State Consumer Disputes Redressal Commission
Smt.Laxmibai Shivram Salunkhe vs 1. Smt.Rashmi Ayyer, Divisional Head, ... on 21 July, 2015
BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL
BEFORE THE HON'BLE STATE CONSUMER DISPUTES
REDRESSAL
COMMISSION, MAHARASHTRA,
MUMBAI
FIRST APPEAL NO.A/11/527
(Arisen out of Order
Dated 06/04/2011 in Consumer Complaint No.249/2010 of District Forum, Satara)
Smt.Laxmibai Shivram Salunkhe,
R/o.Yerad, Tal.Patan, Dist.Satara
...........Appellant(s)
Versus
1. Smt.Rashmi Ayyer,
Divisional Head, ICICI Lombard General Insurance Co.Ltd.
Zeaneth House, Keshavrao Khade Marg, Mahalaxmi, Mumbai -34.
2. Smt.Sucheta Pradhan,
Div.Head, Kabal Insurance Services Pvt.Ltd.
101, Shivaji Nagar, 3rd floor, Near to Mangala
Talkies, Pune 411 005.
3. Maharashtra State,
Through the Collector,
Satara.
............Respondent(s)
FIRST APPEAL NO.A/11/528
(Arisen out of Order
Dated 06/04/2011 in Consumer Complaint No.250/2010 of District Forum, Satara)
Shri Niwas Pandurang Bhopate,
R/o.Khodashi, Tal.Karad, Dist.Satara.
...........Appellant(s)
Versus
1. Smt.Rashmi Ayyer,
Divisional Head, ICICI Lombard General Insurance Co.Ltd.
Zeaneth House, Keshavrao Khade Marg, Mahalaxmi, Mumbai -34.
2. Smt.Sucheta Pradhan,
Div.Head, Kabal Insurance Services Pvt.Ltd.
101, Shivaji Nagar, 3rd floor, Near to Mangala
Talkies, Pune 411 005.
3. Maharashtra State,
Through the Collector,
Satara.
............Respondent(s)
FIRST APPEAL NO.A/11/529
(Arisen out of Order
Dated 06/04/2011 in Consumer Complaint No.251/2010 of District Forum, Satara)
Smt.Swatidevi Sanjay Patankar,
R/o.Patan, Tal.Patan, Dist.Satara.
...........Appellant(s)
Versus
1. Smt.Rashmi Ayyer,
Divisional Head, ICICI Lombard General Insurance Co.Ltd.
Zeaneth House, Keshavrao Khade Marg, Mahalaxmi, Mumbai -34.
2. Smt.Sucheta Pradhan,
Div.Head, Kabal Insurance Services Pvt.Ltd.
101, Shivaji Nagar, 3rd floor, Near to Mangala
Talkies, Pune 411 005.
3. Maharashtra State,
Through the Collector,
Satara.
............Respondent(s)
FIRST APPEAL NO.A/11/530
(Arisen out of Order
Dated 06/04/2011 in Consumer Complaint No.261/2010 of District Forum, Satara)
1.Smt.Aarti Prakash Pawar
R/o.Malharpeth, Tal.Patan, Dist.Satara.
...........Appellant(s)
Versus
1. Smt.Rashmi Ayyer,
Divisional Head, ICICI Lombard General Insurance Co.Ltd.
Zeaneth House, Keshavrao Khade Marg, Mahalaxmi, Mumbai -34.
2. Smt.Sucheta Pradhan,
Div.Head, Kabal Insurance Services Pvt.Ltd.
101, Shivaji Nagar, 3rd floor, Near to Mangala
Talkies, Pune 411 005.
3. Maharashtra State,
Through the Collector,
Satara.
............Respondent(s)
FIRST APPEAL
NO.A/11/836
(Arisen
out of Order Dated 29/04/2011 in Consumer Complaint No.280/2010
of District Forum, Satara)
Smt.Ranjana Janardhan Gadhave,
R/o.Khandala, Tal.Khandala, Dist.Satara.
...........Appellant(s)
Versus
1. Shri Jitendrakumar,
Law Dept., ICICI Lombard General Insurance Co.Ltd.
Zeaneth House, Keshavrao Khade Marg, Mahalaxmi, Mumbai -34.
2. Smt.Sucheta Pradhan,
Div.Head, Kabal Insurance Services Pvt.Ltd.
101, Shivaji Nagar, 3rd floor, Near to Mangala
Talkies, Pune 411 005.
3. Maharashtra State,
Through the Collector,
Satara.
............Respondent(s)
BEFORE:
P.B.Joshi, PRESIDING MEMBER
Dhanraj Khamatkar, MEMBER
For the Appellant:
Adv.Padmanabh Pise
For the Respondents
(original complainants):
Adv.Nikhil Mehta
ORDER
Per Mr.Dhanraj Khamatkar, Member [1] These appeals take an exception to the orders dated 06/04/2011 and 29/04/2011 in Consumer complaint no.249/10, 250/10, 251/10, 261/10 and 280/10 respectively passed by District Consumer Disputes Redressal Forum, Satara.
