PER SHRI. S.S. PATIL - HON’BLE MEMBER :
1)This is complaint regarding the deficiency in service on the part of Opposite Party as it did not settle the legitimate insurance claim of the Complainant.
2)The facts of the complaint are that, the Complainant is a widow of one Gorakh Savla Khare, Age 56, years of village Mhaisgoan, Tal. Mhada,, Dist.Solapur. The deceased was an agriculturist. he died on 07/02/06 at his agriculture field, where he was hit by a bullock and sustained injuries due to which he died on the spot.
3) The Complainant has further stated that she is the legal heir of the deceased Gorakh Khare. Her deceased husband is holding agriculture land and she has produced 7/12 Extract of the revenue record as well as 8-A form of the Khate Pustika showing that her husband was holding an agricultural land and was a farmer. She has also stated that a postmortem was performed on the dead body of her husband and she has attached the copy of the post mortem notes in this respect. The above incident of hitting by the bullock was registered at Kurudwadi Police Station and she has annexed the relevant papers prepared by the said police station.
4) The Complainant has further stated that she and her other legal heirs were totally dependent on the earnings by her deceased husband. By the sudden death of her husband, she and other legal heirs were deprived of the income earned by her deceased husband.
5) The Complainant has further stated that she is entitled to the insurance claim of Rs.1 Lac under the ‘Farmer’s Personal Accident Insurance Policy’ taken out by the Government of Maharashtra from the Opposite Party as the insurer. For this purpose, the Complainant has submitted all the relevant papers to the Opposite Party through the concerned Tahasildar within the time prescribed in the scheme of the insurance policy. However, the Opposite Party has not paid any amount towards the above said claim till date inspite of constant follow up by her with the Opposite Party.
6) As the Opposite Party failed to pay the claim of the Complainant, she issued a notice dtd.25/05/2010 to the Opposite Party through her advocate and called upon the Opposite Party to pay the insurance claim to her. The said notice was received and acknowledged by the Opposite Party but in vain. Therefore, the Complainant has filed this complaint as the Opposite Party has failed to settle her legitimate insurance claim under Farmer’s Personal Accident Insurance Policy.
7) The Complainant in her complaint has clarified that, she had filed her claim within the prescribed time limit under the scheme but the Opposite Party has not repudiated the claim till date. Therefore, there is no delay in filing this complaint. If there is any delay, it may be condoned in the interest of justice. It is further prayed by the Complainant that the Opposite Party be directed to pay a sum of Rs.1 Lac to the Complainant towards the insurance claim alongwith interest @ 12%.
8) The Complainant has attached the xerox copies of the following documents in support of her complaint –
Extracts of 7/12, 6-C and 8A, Statement of one, Sunil Chaudhari, Inquest Panchanama, Spot Panchanama, Certificate of Police Patil, Final Police Report, Certificate from police, Document of Government of Maharashtra regarding the Farmers’ Personal Accident Insurance Policy. The complaint is also supported by the affidavit of the Complainant.
9) The Complainant has filed a delay condonation application alongwith the complaint. The notice was issued to the Opposite Party and sought its reply on delay condonation application of the Complainant. The Opposite Party filed its reply vehemently taking objection for the delay and stated that there is delay of 2 years 5 months and 19 days. The Opposite Party has only stated that the claim of the Complainant was repudiated on the proper grounds but has not mentioned as to when the Opposite Party has repudiated the claim. As the claim was not specifically repudiated by the Opposite Party, the cause of action continued till filing of this complaint and as such, the delay was condoned by this Forum by order dtd.13/04/2011 and the complaint was admitted.
10) Notice of the complaint was served on the Opposite Party who filed its written statement wherein it denied the deficiency but admitted that the Complainant had made a claim of Rs.1 Lac with Opposite Party as per insurance policy introduced by the Government of Maharashtra in cooperation with the Opposite Party to insure Former’s sudden death since 2004. In this policy the beneficiaries are the genuine farmers. It has also explained by the Opposite Party that the purpose to introduce this policy is the welfare of the farmers, whose source of income is agriculture and who are financially week and to provide financial help to families of the farmers after accidental death of sole bread earner of the family.
11) The Opposite Party has further stated that the present claim is being adjudicated by the Hon’ble National Commission in respect of complaint filed by the State Government wherein 2232 claims are being adjudicated. However, the Opposite Party has not filed any document in this respect.
