BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SIRSA.
Consumer Complaint no. 415 of 2019.
Date of Institution : 02.08.2019.
Date of Decision : 07.07.2022.
Guddi aged 60 years wife of Amar Singh, resident of village Ganga, Tehsil Dabwali, District Sirsa. Mb. No. 99927-01597.
……Complainant.
Versus.
1. ICICI Lombard General Insurance Company Ltd. 4th Floor, the Statement Building, Plot No.149, Industrial Area, Phase-I, Next to Hometel Hotel, Chandigarh- 160002 through its Manager.
2. Sarva Haryana Gramin Bank, Branch village Ganga, Tehsil Dabwali, District Sirsa through its Branch Manager.
3. Deputy Director Agriculture, Sirsa, District Sirsa.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986 as amended under Section 35 of the Consumer Protection Act, 2019.
BEFORE: SH. PADAM SINGH THAKUR ………………PRESIDENT
MRS.SUKHDEEP KAUR………………………MEMBER.
SH. SUNIL MOHAN TRIKHA…………………MEMBER
Present: Sh. Mahesh Pareek, Advocate for complainant.
Sh. R.K. Mehta, Advocate for opposite party No.1.
Sh. M.S. Sethi, Advocate for opposite party no.2.
Sh. Satish Kumar, Statistical Assistant for opposite party no.3.
ORDER
The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 as after amendment under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as Ops).
2. In brief, the case of the complainant is that complainant is an agriculturist having land in joint share (as detailed in para no.1 of the complaint) situated in village Ganga, Tehsil Dabwali District Sirsa as per jamabandi for the year 2012-2013 and is wholly dependent upon agricultural income. She is having her account bearing No. 81618800016263 with op no.2. It is further averred that as per scheme of Central Government namely Prime Minister Fasal Beema Yojna, the crops sown in the land of complainant was insured with op no.1 against loss, damages of crop due to natural causes and accordingly an amount of Rs.3177.63 was deducted on 28.7.2017 as premium by op no.2 from the account of complainant and was transferred to the account of op no.1 for the insurance of crops. That complainant had sown crop of cotton in about six acres of land in year 2017 which was damaged due to disaster of white bees and other natural calamities and therefore, complainant is entitled to insurance amount of Rs.3,00,000/- approximately at the rate of Rs.50,000/- per acre but the insurance company/ ops have paid an amount of Rs.50,693.38 only on 5.1.2019 which is inappropriate and not in accordance with the scale of insured land and quantum of damage to the cotton crop sown by complainant. It is further averred that complainant has made her all best efforts to get remaining amount of insurance claim from ops but ops are adamant not to release the claim amount to the complainant and have caused harassment as well as mental agony to the complainant. Hence, this complaint.
3. On notice, opposite parties appeared. Op no.1 filed reply raising certain preliminary objections. It is submitted that as per complaint, loss of cotton crop has been effected in village Ganga, Tehsil Dabwali District Sirsa due to the reason mentioned in the loss assess report “Rains not lead to Inundation” which has not been covered under the terms and conditions of the insurance policy. As such complaint is liable to be dismissed on the ground given in the loss assess report alone. It is further submitted that insurance company cannot be questioned for proposal related disputes. The role of insurance company is only to pay claim in accordance with scheme of “Pradhan Mantri Fasal Bima Yojana” and thus, insurance company cannot be held liable for any mistake done either by complainant herself or by bank of complainant. In the present complaint, complainant is claiming for cotton crop, but alleged loss to the crop was not covered under the reason “Inundation and Hailstorm”. It is further clarified that insurance of farmer has been done on the basis of good faith and declaration made by bank of farmers. If any mistake is done by bank of complainant, insurance company cannot be held liable for claim amount. It is further submitted that it is clarified that except localized claims, all other perils were to be finalized by government agencies on the basis of yield of crop and thereafter, claims were to be paid to bank of farmers. The insurance company is playing a role of implementing agency in the scheme in accordance with guidelines prescribed by Government. Further more, in localized claims, three perils are covered under the scheme i.e. Hailstorm, Landslide and Inundation affecting isolated farms in the notified area. For localized claims, there was a condition for immediate intimation of claim within 48 hours of loss. After intimation of claim, necessary survey of affected area had to be conducted by surveyor for decision of claim of farmers. It is further submitted that it is not an individual insurance policy like other insurance policies rather it is a group insurance scheme in accordance with agreed terms and conditions of scheme which are binding on all of concerned related to the scheme. The complainant should have approached to DAC & FW department for any kind of grievance related to scheme or claim and the decision of said department would be binding on all state Government/ Insurance Company/ Bank and farmers. But instead of filing complaint or grievance before DAC & FW department, the complainant has approached this Forum by violating standard terms and conditions of scheme and thus, present complaint cannot be adjudicated before this Forum. It is further submitted that complainant never intimated any claim to insurance company for loss of crop and thus, connected story of claim of complainant cannot be believed in absence of credible evidence of loss of crop and proof of timely intimation of claim. Merely allegation of claim intimation is not enough to establish that loss had actually occurred. Further, in absence of immediate intimation of claim, survey of damage field could not be conducted and therefore, it is almost impossible to determine quantification of loss. As per guidelines of scheme, immediate intimation was to be given within 48 hours but complainant has failed to give any claim intimation to company for loss of crop which reveals violation of terms and conditions of scheme. Other preliminary objections regarding non submission of proof of loss or weather report, limited coverage as per scheme, yield basis claims are decided by Government, no survey no quantification of loss, no privity of contract, non impleading of necessary parties and involvement of complicated facts and law are also taken. On merits, the contents of complaint are denied and above said pleas are also reiterated. It is submitted that claim of complainant was rejected as the crop loss was occurred due to “Rains” but the same is not leading to Inundation, which is covered for loss under the scheme and complainant has made a false, bogus and baseless story just to grab the compensation. With these averments, prayer for dismissal of complaint made.
