Final Order / Judgement | JUDGMENT Sri A.K.Patra, President - The captioned Consumer Complaint is filed by the complainant named above inter alia alleging negligence & deficiency in service on the part of Opposite Parties for non release of crop insurance benefit claimed on account of loss of paddy crop grown during Kharif 2017-18.
- The complainant seeks for an order directing the Ops to release the crop insurance benefit along with all other allied benefit with interest and to award the litigation cost.
- The factual matrix leading to the case of the complainant as emerged from the case record is that, the complainant is a farmer by occupation. During Kharif 2017-18 he had availed agriculture loan vide Loan A/C No.06410510006337 from Op 1/UCO Bank , Kesinga to grow paddy crop over his agriculture land situated in Mouza:- Dumermunda, Po:-Sirol,G.P:-Sirol,Ps-Kesinga, Dist-Kalahandi,Odisha. Accordingly his crop was insured with the OP2/ Tata AIG General Insurance Co. Ltd by the concern bank/Op1 deducting premium sum of Rs.8165/-on 31.07.2017 from his account vide No.06410510006337. Govt. has declared damage of 65% of Paddy crop grown over the Sirol Gram Panchayt during Khariff 2017 accordingly insured co-farmers have already received their crop insurance benefit but the complainant has not yet received his crop insurance benefit in spite of repeated approaches to the Ops which caused financial loss & mental agony to the complainant for which he reported the matter before the grievance redressal forum of the insurance company /OP 2 but no avail .Lastly he lodged complaint before the Insurance Ombudsman, Bhubaneswar where it was advised to present his complaint in proper forum . Hence, this complaint.
- On being notice, the Ops have appeared and filed their respective written version denying the complaint allegation.
- The OP 1/UCO Bank Kesinga has filed their written version admitting the facts that, the complainant is a loanee farmer availed agriculture loan from the OP 1/Bank vide loan Account No.06410510006337 and that, the bank has received the insurance premium amount of Rs.8165/- form the complainant /the borrower and credited it to the insurance company/Op 2 without any delay acting simply as collection agent of insurance company/Op 2. It is further submitted that, while opening account the Bank only maintain the detail postal address of the borrower and property detail as mentioned in the ROR . As a matter of fact, the ROR does not bear name of any Grampanchayt nor it was disclosed by the borrower while opening of said account. So while entering the details of the borrower in the insurance format it is duty of the borrower to disclose detail as required for insurance and the officer of the bank gets it entered as per the version of the borrower only. In the case in hand also every entry concerning crop insurance was made as per information given by borrower and it is the duty of the insurer to verify the entry detail whatever entered by the bank by utilizing the own resource to verify the genuineness of entry made by the bank which is an establish practice & procedure so far as PMFBY scheme is concerned and there is no fault on the part of O.P 1/Bank for remittance of details of the information of crops insured to the insurance company /Op 2 . It is further submitted that, soon after receiving the premium on dt.31.07.2017 from the complainant/borrower it was credited to the OP2/Insurance Company on the same date as such the bank is no way concern with the dispute between complainant & OP2/ insurance company for non release of crop insurance benefit. It is further submitted that, the complainant for the first time made a complaint in the month of Oct 2018 that, he has not yet received the crops insurance benefits under PMFBY upon which the O.P 1 /Bank on dt.23.10.2018 made communication with the insurance company thereafter the insurance company /O.P 2 on dt 05.10.2018 informed the O.P 1/ Bank that, “Kundabandh” Grampanchayat as mention in the insurance policy of the complainant does not cover under PMFBY . Soon after receiving of such information, the O.P1 /bank inquired form the complainant and after ascertaining the facts that Mouza /village “Dumermunda”, over which the agriculture land of the complainant exist, actually comes under the “Sirol” Grampanchayat, the O.P 1/Bank conveyed the same to the insurance company/O.P 2 vide letter No.BR/Kesing/Mis/85/2018 -19 /dt.01.10.2019 and requested to make necessary correction. The O.P1 /Bank further submits that, as insurance company has neither rejected the policy application nor it has return the premium so it is natural duty of the insurer to make good the complainant but the reason best known to the insurance company/Op 2 for non releasing of crop insurance benefit to the insured farmer/complainant for the loss of crops grown during Kharif 2017-18. It is further submitted that, this complaint is not maintainable in the eye of law and it is barred by law of limitation. With this submission the O.P 1/ Bank urged to dismiss this complaint against him claiming no deficiency in service or unfair trade practice on their part. The OP 1 /Bank have relied on the following documents to substantiate their claim:-
- Copy of account statement of complainant vide Loan Account No.06410520006337.