12) It is further stated by the Opposite Party that there is no evidence to show that the death of the deceased was caused by the hit of a bullock. It is also alleged by the Opposite Party that the Complainant has failed to prove that the deceased was a registered farmer before the tenure of the policy.
13) It is also alleged by the Opposite Party that no FIR, Charge Sheet or Police Final Report, Death Certificate & Statement of Eye Witness were attached by the Complainant to the claim application.
14) The Opposite Party has further alleged that the Complainant has deliberately and intentionally concealed the relevant facts. The cause of death of the deceased stands unproved. It is also stated by the Opposite Party that, as per the terms and conditions of the policy the claimant should provide 6-C Form to the Opposite Party. The Complainant has not provided necessary documents required to adjudicate the claim hence, the claim was rightly repudiated by the Opposite Party on just and proper grounds. Finally the Opposite Party has submitted that the complaint be dismissed with exemplary cost. The written statement of the Opposite Party was supported with affidavit of evidence by the Opposite Party.
15) The Complainant has further filed her affidavit of evidence and written argument wherein she reiterated the facts mentioned in the complaint. We heard the Ld.Advocates of both the parties and perused the papers submitted by both the parties. Our findings are as follows.
16) The deceased person Shri Gorakh Savla Khare, Age 51 Years was a farmer of Village Mhaisgaon, Tal. Mhada, Dist. Solapur, The Complainant has produced the extract of 7/12 of Revenue Department i.e. from the record of Talathi which shows that the deceased was holding an agricultural land of 2 hector 95 acr i.e. about 7 acres at village Mhaisgaon, Tal. Mhada, Dist. Solapur. After his death his heirs i.e. widow Smt. Vaijantabai (the Complainant) and his son – Samadhan have been brought on record as the same land holder. He was cultivating Jawar crop. The Complainant has also attached the copy of village Form 8(A) in which the name of the son of the deceased was entered as per the copy dtd.03/05/06.
17) The Complainant has also filed the statement of some witness, Spot Panchanama where the deceased died and Inquest Panchanama drawn by the Police, Death Certificate, Certificate of the Kurudwadi Police Station regarding the accidental death of the deceased. Postmortem Notes of the dead body of deceased Gorakh Savla Khare is submitted by the Complainant. All these documents show that the deceased was a farmer and he died on 07/02/06 as he was hit by a bullock in his agricultural field. Still the Opposite Party has stated that the deceased was not a farmer and the Complainant has not proved that the death was an accidental one. In our candid opinion, the Opposite Party has not considered the documents stated above and submitted by the Complainant alongwith claim form through the concerned Tahasildar.
18) The Opposite Party has also taken a plea that the mater is pending in the Hon’ble National Commission. But the Opposite Party has miserably failed to file any document in this connection to show that this matter is pending adjudication in the Hon’ble National Commission.
19) It is also the contention of the Opposite Party that the claim is not as per the terms and conditions of the policy as the deceased was not a registered farmer. In this respect, the extract of 7/12 of Village Mhaisgaon shows the name of the deceased was agricultural land holder. The Form 8A and 6A attached by the Complainant also shows that the deceased was a farmer. Therefore, the Opposite Party has not considered the papers submitted by the Complainant.
20) It is really interesting that the Opposite Party in its written statement has stated that it repudiated the claim of the Complainant on just and proper grounds. However, it is seen that, the Opposite Party has never repudiated the claim. Therefore, it is a clear deficiency in service on the part of Opposite Party that it did not take any decision on the claim submitted by the Complainant to the Opposite Party and not settled the insurance claim of the Complainant though her husband, Gorakh Savla, Age 51 years died in bullock hitting i.e. he died in an accident.
In view of the above findings and taking into consideration the prayer of the Complainant, we pass the following order -
O R D E R
i. Complaint No.253/2010 is partly allowed.
ii Opposite Party is directed to pay Rs.1,00,000/- (Rs. One Lac Only) to the Complainant towards the settlement of
the insurance claim for the death of Late Shri. Gorakh Savla Khare, Age 51 years on 07/02/06 alongwith interest
@ 10% from 07/03/2006 till its payment.
iii.Opposite Party is directed to comply with the above order within 30 days from the receipt of this order.
iv.Certified copies of this order be furnished to the parties free of cost.
