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 son Mr.Pradeep Sopan Rakhunde was an agriculturist holding Gut No.513/7/B at village Kandar, Taluka-Karmala, District-Solapur. He died accidentally on 24^th July, 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 opponent appeared and filed written statement. It is submitted that the claim was already repudiated vide letter dated 3^rd November, 2011. The complainant did not submit the required documents. The deceased had no valid driving license therefore the complainant is not entitled for the insurance claim.  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 son was holding agricultural land and he was farmer.  The complainant also produced copies of F.I.R., Spot Panchanama, Inquest Panchanama, Driving License of the Deceased, post mortem report, Death Certificate, School Leaving Certificate. On going through all these papers, it is clear that son of the complainant died in motor vehicle accident. The complainant also produced copies of claim form showing that the claim was submitted to the opponent. The complainant produced information received under Right to Information Act, 2005 showing that the insurance claim was submitted by the complainant and her claim was rejected as the claim was received after ninety days. In the agreement, power is given to the Insurance Company to accept the claim even after ninety days after the expiry of the insurance period.  The complainant is the illiterate mother of the deceased who is residing in the village, far away from the opponent office.  In the Government Resolution, responsibility is fixed on the revenue department to submit all the papers to the opponent.  Rejecting claim on failure of the revenue department will not be proper.  It is against the very purpose of the agreement to protect the illiterate and poor farmers.  Therefore, we think the claim was wrongly repudiated.

5)                It is submitted by the learned advocate for the complainant that the accident took place due to the fault of the driver of unknown vehicle and not of the deceased. The unknown vehicle gave dash from the back side of the deceased.  Therefore, the defence of the opponent about non submission of driving license should not be accepted.  For this purpose, he 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 in First Appeal No.1009/2007 dated 7^th January, 2008. 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 police investigation papers, accident took place due to the fault of the driver of the unknown vehicle and not of the deceased.  Therefore, the repudiation of claim by the opponent was not proper. The learned advocate for the opponent has placed reliance on the judgment of the Hon’ble Supreme Court reported in (2008) 2 Supreme Court Cases 338.  In that judgment the driver of the offending vehicle had no valid driving license.  In the instant complaint before us, offending vehicle is unknown.  The evidence on record show that accident took place due negligence of the driver of the unknown vehicle.  Therefore, this judgment is not applicable.  The learned advocate for the opponent has further placed reliance on the judgment of Hon’ble National Commission reported in 1194(1) CPR 108.  In that judgment detailed reason was given.  In the instant complaint before us, claim was repudiated as it was submitted after ninety days.  Therefore, this judgment is not applicable.

6)                Thus, there is sufficient evidence on record to show that deceased was the farmer holding agricultural land. He died accidentally. The complainant is a mother. 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. Therefore, the opponent is liable to pay claim amount with interest.  Besides this, the opponent is liable to pay cost of this proceeding Rs.5,000/-.  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. 24^th July, 2011 till its realization.
3. The opponent is further directed to pay Rs.5,000/- (Rs.Five 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 1^st September,  2014