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 Mangesh Dattaram Khanolkar @ Madwal was an agriculturist holding Gut No.37 at village Khanoli, Taluka-Vengurla, District-Sindhudurg. He died accidentally on 1^st December, 2010 by fall from mango tree. 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 appeared and filed written statement.  It is submitted that the claim was already rejected vide letter dated 9^th June, 2012 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 appeared and filed written statement. It is submitted that the claim of the complainant was received through District Agricultural Officer, Sindhudurg on 4^th October, 2011 and the same was forwarded by this O.P. to O.P.No.1. The O.P.No.1 repudiated the claim vide letter dated 9^th June, 2012.

4)                The O.P.No.3 failed to appear though duly served therefore the O.P.No.3 proceeded exparte.

5)                After hearing all the parties and after going through the record, following points arise for our consideration.

POINTS

REASONS

6) 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 and Post Mortem Report. On going through all these papers, it is clear that the husband of the complainant died and the matter was reported to the police station.  Police registered accidental death under section 174 of Cr.P.C. on 1^st December, 2010 and made investigation including Spot Panchanama and Inquest Panchanama. Body was sent for post mortem and post mortem was conducted.  According to the O.P.No.1 as per post mortem report, death was caused due to cardio respiratory arrest due to myocardial infarction.  According to the O.P.No.1 it was natural death and not accidental death therefore the claim of the complainant was repudiated vide letter dated 9^th June, 2012. On the other hand, it is submitted by the learned advocate for the complainant that the deceased fell down from the tree and thereby he died.  According to him, it is not necessary that there should be injuries on the body.  For this purpose, he has placed reliance on the judgment of Hon’ble National Commission reported in II (2014) CPJ 112 (NC) in the case of Additional Secretary, Chhatisgarh State Power Holding Company Limited –Versus- Bajaj Allianz General Insurance Company Limited, decided on 19^th March, 2014. In para 10 of the judgment, the Hon’ble National Commission has laid down as under

Para 10.     As per the above report, the cause of death is cardiorespiratory failure.  The cause of cardiac arrest could be the existence of a pre-cardiac disease or even in the absence of such a disease, the cardiac arrest could take place due to shock upon falling from a pole 36’ in height.  In the event of death by any means, the cardiac arrest or cardiac failure has to take place and only after that, a person is usually declared as dead.  The cause of death stated in the post mortem report, therefore, does not support the version of the respondent that it was a death not due to accident.  Further, it has been stated in the post mortem report that no external injury was found on the body of the deceased.  During fall from a pole, it is not necessary that bodily injury should always take place.  The basic point is that there has been a fall from a pole and there has been the death of the employee.

In the instant complaint before us also, police investigation papers show that the deceased fell down from the mango tree and died.  As per post mortem report, there were injuries i.e. abrasion on left forearm and abrasion on scalp.  The death was due to cardio respiratory arrest due to myocardial infarction.  If, the police investigation papers are considered death was due to fall from the mango tree.  There were two injuries on the dead body.  In view of the abovecited judgment of the Hon’ble National Commission, the death was accidental and not natural.  The O.P.No.1 has wrongly repudiated the claim.  The complainant is entitled for the benefit under the scheme of Shetkari Apghat Vima Yojana.

7)                In the written statement, it is submitted by the O.P.No.1 that claim was not submitted within time limit along with the required documents.  This defence is inconsistent to the earlier defence i.e. death was natural and not accidental and the claim was repudiated vide letter dated 9^th June, 2012. 

8)                Thus, there is sufficient evidence on record to show that the deceased was the farmer holding agricultural land. He died accidentally due to fall from the mango tree. 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 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 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 insured i.e. 1^st December, 2010 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 18^th October, 2014