- Copy of all communication made by bank to Tata AIG,
- Copy of ROR No.121 of mouza:- Dumermunda recorded in the name of complainant.
- Copy of ROR No.226/147 of Mouza Dumermunda recorded in the name of Purna Chandra Sahu.
But no such documents are placed on record - The O.P 2/ Tata AIG Insurance Co. Ltd has filed their written version with a preliminary objection on the maintainability of the complaint petition for mis- joinder & none-joinder of necessary party, barred by limitation, principle of estoppels, waiver, acquiescence and urged to dismiss this complaint. However it has admitted the facts that, the details of complaint was made entry by Bank/ OP 1 in the concern Govt. portal and that, the premium was received by the O.P 2 under PMFBY scheme . It is submitted that, the O.P 2/Insurance Company has checked the detail and found there in that, in the Govt portal the application No.1017716365, name:- Prafulla Kumar Sahu, Kesinga Block, Kundhabandh G.P , Crop -paddy (Dhan), Area-Ac 7.1 dcl is insured. It is further submitted that, the O.P 2 has verified the facts from the data share by the State Govt. and found that, there is no shortfall in yield for these complainant farmer in “Kundhabandh” G.P hence no claim is declared by Govt. and the same has been communicated by the Op 2 /Insurance company to the Bank / O.P 1 through mail dt.29.10.2018 and on dt.05.12.2018. So the insurance company is no way responsible for wrong entry made by the O.P 1/Bank. It is further submitted that, as no Insurance premium has been paid for the insurance of the Paddy crop of the complainant grow in “Sirol” G.P the complainant is not entitle for insurance benefit under PMFBY for any loss there in that G.P of “Sirol”. It is further submitted that, the complainant through O.P 1 has insured the paddy crop grown over “Kundabandh” G.P of Kesing Block only accordingly he is entitle for insurance benefit in case of declaration of crop loss in “Kundabandh” G.P only but the Govt. has not declared any loss in the “Kundaband” G.p of Kesing Block ,Dist-Kalahandi accordingly the complainant is not entitle for crop insurance benefit under PMFBY and there is no negligence or deficiency in service or Unfair trade practice on the part of O.P 2/Insurance Company for which this complaint need to be dismissed against the O.P 2/ Insurance Company. It is further submitted that, the learned insurance ombudsman Bhubaneswar vide its letter No.BHU-G-047-1819-0163/3167 dt.27.02.2020 advised the complainant to put forth his grievance in proper forum establish there under PMFBY scheme but the complainant has never file his grievance before the grievance redressal mechanism under PMFBY and filed this complaint is not maintainable rather liable to be rejected.
- Complainant as well as the O.P 1 led their evidence on affidavit. No evidence on affidavit is filed by the O.P 2 / Insurance Company as prescribed under C.P.Act 2019 and failed to prove their contention.
- The Op1/Bank has filed the evidence affidavit of one Biswa Ranjan Digal ,the Branch Manager ,UCO Bank ,Kesinga.The facts stated there in the affidavit evidence are corroborating with the averment of the written version of the OP1/Bank.
- To proved his contentions the complainant has filed his evidence on affidavit .The complainant in his evidence affidavit stated that ,he had availed agricultural loan of Rs. 90,000/- from UCO Bank ,Kesinga vide loan A/C No. 06410510006337 in the year 2017 and UCO Bank ,Kesinga insured the loan amount under PMFBY deducting Rs, 8,165/- from his said loan account and that ,the bank personnel have filled up all necessary form and sent it to the insurance company along with necessary papers and that, when he had not received the insurance amount for the year 2017 after the draught declared by the Govt of Odisha he made contract with the bank authority and there after the bank authority communicated the matter to the concerned insurance company as they realize their mistake and that, the bank authority was wrongly entered the name of his Grampanchyat as “Kundabandh” instead of “Sirol” in his insurance paper & sent it to the Op/Insurance Company as it revels from the letter issued by the Op 2 to the complainant and that ,due to wrong entry in insurance paper of the complainant made by the Op 1/Bank he is unable to get insurance amount till date so the Op 1/bank is completely liable for the same .The complainant has also filed the self attested photo copy of ROR vide Khatian No. 121 recorded in the name of Prafulla Kumar Sahu , Copy of ROR vide Khatian No. 125 recorded in the name of Purnachandra Sahu , copy of ROR vide Khatian No. 226/147 recorded in the name of Purnschandra Sahu all are of mouza/village Dumermunda ,PS-Kesinga,Tahasil-Kesinga, Dist :-Kalahandi. He has also filed the self attested photo copy of his account vide No. 06410510006337 of UCO Bank, which clearly shows that on dt. 31.07.2017 an amount of Rs. 8,165 was withdrawn towards PMFBY crops insurance premium .We found nowhere in the aforesaid document the name of the Grampanchyat of the complainant is reflected so to made entry of the name of the Grampanchyat under which the landed property of the complainant is situated where over the insured crops of the complainant were grown as such we agree with the contention of the OP1/Bank that unless it is supplied by the complainant /farmer himself to his bank/Op1 it is not amenable to made entry of the name of the GP of the complaint. The complainant has failed to adduced any cogent evidence to hold that , he has ever supply such information to insert the name of his Grampanchyat in his application for the alleged crop insurance in Kharif 2017 rather it is proved on affidavit that , soon after receiving of such information, the O.P1 /bank inquired form the complainant and after ascertaining the facts that, Mouza /village Dumermunda, over which the agriculture land of the complainant exist, actually comes under the “Sirol” Grampanchayat the O.P/Bank conveyed the same to the insurance company/O.P 2 vide letter No.BR/Kesing/Mis/85/2018 -19 /dt.01.10.2019 and requested to make necessary correction and to release the crop insurance benefit to the complainant. As such the contention of the complainant that, due to wrong entry in insurance paper of the complainant by the Op 1/Bank he is unable get insurance amount till date so the Op 1/Bank is completely liable for the same is not acceptable .We found no negligence or deficiency in service on the part of Op1/Bank for non release of said crop insurance benefit to the complainant for the loss of insured crops during 2017.
