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 Mohan Shivaji Bhosale was an agriculturist, holding Gut No.5/1 at village Panmalewadi, Post-Visapur, Taluka-Tasgaon, District-Sangli.  He died accidentally on 28^th October, 2013 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/Insurance Company appeared and filed written statement. It is submitted that the claim alongwith the 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 remained absent though duly served therefore the O.P.No.2 was proceeded exparte.

4)                After hearing the argument of complainant and the O.P.No.1 and after going through the record, following points arise for our consideration.

POINTS

REASONS

5) As to Point No.1 & 2 :- The complainant has produced the revenue record showing that her husband was holding agricultural land and he was farmer. The complainant has also produced the copies of F.I.R., Police Report, Crime Details Form, Inquest Panchanama, Post Mortem Report, Death Certificate and copy of Claim Form submitted through Taluka Krishi Adhikari.  On going through all these papers, it is clear that the husband of the complainant died in motor vehicle accident. As per written statement filed by the O.P.No.1, the claim along with complete set of documents was not submitted within time. 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 opponent.  Liability is fixed on the government agricultural department.  The beneficiary should not be suffered due to lack of compliance within time by the government machinery.  According to the complainant, the claim was submitted to the opponent/government office within time. In the written statement, the opponent has submitted that the claim was not submitted and produced the copy of repudiation letter dated 29^th April, 2014 saying that claim was filed after the period of limitation.  The deceased died on 28^th October, 2013.  As per Government Resolution dated 17^th October, 2013, the policy period was extended from 23^rd October, 2013 to 31^st October, 2013 and the government paid premium to the O.P.No.1.  Thus, the policy was in force on the day of death of the deceased.  Therefore, the repudiation of the claim by the O.P.No.1 is apparently against the Tripartite Agreement and the Government Resolution dated 17^th October, 2013.  There is no other defence raised by the O.P.No.1 therefore, the defence taken by the O.P.No.1 can not be accepted. The complainant has produced all the required documents under the Agreement therefore her claim can not be rejected.  

6)                The learned advocate for the O.P.No.1 has placed reliance on the judgment of Hon’ble National Commission in Original Petition No.137 of 1993, in the case of M/s. Zenith Computers Limited and another –Versus- The New India Assurance Company Limited, decided on 13^th December, 1994.  But as discussed above, the O.P.No.1 has wrongly repudiated the claim as time barred though the policy was in force.  Therefore, the abovecited judgment is not applicable.

7)                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, the claim form was immediately submitted to the government office. Therefore, the claim of the complainant can not be repudiated. 

8)                Thus, there is sufficient evidence on record to show that the deceased was the farmer holding agricultural land. He died accidentally in 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 claimed. 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 deceased insured i.e. 28^th October, 2013 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 2^nd December, 2015