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 Mansur Kutub Pathan was an agriculturist holding Gut No.43/1 at village Manik Doudi, Taluka-Pathardi, Taluka-Ahmadnagar. He died accidentally on 2^nd November, 2005 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. appeared and filed written statement.  It is submitted that complete set of documents was not submitted within time.  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 Cause of Death Certificate.  On going through all these papers, it is clear that the husband of the complainant died in the motor vehicle accident.  According to the opponent, there is no evidence on record about the motor vehicle accident.  The complainant has already produced copies of police investigation papers on record.  As per police investigation papers, the accident was investigated by P.S.I. Gawade from Pathardi Police Station.  After investigation, he lodged complaint with the police station and the offence was registered against the truck driver.  As per his investigation, deceased Mansur Kutub Pathan was sitting in a truck and due to negligent driving of the truck driver accident took place and he died.  It is also supported by Spot Panchanama, Inquest Panchanama and Post Mortem Report.  These documents are sufficient to come to conclusion that Shri Mansur Kutub Pathan died in motor vehicle accident and the accident took place due to negligence of the truck driver. 

5)                It is also submitted by the opponent that the claim was not submitted along with the required documents.  In the written statement, it is stated that claim was not submitted along with the documents.  The contents of the written statement are inconsistent to the reply filed by the opponent to the application for delay condonation.  In para 1 of the reply, the opponent has stated as under :

That the complainant has filed this complaint against the Opposite Party on repudiation of the insurance claim lodged by the Complainant for the death of the Complainant’s husband.  The said claim was lodged under the “Shetkari Apghat Vima Yojana” for Rs.1,00,000/-.  The Opposite Party states that the said claim of the Complainant was repudiated by the Opposite Party on just and proper reasons as the claim made by the Complainant was not proper and lawful and the same was not accompanied with the necessary documents. 

In para 5 of the written statement also, the opponent has stated that the complainant failed to provide the documents to the opponent at the time of intimation of claim therefore the opponent could not consider the claim of the complainant.  Thus, in para 1 of the reply and para 5 of the written statement, the opponent has specifically admitted that the claim was submitted but the same was repudiated for the proper reason.  The opponent has not produced those reasons to repudiate the claim.  On the other hand, new inconsistent defence is taken in written statement.  Once the admission is given by the opponent, it can not be ignored.  The opponent is bound by the admission given in reply on record. Thus, from the admission of the opponent, it is clear that claim was submitted by the complainant.  There is no evidence on record showing the reasons for repudiation of claim.  As this juncture, 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, as per admission of the opponent, the claim was submitted but it was repudiated. As stated above, there is no evidence showing the repudiation and information given to the complainant about the repudiation.

6) As to Point No.3 :- According to the opponent, the claim is barred by limitation.  The limitation period will start from the date of repudiation.  As stated in para 5 of the written statement and para 1 of the reply filed by the opponent, the claim was repudiated as the complainant failed to produce the required documents.  There is absolutely no evidence on record to show that the repudiation was intimated to the complainant.  As there is no evidence about the intimation of repudiation, the limitation period will continue and therefore the claim within limitation.  Moreover, the delay is already condoned for filing of the complaint and the same is not challenged by the opponent. 

7)                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 Government Resolution the opponent is liable to satisfy the claim of the complainant. The complainant has complied all the formalities as required under 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 filing of the complaint i.e. 6^th July, 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 1^st November, 2014