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, he is the agriculturist, holding agricultural land, Gut No.641 at village Belwadi, Taluka-Indapur, District-Pune. He suffered injury and disability while he was cutting the fodder in the machine on 15th December, 2012. He submitted insurance claim under the Government Scheme of Shetkari Apghat Vima Yojana. His claim was not satisfied therefore he 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 claim of the complainant was repudiated on 4th June, 2013 as complete set of documents was not submitted within time as per Tripartite Agreement therefore, he 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
Sr.No. | Points | Findings |
1) | Whether there is deficiency in service ? | No |
2) | Whether the complainant is entitled for the relief as claimed ? | No |
3) | What Order ? | As per final order |
REASONS
4) As to Point No.1 & 2 :- According to the complainant, he suffered injuries and disability while cutting the fodder in the machine on 15th December, 2012. He has produced the Xerox coy of Disability Certificate issued by Sasoon General Hospital, Pune. It is not original or certified document. In fact, it was necessary for the complainant to produce the original Disability Certificate on record. He has also not produced the medical case papers showing the injury suffered by him. As per Xerox copy of Disability Certificate, the complainant suffered 70% disability. The Scheme of Shetkari Apghat Vima Yojana is applicable only to the following category. As per Tripartite Agreement Clause (I) 5),
5) Benefits :
Benefits | Compensation as % of the Capital Sum Insured |
Death only | 100 |
Loss of one limb or one eye | 50 |
Loss of sight on both eyes | 100 |
Loss of both hands | 100 |
Loss of both feet | 100 |
Loss of one hand and one foot | 100 |
Loss of one eye and one hand | 100 |
Loss of one eye and one foot | 100 |
It was necessary for the complainant to bring evidence on record showing that he suffered injuries while cutting fodder in the machine. If, according to the complainant, he suffered injuries then naturally he had taken medical treatment. The complainant has not produced the papers showing the injuries and medical treatment taken by him. It was necessary for the complainant to bring the evidence on record that he suffered disability due to injuries. There is absolutely no evidence on record showing the injuries suffered by the complainant in accident. The complainant has merely produced the xerox copy of Disability Certificate. We do not think it just to accept the xerox copy of Disability Certificate in the absence of medical treatment papers. There is no evidence on record showing the connection of disability with the injuries suffered by the complainant in the accident. In the absence of such evidence, the complainant is not entitled for the benefit under the Scheme. The opponent has already repudiated the claim vide letter dated 4th June, 2013. On this background, it was necessary for the complainant to produce the medical treatment papers on record showing the connection of disability. Therefore, the complainant is not entitled for the relief as prayed. Hence, we proceed to pass the following order.
ORDER
- Complaint stands dismissed.
- Parties are left to bear their own costs.
- Inform the parties accordingly.
Pronounced on 5th January, 2016
