State Consumer Disputes Redressal Commission
The Manager,National Insurance Co Ltd vs Anjali Santosh Wanole on 15 March, 2024
1 A/635/2019
Date of filing: 05.03.2019
Date of order :15.03.2024
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
FIRST APPEAL NO. : 635 OF 2019
IN COMPLAINT CASE NO.: 22 OF 2018
DISTRICT CONSUMER FORUM : HINGOLI
1. The Manager, ...APPELLANTS
National Insurance Co.Ltd. , (Adv.S.R.Bodade )
Divisional Office, 174, Kasba(South),
4th floor, Shubhroya Towers,
Datta Chowk,
Solapur 413 007.
2. The Manager,
National Insurance Co.Ltd. ,
Divisional Office, Nagina Ghat Road,
Nanded.
Nos.1 & 2 through:
National Insurance Co.Ltd. ,
Through its Divisional Manager ,
Hazari Chambers, Station Road,
Aurangabad.
VERSUS
1. Anjanabai Santosh Wanole, ...RESPONDENT NO.1
R/o Gholva, Tq.Kalamnuri, (Adv. S.N.Lavekar )
Dist.Hingoli.
2. The Agriculture Officer, ...RESPONDENT NO.2
Agriculture Officer Office,
At Kalamnuri, Tq.Kalamnuri,
Dist.Hingoli.
2 A/635/2019
CORAM : Dr.Nisha.A.Chavhan, Hon'ble Presiding
Member,Nagesh.C.Kumbre, Hon'ble Member.
JUDGMENT
(Delivered on 15/03/2024) Per Dr.Nisha Amol Chavhan, Hon'ble Presiding Member.
The appellant has challenge in this appeal, Order and Judgment passed by the ld. District Consumer Disputes Redressal Commission, Hingoli on dated 15.12.2018 in C.C. No.22/2018.
2. The facts giving rise to this appeal are as under.
3. It is submitted that, Respondent's husband named Santosh Narayan Wanole was holding and owned agriculture land, Gut No.118 at Gholva, Tq. Kalamuri, Dist. Hingoli. He was agriculturist. respondent's husband was insured under the scheme of Gopinath Munde Shetkari Apghat Vima Yojna, he was covered under the said scheme of Rs. 2, 00,000/- towards accident claim.
4. It is submitted that, Respondent's husband has met with an accident on 20/8/2016 and died. The FIR was lodged with Laxmipuri Police station under crime no. 0/2016. The respondent is the legally wedded wife of the deceased. Respondent's husband was insured under the scheme of Gopinath Munde Shetkari Apghat Vima Yojna. The duration of the said scheme is of 1/12/2015 to 30/11/2016 and death of the respondent's husband occurred on 20/8/2016. Therefore, 3 A/635/2019 respondent is entitled to get the compensation of Rs.2,00,000/- as a beneficiary.
5. Appellant submitted that, on 10/1/2017 he received proposal form from the respondent. But she has not submitted any documentary evidence showing that her husband was farmer on the date of commencement of policy i.e. 1/12/2015. Therefore, appellant repudiated her claim.
5. Respondent filed the consumer complaint before Ld. District Consumer Disputes Redressal Commission, Hingoli on dated 15.12.2018 in CC. No.CC/22/2018.
6. Ld. District Consumer Disputes Redressal Commission, Hingoli has partly allowed the complaint and thereby directed to the present appellant insurance company to pay an amount of Rs.2, 00,000/- to the respondent No.1 within 15 days along with 8% per annum interest from 23/7/2018 till its realization and also directed the appellant to pay an amount of Rs.5, 000/- towards the mental harassment and Rs.1, 000/- towards the cost of litigation.
7. Appellant is not satisfied with the judgment given by Ld. District commission Hingoli, hence he filed appeal before this commission 4 A/635/2019
8. Adv. S.R. Bodade appeared for appellant. Adv. S.N. Lavekar appeared for respondent. Both parties submitted their written notes of argument.
