State Consumer Disputes Redressal Commission
The Oriental Insurance Co Ltyd vs Manju Suresh Rathod on 2 July, 2025
1 A/863/2023
Date of filing :30.06.2023
Date of order :02.07.2025
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
MISC.APPLICATION NO.:458 OF 2023
& FIRST APPEAL NO. : 863 OF 2023
IN COMPLAINT CASE NO.: 459 OF 2022
DISTRICT CONSUMER FORUM : AURANGABAD
The Oriental Insurance Co.Ltd. , ...APPELLANT
Pune Regional Office No.3, 231/A-2, (Adv.R.P.Mugdiya)
Oswal Bandu Samaj Building,
J.N.Road, Pune 411 042,
Through its authorised signatory &
Its Assistant Manager Legal,
Divisional Office-II, Osmanpura,
Aurangabad,
Shri.Sachin Sadashiv Ware.
VERSUS
Smt.Manju Suresh Rathod, ...RESPONDENT
R/o Aakhaatwada, Tq.Khultabad, (Adv.P.A.Kuber )
Dist.Aurangabad.
CORAM : Milind.S.Sonawane, Hon'ble Presiding Member.
Dr.Nisha.A.Chavhan, Hon'ble Member,
Nagesh.C.Kumbre, Hon'ble Member
JUDGMENT
(Delivered on 02/07/2025) Per Dr.Nisha Amol Chavhan, Hon'ble Member.
1. This is an appeal challenging the correctness and legality of the judgment and order passed by the Ld. District Consumer 2 A/863/2023 Disputes Redressal Commission Aurangabad ('District Commission' for short) in Consumer Complaint No. 449/2022. In the said case, the Ld.District Commission has been allowed the complaint and directed to pay the compensation of Rs.2.00.000/- to the complainant within 30 days from the date of order with 6% par Annam interest and also directed to pay Rs.1500/- towards the expenses of the case.
2. Being aggrieved by the order passed by the Ld. District Consumer Disputes Redressal Commission Aurangabad in the consumer complaint No.449 of 2012 on 27/02/2023, Appellant filed an appeal with delay condonation application.
3. Adv. R. P. Mugdiya is appeared for Appellant. Adv. P.A Kuber appeared for respondent. Both advocates filed a pursis on record that appeal as well as delay condonation application may kindly be heard on same day. Accordingly we heard both advocates on delay condonation application and appeal on merit.
4. According to Ld. Adv. R. P. Mugdiya, there is 61 days delay in preferring the appeal. It is submitted by the appellant that, the Ld. Dist. Commission issued the copy of judgment and order on dated 14/03/2023 which is received by the appellant on same 3 A/863/2023 date. The appeal ought to have been filed on or before 27/4/2023.but appellant filed on 13/7/2023 after 61 days delay.
5. Appellant submitted that, deceased Suresh Rathod was the husband of the respondent and he was a farmer as well as he was insured under the policy "Shetkari Apghat Vima Yojna" for the period of 8/12/2018 to 7/12/2019.
6. On 10/8/2019 at 12.00 p.m., respondent's husband, while spraying pesticide in his field, the said pesticide accidently inhaled in the nose and mouth and he was required to hospitalize on 11/8/2019 and he died. After the death, respondent filed the claim for the insurance benefit with all necessary documents but insurance company rejected her claim on the ground that his name was not enrolled on 7/12 extract in the revenue record at the time of inception of the insurance policy. Therefore Respondent filed Consumer Complaint before the District Commission Aurangabad.
7. District Consumer Dispute Redressal Commission Aurangabad allowed her complaint, and directed to Insurance Company to pay an amount of Rs. 2,00,000/- along with 6% p.a. interest and of Rs.1500/- towards the cost of complaint. That being aggrieved with the judgment and order passed by the 4 A/863/2023 District Consumer Dispute Redressal Commission Aurangabad, insurance company filed appeal before us with delay condonation application.
8. Appellant mentioned that impugned order has been at Aurangabad Divisional office on 17/3/2023. That on 5/4/2023 entire case papers were sent to Regional office at Pune for further instruction. The regional office Pune sent case paper to their panel advocate on 18/4/2023 for legal opinion. The panel advocate received the case paper on 21/4/2023. The Pune regional office received legal opinion on 17/5/2023. That after gone through the legal opinion of their advocates, it was decided to file appeal in the said matter before this commission. Afterword regional office Pune forwarded the case paper along with legal opinion to Aurangabad division office on 26/5/2023 same was received on 31/5/2023. And on 6/6/2023, entire file was handed over to local Advocate for filling first appeal. That took time for getting the draft of appeal memo being approved for such appeal has been filed on 27/6/2023. Hence, delay has been caused in filling the appeal is not intentional if the delay is not condoned, it will cause failure of the justice which is sought to be 5 A/863/2023 rectified under this appeal. Therefore, in the interest of justice, the delay may be condoned.
9. Ld. Adv. P.A.Kuber for Respondent mentioned that the reason stated in delay condonation application is based on oral submission without any documentary evidence, therefore it is highly untrustworthy and it will adversely affect the purpose of limitation in Consumer Protection Act.
10. Ld. Adv.Kuber relied on the Hon'ble National Commission's judgment of Oriental Insurance Company Ltd. VS Indumat RP/1325/2013 dismissed the delay condonation application vide order dated 13/9/2023.