- Here in this case, it is proved on admission that, the complainant is a loanee farmer obtained agriculture loan vide loan OP1/Bank. The bank /OP1 has deducted the adequate premium of Rs.8165/-on dt.31.07.2017 for sum assured amount o Rs. 408250/- from the account of the complainant and remitted the same to the insurer /Op 2 for the insurance of paddy crop of the complainant grown in Kharif 2017 vide application ID No.1017716365 , farmer ID No. 16541611 which was received by the Insurer/OP2 along with farmers detail sent by the OP1/Bank for settlement of the crop insurance claim in case of loss sustained by the insured farmer /complainant but no insurance benefit is released to the complainant as on date .
- On being asked the Chief District Agriculture Officer, Kalahandi to submit the detail information regarding paddy crop damage report of Kharif 2017-18 of the village “Dumermunda” under “Sirol” GP of district:- Kalahandi, the Chief District Agriculturae Officer ,Kalahandi ,Bhawanipatna vide his letter No.2096//Adril.dt.01.03.23 informed the facts that, Actual Yield was 1702 and Threshold Yild was 3244 there in Sirol GP of Kesinga Block of Kalahandi district in Kharif 2017 which shows that there was short fall of 1542 remain undisputed accordingly it may safely be hold that claim payment percentage in Sirol Gp during Kharif 2017 is 47.53% as declared by the Government . As such it is proved in favour of the complainant that, he suffered loss of paddy grown during Kharif 2017-18.
- The OP 2/ Insurer has contended that, they have checked the detail and found there in the Govt portal that, the application No.1017716365, name:- Prafulla Kumar Sahu, Kesinga Block, Kundhabandh G.P , Crop -paddy (Dhan), Area-Ac 7.1 dcl is insured. It is further submitted that the O.P 2 has verified the facts from the data share by the State Govt. and found that, there is no shortfall in yield for these complainant farmer in “Kundhabandh” G.P hence no claim is declared by Govt. and the same has been communicated by the Op 2 /Insurance company to the Bank / O.P 1 through mail dt.29.10.2018 and on dt.05.12.2018. So the insurance company is no way responsible for wrong entry made by the O.P 1/Bank . It is further submitted that, as no Insurance premium has been paid for the insurance of the Paddy crop of the complainant grow in “Sirol G.P” the complainant is not entitle for insurance benefit under PMFBY for any loss there in that G.P of “Sirol”. However , the Op 2/Insurance Company has failed to proved those contention. No copy of proposal Form /application of the complainant for the alleged crops insurance is placed on record for perusal.
- Admittedly, PMFBY is a beneficial scheme of the government meant to protect the farmer at peril . It makes compulsory and duty bound on the part of bank to insure the crop of the loanee farmer by deducting adequate premium from the account of the loanee farmer and to remit the same along with the information detail of the farmer/complainant , crop insured, collect CSC Form in prescribed manner, as such remittance of premium & required information of the insured farmer to the insurance company is the business between the bank/Op1 and insurer/OP2 .The loanee farmer /here the complainant is no way responsible for any omission & commission made by the Bank /OP1 while furnishing information in the concern portal at the time of remittance of insurance premium for further reference at the peril by the insurer/OP2 when the crop of the insured farmed sustained loss. As such for the omission and commission of the bank, the complainant /insured farmer should not suffer.
