(Passed on 29/01/2024 )

Per Mr. Sachin Vinodkumar Jaiswal, Hon’ble Member

1. The complainant had filed the present complaint under Section 35 of Consumer Protection Act, 2019 in Gopinath Munde Shetkari Apghat Vima Yojna, claiming compensation against the OP.
2. The brief facts of the case are as under.
3. That the complainant is residing at the address mentioned in cause title  of the complaint. The OP Nos. 1 and 2 are the insurance company who had insured the farmers of Maharashtra under the scheme floated by Government of Maharashtra namely Gopinath Munde Shetkari Apghat Vima Yojna. The OP No. 3 is the insurance broaker and OP No. 4 is the Taluka Krushi Adhikari.
4. The deceased husband of the complainant Mr. Pramod Haridas Karkade’s father Mr. Haridas Narayan Karkade  having agriculture land at Mauja Shivni, Tahsil Sindevahi, District Chandrapur vide survey No. 587. The father of the deceased was doing agricultural work and the entire family of the complainant were depending on agricultural income. As per the Government scheme, any one member of the agriculturist family is insured under the scheme (Shetkari Apghat Vima Yojna) of the Maharashtra Government and the same insured  under the scheme for  Rs. 2,00,000/-. The complainant being legal wedded wife of the deceased is the beneficiary under the policy.
5. The deceased husband of the complainant died on 27/09/2019 due to snake bite when he was working in his farm land. The complainant after the death of her husband filed detailed claim along with all the relevant documents with the OP No. 4 on 20/11/2019 and complied documentary requirements by the OP Nos. 4 and 3.
6. Even after the submissions of all the documents, the status of the claim had not been intimated to the complainant and the complainant through her counsel made RTI application to District Superintendent, Agriculture Officer, Chandrapur which was answered on 23/10/2020. That the claim is still under process. As per the policy issued by OP Nos. 1 and 2 to Government of Maharashtra, it is mandatory on the part of the OP to decide the claim of beneficiary within 90 days from the date of receipt of claim. The Ops Nos. 1 to 4 were deficient in providing services to the complainant for not deciding the claim of the complainant for years together.
7. The complainant filed the present claim seeking compensation under the said claim of Rs. 2,00,000/- along with compensation for mental agony and harassment and cost of litigation.
8. The Commission was pleased to issue notice to the OP and after receipt of notice, the OP Nos. 1 to 4 appeared through counsel and filed their reply. The OP Nos. 1 and 2  denied the allegations made against them by the complainant. It was specifically pleaded that the deceased was a major person and not depending on the income of his father and therefore not covered under the scheme. It is therefore submitted by the OP Nos. 1 and 2 that the Chemical Analysis (CA) report for snake bite had not been filed by the complainant and prayed for dismissal of the complaint with exemplary cost.
9. The OP Nos. 3 and 4 also filed their reply and denied all the allegations made against them and OP No. 3 filed repudiation letter dated 19/08/2020 that the claim of the complainant had been  repudiated for the reason “Deceased does not have 6D फेरफार, 6K and 7/12 extract”.

REASONING

10.   We  heard counsel for complainant and counsel for OP Nos.1 and 2. None present for OP Nos. 3 and 4. The complainant relied on the following citations mentioning that the OP cannot travel beyond their repudiation letter and issue raised by OP Nos. 1 and 2 in their argument were raised for the first time and OP Nos. 1 and 2 had not raised the same in their repudiation letter.

1. JSK Industries Pvt. Ltd. Vs. Oriental Insurance Company Limited, IV(2022) CPJ 43 (NC)
2. Saurashtra Chemical Ltd. Vs. National Insurance Co. Ltd., I(2020) CPJ 93 (SC)

11. The OP Nos. 1 and 2 argued in consonance with their written statement filed on record and relied on the following judgments and also Government notification which was very much existence  at the time of inception of policy and therefore the deceased son of the registered farmer is covered under the policy need not find any force in the argument of OP Nos. 1 and 2.

1. The oriental Ins. Co. Vs. Arun Bakliwal and Ors., WP No. 12259 of 2021, passed  by Hon’ble High Court Bombay Bench at Aurangabad.
2. RP No. 955/2020, National Ins. Co. Ltd. Vs. Ranjana Jadhav, passed by Hon’ble National Consumer Disputes Redressal Commission, New Delhi

12. The citations filed by the OP Nos. 1 and 2 were on  different footings and not applicable to the present facts and circumstances of the case and therefore cannot be considered. On the basis of the argument tendered by both parties, Commission pass following order.

ORDER

1. The complaint is partly allowed.
2. The OP Nos. 1 and 2 are jointly and severally liable to pay the claim amount of Rs. 2,00,000/- under the Shetkari Apghat Vima Yojna with 9 percent interest from the date of filing of complaint i.e. on 26/02/2021 till realization to the complainant within a period of 45 days on the date of receipt of order.
3. The OP Nos. 1 and 2 jointly and severally pay Rs. 50,000/- towards mental agony and harassment and Rs. 20,000/- towards cost of litigation.
4. Complaint against OP Nos. 3 and 4 are dismissed.
5. Copy of order be furnished to both parties, free of cost.