11. Therefore it would be just, legal and proper to dismiss the delay condonation application as per law laid down by Anshul Agrawal Vs New Okhla Industrial development authority and others.
12. Ld. Adv. P.A Kuber for Respondent further submitted that It is pertinent to note here that, District Monitoring Committee constituted by the Government with an object to redress the grievances of beneficiaries at administrative level, vide clause No. 14 of G.R. dated 04/12/2009 and empowered it to decide the dispute, if any, between beneficiaries and insurance company.
6 A/863/2023 The complainant raised her grievance before the committee and prayed for redress her grievance. The District Monitoring Committee after discussion and considering ground of repudiation as well as all documents submitted by the complainant pleased to pass award and directed insurance Company to pay the claim of complainant and further directed to communicate compliance of order to the Committee. The award passed by the Committee was communicated to the Insurance Company by Member Secretary of the Committee i.e. District Superintendent Agriculture Officer, vide letter dated 02/05/2022.
13. As per Policy Terms binding effect of the Order Passed By Dist. Monitoring Committee, Reads As Under-
"XVI) Grievance Procedure for Claims: In the event of any dispute arising between the insured and the insurance companies due to settlement of any claim not relating to the claim amount conciliation proceedings shall be adopted. A Committee consisting of one representative each of the insured Insurance Company and the consultant shall be formed at the District level.
1 District Collector Chairman 7 A/863/2023 2 Chief Executive Officer Member 3 Resident Deputy Collector Member 4 Divisional Head of Broker/Consultant Member 5 Representative of Insurance Company Member 6 District Superintendent Agriculture Member Secretary Officer The Chairman after hearing the case shall give an award within 15 days. The award shall be binding on all the parties. In case, any of the parties refuse to accept the award, they have the option to approaching the Ombudsman/Consumer Courts or take any other legal action as it may deem fit."
14. In present case, the Insurance Company neither obeyed/complied the award passed by the Committee nor challenged it before any competent court of law. Therefore, complainant constrained to approach before the learned District Consumer Dispute Redressal Commission
15. It is pertinent to note here that, considering the above stated legal position, the learned Commission below rightly observed in its judgment & order that, it was just, legal and proper on the part of insurance company to obey/comply the 8 A/863/2023 order passed by the Committee, but due to disobedience/non- compliance of order of Committee, complainant constrained to file complaint, hence complainant is eligible to receive claim amount with interest.
16. The observations of the learned Commission below are just, legal & proper as per law laid down by the Hon'ble Apex Court (Coram: Hon'ble A.K. Mathur & Markandey Katju, JJ) in Appeal (Civil) No. 5732 of 2007 (Divisional Manager, Aravali Golf Club & Anr. V/s Chander Hass & Anr.) In this view of above referred policy terms and condition, the insurance company failed to challenge the award passed by the District Monitoring Committee before any competent court of law, therefore the insurance company has no legal right to raise any dispute regarding eligibility of complainant in a proceedings filed by decree holder i.e. complainant. Therefore there is absolutely no reason to try & entertain the alleged grounds raised by the appellant insurance company in present appeal.
17. After the perusal of the documents on record as well as oral submission of the both sides, Commission has following observations.
9 A/863/2023 OBSERVATIONS
18. Against this background, we perused the copy of the complaint and written version given by the parties in original proceedings, Copy of Insurance policy and other documents which had been placed before the District Consumer Commission Aurangabad. We have also gone through the impugned judgment. It is found that, there is no error committed by the Ld. District Consumer Commission Aurangabad on the factual as well as on legal aspects.
19. In the present case, deceased Suresh Rathod was the husband of the respondent and he was a farmer as well as he was insured under the policy "Shetkari Apghat Vima Yojna" for the period of 8/12/2018 to 7/12/2019.
20. After the perusal of record we found that insurance company rejected her claim on the ground that his name was not enrolled on 7/12 extract in the revenue record at the time of inception of the insurance policy. But record showed that deceased's father was the farmer and after his death, deceased 10 A/863/2023 name entered on mutation entry as a legal heir, therefore he is also farmer
21. Further, after perusal of the document we found that respondent's husband died due to inhale of poisonous contain but did not proved that it was a suicide therefore reason of the death was an accident. Therefore order and judgment passed by the Ld. District commission needs to be confirmed.
21. Even, the 61 days delay for filling of the appeal is also not properly explained. We also relied on the judgment of the Hon'ble National commission in Oriental Insurance Company Ltd. VS Indumat RP/1325/2013. It was observed that, "taking legal opinion is a common practice and there is nothing unusual or abnormal about it but does not mean that the opinion ought not to be procured within time and that the law of limitation should be put in the backyard in that process, A complete disregard of the law of limitation will eventually frustrate and defeated the salutary purpose which inspires the enactment in this regard wherever provided.
22. In the above situation, we do not deem it proper and necessary to interfere the decision of the Ld. District Commission Aurangabad, refusing to condone the inordinate delay in filing 11 A/863/2023 the proposed appeal. The Appeal, as such, lacks merit and is dismissed. Hence, we pass the following order.
ORDER
1. The Misc. Application for condonation of delay as well as appeal are hereby dismissed
2. The impugned Order passed in C.C.No. 459/2022 is hereby confirmed.
3. No order as to Cost.
4. Copies of the judgment be supplied to both the parties.
Sd/- Sd/- Sd/- N.C.Kumbre Dr.N.A.Chavhan M.S.Sonawane Member Member Presiding Member