postal receipt and acknowledgement, it is clear that the claim form was submitted to the O.P.No.1. According to the opponents, no claim was submitted. But, the evidence on record show that the claim form was submitted though it was late. The learned advocate for the complainant has submitted that it is necessary to submit the claim within two years from the date of death. For this purpose, he has placed reliance on the judgment of Hon’ble National Commission reported in III (2011) CPJ 507 (NC).  In para 13 of the judgment, the Hon’ble National Commission has held that if the claim is not made within two years to the Insurance Company, it will be barred by limitation.  In the instant complaint before us, claim was submitted by post and the postal receipt dated 27^th October, 2012 is produced on record.  Reminder was also sent on 2^nd March, 2013.  The deceased died on 21^st March, 2011 and the claim was submitted within two years from the date of death.  Therefore, the submission made by the opponents cannot be accepted. 

7)                The learned advocate for the Opponent has placed reliance on the judgment of Hon’ble National Commission reported in 1994(1) CPR 108 in the case of Jewellers Narandas & Sons –Versus- The Oriental Insurance Company Limited, decided on 16^th December, 1993. In para 5 of the judgment, the Hon’ble National Commission has laid down as under :

Annexure R-V is a communication that gives detailed reasons in support of the decision taken by the insurer to repudiate the claim and it cannot be said that the said decision was taken arbitrarily and without due application of mind of the relevant facts and circumstances or otherwise than in good faith.  Such being the position, we have no hesitation to hold that there was no deficiency in service on the part of the Insurance Company so as to entitle the complainant to seek relief under the Consumer Protection Act.  In case the complainant feels aggrieved by the action of the Insurance Company in repudiating its claim, the remedy of the complainant to approach the ordinary Civil Court for appropriate relief.

In that judgment detailed reasons were given for repudiating the claim.  In the instant complaint before us, it is submitted by the opponents that no claim was submitted therefore abovecited judgment is not applicable.

8)                Thus, from the evidence on record, it is clear that claim was submitted directly to the O.P.No.1 within two years from the date of death.  The complainant has produced all the required documents.  The defence of the opponents that no claim was submitted can not be accepted.

9)                It is submitted by the learned advocate for opponents that the deceased was not having valid driving license therefore he is not entitled for the benefit of this scheme.  For this purpose, he has placed reliance on the judgment of Hon’ble Supreme Court reported in (2008) 2 Supreme Court Cases 338.  This judgment is under Motor Vehicle Act.  The Scheme of Shetkari Apghat Vima Yojana is a special scheme which is beneficial to the farmers.  Therefore, the above cited judgment is not applicable here.  The learned advocate for the complainant has submitted that there was no fault of deceased in the accident.  Therefore, driving license is not required.  For this purpose, he has placed reliance on the judgment of our State Commission in the case of ICICI Lombard General Insurance Company Limited –Versus- Smt.Sindhubai Khanderao Khairnar in First Appeal No.1009/2007 dated 7^th 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 7^th 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 the police investigation papers, accident took place due to the fault of the driver of the Truck and not of the deceased.  Therefore, the submission of the learned advocate for the opponent can not be accepted.

10)              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 O.P.No.1/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. 21^st March, 2011 till its realization.
3. The O.P.No.1/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 3^rd December, 2014