Learned District forum has dismissed the complaints by passing separate orders and aggrieved thereby these appeals have been filed separately challenging impugned orders passed by the District Forum.
[2] Since these appeals involve common question of law and facts and ground of dismissal of the complaints are also common, all these appeals are heard finally and disposed off by this common order.
[3] We heard learned counsel Mr.Padmnabh Pise-advocate for the appellants and learned counsel Mr.Nikhil Mehta-advocate for the respondent no.1.
Respondent no.2 and 3 remained absent though duly served.
[4] Complainants/appellants are farmers and are covered by insurance policy availed by the Govt. of Maharashtra across the State. Original opponent no.2/respondent no.2 is an agency assisting beneficiaries of the scheme in preparation of the insurance claim and submitting the same to the original opponent no.1/respondent no.1-insurance company and the opponent no.3 is State of Maharashtra represented through Revenue Authorities of the districts to ensure the beneficiaries get their claims settled.
[5] In consumer complaint no.249/10 [A/11/527], husband of the complainant-Shivram Dagade Salunkhe, who was an agriculturist, died on 14/11/2005 by the dash given by unidentified vehicle. He was an agriculturist and as his heir, his widow-Laxmibai Shrivram Salunkhe submitted the claim to Talathi, Yerad and Talathi, Yerad forwarded the claim to the respondent no.1 [opponent no.1] in December 2005.
As the claim was neither sanctioned nor repudiated by the original opponent no.1. Alleging not sanctioning the claim amounts to deficiency in service on the part of the opponent no.1, original complainant/appellant has filed consumer complaint praying therein that respondent be directed to sanction the claim of Rs.1,00,000/-, Rs.40,000/- for mental agony and Rs.3,000/- as costs.
[6] In Consumer complaint no.250/10, original complainant/appellant-Niwas Pandurang Bhopate met with an accident on 06/05/2005. At the time of accident, he was covered by the policy availed by the Government of Maharashtra for the farmers in the State being an agriculturist. For the injuries, he was treated in the hospital at Karad and Pune. H has filed his claim to Talathi, Khodashi in July 2005 and Talathi, Khodashi has forwarded the claim through Tehsildar, Karad to the respondent no.1 [original opponent no.1].
Respondent/opponent no.1 has neither sanctioned the said claim nor repudiated. Alleging not sanctioning the claim of the complainant amounts to deficiency in service on the part of opponent no.1, he has filed consumer complaint praying that the opponent no.1 b directed to sanction claim of Rs.1 lac, compensation of Rs.40,000/- for mental agony and Rs.3,000/- as costs.
[7] In consumer complaint no.251/10, husband of the complainant-Sanjaysinh Appasaheb Patankar, who was an agriculturist met with an accident and died on 01/04/2006. At the time of accident, he was covered by the policy availed by the Government of Maharashtra for the farmers in the State being an agriculturist. He was an agriculturist and as his heir, his widow-Smt.Swatidevi Sanjay Patankar submitted the claim to Talathi in May 2006 and Talathi forwarded the claim through the Tehsildar, Patan to the respondent no.1 [opponent no.1].
The opponent no.1 has neither sanctioned nor repudiated the claim. Alleging not sanctioning the claim amounts to deficiency in service on the part of the opponent no.1, original complainant/appellant has filed consumer complaint praying therein that respondent be directed to sanction the claim of Rs.1,00,000/-, Rs.40,000/- for mental agony and Rs.3,000/- as costs.
[8] In consumer complaint no.CC/10/261, Prakash Sitaram Pawar, an agriculturist met with an accident and died on 10/12/2005. At the time of accident, he was covered by the policy availed by the Government of Maharashtra for the farmers in the State being an agriculturist. Being an heir, his widow-Smt.Aarti Prakash Pawar submitted the claim to Talathi, Mandrul Haveli in January 2006 and Talathi, Mandrul Haveli forwarded the claim through Tehsildar, Patan to the respondent no.1 [opponent no.1]. The claim was neither sanctioned nor refused by the original opponent no.1.
Alleging not sanctioning the claim amounts to deficiency in service on the part of the opponent no.1, original complainant/appellant has filed consumer complaint praying therein that respondent be directed to sanction the claim of Rs.1,00,000/-, Rs.40,000/- for mental agony and Rs.3,000/- as costs.
[9] In consumer complaint no.CC/10/280, Janardhan Wavan Gadhave, an agriculturist met with an accident and died on 11/10/2005. At the time of accident, he was covered by the policy availed by the Government of Maharashtra for the farmers in the State being an agriculturist. Being an heir, his widow-Smt.Ranjana Janardhan Gadhave submitted the claim to Talathi, Khandala and Talathi, Khandala forwarded the claim through Tehsildar, Khandala to the respondent no.1 [opponent no.1]. The claim was neither sanctioned nor refused by the original opponent no.1.
Alleging not sanctioning the claim amounts to deficiency in service on the part of the opponent no.1, original complainant/appellant has filed consumer complaint praying therein that respondent be directed to sanction the claim of Rs.1,00,000/-, Rs.50,000/- + Rs.40,000/- for mental agony and Rs.3,000/- as costs.