4. Opposite party no.2 filed written statement taking certain preliminary objections. It is submitted that an amount of Rs.3177.06 was debited from the account of complainant and was transferred to op no.1 as premium for insurance of crops of complainant under Prime Minister Fasal Bima Yojna. As per clause 19 (XXII) of Haryana Govt. Agriculture and Farmer, Welfare Department Notification No.941-Agri-II (I)-2018/4332 dated 30.03.2018, the insurance company shall verify the data of insured farmers pertaining to area insured, area sown, address, bank account number (KYC) as provided by the banks independently on its own cost within two month of the cutoff date and in case of any correction must report to the State Govt. failing which no objection by the insurance company at a later stage will be entertained and it will be binding on the insurance company to pay the claim. It is further submitted that in the present case, op no.1 has accepted the premium without any objection and has never refunded the same, so it is presumed that op no.1 has insured the crops of complainant after accepting the premium. If there is any loss to the complainant, then op no.1 is liable to compensate the same. After acceptance of premium by insurance company, the matter regarding payment of compensation is between the complainant and insurance company. Remaining contents of complaint are also denied to be wrong and prayer for dismissal of complaint qua op no.2 made.
5. OP no.3 also filed separate written version raising certain preliminary objections as taken by op no.1. It is submitted that answering op is only liable to conduct the CCE’s experiments (crop cutting experiment) and yield basis claims are settled by the insurance company only on completion of other necessary formalities as prescribed in operational guidelines of scheme which have already been given by the answering op within specific time period as prescribed in the operational guidelines of the Government of India. Remaining contents of complaint are also denied.
6. Complainant has tendered her affidavit Ex.CW1/A, copies of jamabandi for the year 2012-2013 Ex.C1 and Ex.C2, copy of pass book Ex.C3, copy of statement of account Ex.C4, copy of application dated 22.07.2019 Ex.C5 and postal receipt Ex.C6.
7. On the other hand, Op no.3 has tendered affidavit of Sh. Babu Lal, Deputy Director of Agriculture, Sirsa as Ex.R1, copy of Haryana Government Agriculture and Farmers Welfare Department notification dated 13.06.2017 Ex.R2, copy of village wise tabulation sheet of sum insured and claim under PMFBY During Kharif, 2017 Ex.R3. Op no.2 has tendered affidavit of Sh. Vikas Kumar, Branch Manager as Ex.R4, copy of application form for agricultural credit (set of documents for Kisan Credit Card Scheme) Ex.R5, copy of statement of account Ex.R6 and data Ex.R7.
8. Op no.1 did not lead any evidence despite availing several opportunities.
9. We have heard learned counsel for the parties as well as Sh. Satish Kumar, SA on behalf of op no.3 and have gone through the case file carefully.
10. The complainant in order to prove her complaint has furnished her affidavit Ex.CW1/A in which she has reiterated all the contents of her complaint and in order to prove her ownership over the agricultural land in village Ganga, District Sirsa has placed on file copy of jamabandi for the year 2012-2013 Ex.C1. Admittedly the complainant has also availed crop loan facility from op no.2. The complainant has also placed on record copy of pass book Ex.C3, from which it is proved on record that on 28.7.2017, an amount of Rs.3177.63 was deducted from her account by op no.2 as insurance premium for paying the same to op no.1 insurance company for insurance of cotton crop of complainant of Kharif, 2017 under Pardhan Mantri Fasal Bima Yojna. According to complainant, as insured cotton crop of complainant of Kharif, 2017 was damaged, she was entitled to insurance claim amount of Rs.3,00,000/- from ops whereas op no.1 has paid only an amount of Rs.50,963.38/- to the complainant. The op no.3 i.e. agricultural department who is to conduct survey of the damage of the crops has placed on file copy of Haryana Government Agriculture and Farmers Welfare Department notification dated 13.6.2017 Ex.R2 which says that “shortfall in yield will be calculated by comparing the threshold yield with the actual yield estimated through Crop Cutting Experiments (CCEs) and in cases where required number of CCEs could not be conducted due to non availability of adequate cropped area, the yield estimate for such IUs will be made by adopting the yield of next higher unit i.e. block. The op no.3 in its written statement as well as in affidavit Ex.R1 has submitted that they have already completed necessary formalities as prescribed in operational guidelines of scheme i.e. have already provided survey report regarding damage of crops to the insurance company. In this regard, op no.3 has also placed on record report of threshold yield as Annexure A with Ex.R2 and Annexure D i.e. list of rain gauge stations and village wise tabulation sheet of sum insured and claim under PMFBY during Kharif, 2017 as Ex.R3. According to Annexure A threshold yield of cotton crop of Kharif, 2017 of block Dabwali was 628.02 Kgs. per hectare whereas according to village wise tabulation sheet of sum insured and claim under PMFBY during Kharif, 2017 Ex.R3, the actual yield of cotton crop of village Ganga under the Block Dabwali was 337.65 Kgs. per hectare and as the actual yield of cotton crop of village Ganga under the Block Dabwali was less than threshold yield of Dabwali block, there was loss to the cotton crop of village Ganga of Kharif, 2017 as per above said notification of Haryana Government Ex.R2. So, it is proved on record that there was also loss to the cotton crop of complainant of Kharif, 2017.