- It is also found that, the PMFBY does not prescribe any separate insurance premium for individual farmer towards insurance of crops grown in separate village. As such, the submission of the insurer/Op2 that, premium has been received from the complainant for the crop grown in village “Dumermunda” of “Kundabandh” GP but not for the crop grown in “Dumermunda” village of “Sirol” GP & if it was so, then the insurance premium would have charged accordingly, is not acceptable.
- Law is well settled that, even in case of insurance contracts, where duty to disclose is generally there, non-disclosure of facts which are not material and have no bearing on the risk undertaken by the insurer, does not render the agreement voidable.
- In V. Shrinivasa Pillai vrs L.I.C of India (A.I.R 1977 SC3810 Honorable Supreme Court of India held that,:-“if the insured has knowledge of a fact which others cannot ordinarily have ,than he should not indulge himself in supressio very suggestion falsi by making a suggession which is false or suppressing a matter which is true ,if deliberateness is writ large in the material furnished by the insured and if the documents disclosed that, the insured applied his mind at the time when a particular detail was called for, then the court will be justified in coming to the conclusion that ,there has been avoidance of a legal or moral duty on the part of the insured and would accept the contention of the insurer that ,the claim is not maintainable.
- The dispute in this case is in a narrow compass .The insurance benefit is denied to the complainant simply for the alleged omission of the name of the “Grampanchyat” while applied for insurance of the crops of the complainant grown during Kharif 2017 the fact of which is not sonly confind with the knowledge of the complainant . Here we found that, there is nothing difficult to identify the property/crops insured because of the omission of the name of the “Grampanchyat” in the proposal Form. So also, the fact of non discloser of the name of “Grampanchyat” where the insured crops is situated is not so material to take decision for underwriting risk on the part of the insurer/Op2.
- There is nothing pleaded or proved that, the complainant/insured farmer has misrepresented any fact or have played fraud to obtained crop insurance under PMFBY for loss of his paddy crop grown during Kharif 2017 and there is nothing fault proved against the complainant, as such we are of the opinion that, the complainant is entitled for crop insurance benefit @ 47.53% of sum assured Rs.408250/- with interest under application vide ID No. 1017716365 ,Farmer Id No. 16541611 but not yet released by the insurer /OP2 is an act of unfair trade practice & deficient in providing service on the part of Op 2/insurance company towards the complainant for which there is sufficient cause to brought this complainant and it is found in time well maintainable under C.P .Act 2019.
- Based on the above facts & circumstances and as per revised guideline we are of the opinion that, enjoying the premium received from the farmer/complainant and sitting over the claim of complainant for an uncertain period of time at the peril is nothing but an unfair trade practice & deficient service on the part of insurance company /OP 2 certainly caused financial loss & mental agony to the complainant cannot be compensated in any manner however, monetary compensation by way of exemplary cost of Rs.1,00,000/- with insurance benefit @ 47.53% of sum assured Rs.4,08,250/- along with interest @ 9% p.a payable by the OP 2/Insurance Company to the complainant within a stipulated time period may compensate the complainant to some extent and it would keep away the op2 /Insurance company to repeat same unfair act prejudice to other insured farmers . Further the Op 2/insurance Company is liable to pay litigation cost to the complainant. Hence, it is order.
O R D E R This consumer complaint is allowed in part on contest against the OP 2/TATA AIG General Insurance Company Ltd. & dismissed against the Opp.Parties NO.1/UCO Bank Kesinga with the following direction :- (i) The OP 2/TATA AIG General Insurance Company Ltd. is here by directed pay monetary compensation by way of exemplary cost of Rs.1,00,000/- and to release the crops insurance benefit of Rs.1,94,041.22 i.e. @ 47.53% of sum assured Rs.4,08,250/ under Pradhan Mantri Fasala Bima Yojana (PMFBY) with interest @ 9% p.a from the date of filling of this complaint i.e. dt.08.01.2021 till its realization and further directed to pay Rs 10,000/- towards litigation cost to the compliant. (ii) It is further directed to compliance the aforesaid order within four weeks from the date of receipt of a copy of this order falling which the OP 2/TATA AIG General Insurance Company Ltd. shall be liable to pay Rs.500/-(five) per day as delayed compensation to the complainant till compliance of this order. (iii) The pending application if any is also stands disposed off accordingly. Dictated & corrected by me. I agree. Sd- Member Pronounced in open forum today on this 11th October 2023 under the seal and signature of this Commission .The pending application if any is also stands disposed off accordingly. Free copy of this order be supplied to the respective parties or they may download the same from the Confonet to treat the same as copy of the order receipt from this Commission. Order accordingly. | |