9. Ld. Adv. Bodade submitted that, as per the Policy term and condition as well as Tri-Partite agreement between Respondent no.1 and Government, a person who covered under the policy, should be agriculturist and having land at 7/12 extract at the date of commencement of policy i.e. on 01.12.2015 and it is mandatory eligibility criteria of the scheme. It is submitted by him that the deceased was not having agricultural land on his name on the date of inception of policy and therefore, repudiation of claim on such ground is legal and proper and there is no deficiency in service committed by appellant.
10. Adv. Bodade has filed copies of tripartite agreement, policy note etc. and relied on judgments of Hon'ble Supreme Court and Hon'ble High court Bombay Bench at Aurangabad. It appears that, the fact of some of the case and the case in hand is distinguishing.
11. We perused the written notes of arguments of both parties, policy document on record as well as oral submission of the both Ld. Advocates. Commission has following observations.
OBSERVATIONS 5 A/635/2019
12. Against this background, we perused the copy of the complaint and written version given by the both parties in original proceedings before the District Consumer Commission Hingoli. We have also gone through the impugned judgment. It is found that, there is error committed by the Ld. District Consumer Commission Hingoli on the factual aspects.
13. We observed that, it is admitted fact; the death of deceased was accidental. The only point of controversy is that weather at the time of commencement of Policy, the deceased was farmer or not and he was having agricultural land in his name or not.
14. On perusing the documents, the name of deceased has appeared as per mutation/pherphar entry, it disclosed that the said entry was taken on 28.05.2016. It means that the land has been transferred in the name of deceased on 28.05.2016.
15. On perusing the policy cover note and Tripartite Agreement which is on record, it appears that the period of policy is valid from 01.12.2015 to 30.11.2016 and the risk covered for the farmer who are enrolled as on the 7/12 extract before or on the date of commencement i.e.01.12.2015 are covered under the said GPA.
16. As per the Tripartite Agreement, clause (I)(C) Farmer means person registered as farmer in Maharastra as evidenced by 7/12 extract. In clause (II) of said agreement the eligibility criteria is the farmers name should be in the land record register i.e.7/12 6 A/635/2019 on the date of the issuance of policy. Therefore, as per the policy and Tripartite Agreement the name of deceased should be in the land record on issuance of policy i.e. on 01.12.2015, but it appears that the land transferred on the name of deceased was on 28.05.2016 i.e. after the issuance of policy. Under such circumstances, it appears that the respondent no.1 has received the premium of such farmers whose name are registered on 7/12 extract, on the date of policy inception.
17. We relied on the judgment of Hon'ble Supreme court in Civil appeal no. 6277/2004 United India Insurance Company Limited V/S M/S.Harchand Rai Chandan Lal , 2004 CJ( SC) 1486 in para 6 it was observed that, The policy is the contact between the parties and both parties are bound by the terms of contract and it is also observed that, The terms of the policy have to be construed as it is and we cannot add or subtract something. Howsoever, liberally we may construe the policy but we cannot take liberalism to the extent of substituting the words which are not intended.
18. As such we agree with the submission of Appellant that, as the deceased was not a registered farmer at the date of policy inception, therefore, the respondent No.1 is not entitled for insurance claim and there is no deficiency in service committed by Appellant towards respondent No.1 on repudiating the claim on the said ground.
7 A/635/2019
19. In view of the above, impugned judgment and Order dated 15/12/2018 passed Ld. District Commission Hingoli in CC. No 22/2018 is to be set aside. Hence we pass the following order.
ORDER
1. Appeal is hereby allowed.
2. Impugned Judgment and Order dated 15/12/2018 passed Ld. District Commission Hingoli in CC. No 22/2018 is set aside.
3. Complaint stands dismissed.
4. No order as to cost.
5. Copy of this judgment be supplied to the both parties free of cost.
Place : Aurangabad.
Date : 15/03/2024 N.C.Kumbre Dr. Nisha A. Chavhan Member Presiding Member