11. Now the question arises for consideration that to what amount of claim the complainant is entitled for the damage of her cotton crop of Kharif, 2017 and who is liable to pay the said claim amount to the complainant? In this regard, complainant has claimed that as cotton crop in her about six acres of land was damaged, therefore, she was entitled to insurance claim amount of Rs.3,00,000/- approximately i.e. at the rate of Rs.50,000/- per acre but op no.1 has paid only an amount of Rs.50693.38 which is inappropriate. From the copy of pass book Ex.C3, it is also evident that on 5.1.2019 an amount of Rs.50,693.38 was paid in her account on account of PMFBY Claim of cotton crop. In the data of complainant Ex.R7 placed on file by op no.2, it is mentioned that amount of premium of Rs.3177.63 for insurance of cotton crop in 2.3026 hectares was paid to insurance company op no.1 but on portal premium amount was shown as Rs.2192.82 and area was shown as 1.589 hectare and claim amount of Rs.50,693.38 was received on 5.1.2019. It is also mentioned in said document Ex.R7 that less area uploaded on portal but full amount paid to insurance company and no amount has been returned by the insurance company to the bank. It is also mentioned in the said document Ex.R7 that as per SGRC Decision dated 2.7.2019, if the premium amount has been paid by Bank and insurance company has not returned the amount to the Bank, then the insurance company will pay the difference amount of claim to the farmer. From the said document Ex.R7, it is evident that said amount of Rs.50,693.38 was paid to the complainant for damage of her cotton crop in 1.589 hectare at the rate of Rs.35208.65 per hectare whereas amount of premium was paid to op no.1 for 2.3026 hectare and therefore, for wrong entry on portal regarding less area, complainant cannot be allowed to suffer. Since no verification regarding the area of complainant has been done by op no.1 insurance company and premium amount of Rs.3177.63 for area of 2.3026 hectares has been retained by op no.1 insurance company, therefore, op no.1 insurance company which retained premium but did not make any verification regarding area is liable to pay the remaining claim amount to the complainant. Moreover, insurance company op no.1 has already made part payment of insurance claim to the complainant and therefore, op no.1 is liable to make payment of remaining claim amount to the complainant. However, the amount claimed by complainant i.e. Rs.3,00,000/- is very excessive and exaggerated amount and complainant has not led any cogent and convincing evidence to prove said loss of the amount of Rs.3,00,000/-. So, we are of the considered view that complainant is entitled to an amount of Rs.35208.65 per hectare as assessed by op no.1 insurance company and for her 2.3026 hectare land, she was entitled to total amount of Rs.81,000/- for the damage to her crop of Kharif, 2017. Since complainant has already been paid an amount of Rs.50693.38 for loss of cotton crop in her 1.589 area by op no.1, therefore, she is entitled to remaining amount of Rs.30,306.62/- from op no.1 insurance company. At the same time, op no.2 bank which updated less area of complainant on portal is also liable to pay compensation to the complainant for unnecessary harassment and unwanted litigation. However, no liability of op no.3 is made out.
12. Thus, as a sequel to our above discussion, we partly allow the present complaint qua opposite parties no.1 and 2 and direct op no.1 insurance company to pay a sum of Rs.30,306.62/- (in round figure Rs.30,307/-) as insurance claim alongwith interest @7% per annum from the date of filing of present complaint i.e. 02.08.2019 till actual realization to the complainant for the loss of her cotton crop of Kharif, 2017. We also direct the opposite party no.2 bank to pay a sum of Rs.10,000/- as composite compensation for mental agony and harassment including litigation expenses to the complainant. Ops no.1 and 2 are directed to comply with this order within a period of 45 days from the date of receipt of copy of this order, failing which complainant will be at liberty to initiate proceedings under Section 71/72 of the C.P. Act, 2019 against ops no.1 and 2. However, complaint qua op no.3 stands dismissed. Copy of the order be supplied to the parties free of costs. File be consigned to the record room.
Announced: Member Member President,
Dated:07.07.2022. District Consumer Disputes
Redressal Commission, Sirsa.
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