[10] Opponent insurance company appeared before the District Forum and contested the complaint by filing separate written version. It is the case of the opponent insurance company that the complainants have not filed claim within stipulated period and the names of the complainants are included in the representativ complaint filed by the Govt. of Maharashtra before the Honble National Commission and same complaint is pending before the Honble National Commission.
[11] Learned District Forum accepting the contentions of the opponent-insurance company dismissed all the complaints. Learned District Forum has taken a technical approach while deciding the complaints. Learned counsel for the appellant has drawn our attention to the submission of the claims through Tehsildar concerned to the opponent insurance company within time limit fixed by the agreement entered into with the Govt. of Maharashtra. Learned advocate further pointed out that as laid down by the Govt. Resolution issued by Govt. of Maharashtra, complainants have submitted their claims to Talathis and respective Talathis forwarded the claim to respective Tehsildar for consideration within time stipulated under the Govt.Resolution. The learned counsel has produced evidence to show that Tehsildar has forwarded the claims to the opponent insurance company. Learned advocate for the insurance company could not establish the fact that they have repudiated the claim and duly informed to appellants.
Learned counsel for the opponent vehemently argued that the claims filed by the appellants are also included in the representative complaint filed by the State of Maharashtra before the Honble National Commission and it is sub-judice and as the matter is sub-judice before the Honble National Commission, claim filed by the appellants cannot be sanctioned. We are unable to agree with the arguments of the learned counsel for the insurance company that only because the claim of the appellants are included in the Class Petition filed by the Govt. of Maharashtra before the Honble National Commission, as there is no prohibitory order by the Hon.National Commission not to consider the claims.
[12] Govt. of Maharashtra with benevolent intention to provide insurance cover to the farmers across the State has availed Group Insurance Policy from the opponent insurance company. Intimation of date or occurrence of incidence of injury to the agriculturist through the Revenue Authority is enough and should be treated as due intimation for filing the claim. In all the cases in hand, respective Tehsildar has promptly and diligently submitted the paper in respect of the appellants by way of claim proposals to the opponent insurance company and that too within stipulated time limit.
Considering the nature of the scheme, the opponent insurance company ought to have settled the claims immediately on receipt of the proposal from the concerned Tehsildar.
However, insurance company deliberately protracted the settlement of the claims without any reasonable ground.
The claims filed in the year 2005 to 2006 in all these cases not decided as yet under the pretext that the claims of the complainants are pending before the Honble National Commission in Class Action Petition. Opponent insurance company could not produce on record, whether they have repudiated the claims and it is duly communicated to the appellants.
The learned District Forum without applying mind and looking into the welfare objective of the scheme dismissed the complaints. Hence, impugned orders passed by the District Forum deserve to be set aside since the opponent insurance company failed to prove that the claim is repudiated and the same is communicated to the appellant.
[13] Learned counsel for the insurance company had pointed out that in consumer complaint no.250/10, the complainants have produced disability certificate wherein disability is shown as 50% and hence is entitled for claim of Rs.50,000/- only. Disability certificate is at page no.35 of the appeal compilation. Perusal of the disability certificate shows that disability in respect of the complainant is shown as 50% by the Medical Board. Learned counsel for the appellant has stated that though the disability is shown 50%, he is physical incapacitated to work as agriculturist and hence as per the Govt.Resolution of the Govt. of Maharashtra, he is entitled for insurance claim of Rs.1 lac. Learned counsel has also relied on authority reported in AIR 1976 SUPREME COURT 222 - Civil Appeal No.1536 of 1970 wherein their Lordship observed that total disablement means such disablement whether of a temporary of permanent nature, as incapacitates workman for all work which he was capable of performing at the time of the accident resulting in such disablement. In the present case, appellant is physically incapacitated to perform his agricultural work and hence he is entitled for insurance claim of Rs.1 lac. The learned counsel for respondent no.1 relied on the order passed by the Honble National Commission in Revision Petition No.3719 of 2011 dated 30/11/2010. However, the said judgement is not relevant in the facts and circumstances of the case under appeal.
[14] In view of the aforesaid discussion, order passed by the District Forum deserves to be set aside as the claims are pending since 2005-06.
Complainants/appellants need to be compensated by granting suitable rate of interest for unreasonable delay in sanctioning the claims. We hold accordingly and pass the following order.
ORDER (1) Appeal No.A/11/527 is hereby allowed.
(i) Impugned order dated 06/04/2011 is hereby set aside.
(ii) The Opponent Insurance Company is directed to make payment of Rs.1,00,000/- [Rs.One Lac only] to the complainant with interest @9%p.a. from the date of filing of the consumer complaint i.e. 29/10/2010 within a period of 45 days from the date of this order, failing which additional penal interest @3% p.a. will be payable on the amounts ordered to be paid.
(iii) The Opponent Insurance Company to bear its own costs and amount of Rs.10,000/- [Rs.Ten Thousand only] shall be paid as costs of litigation to the complainant.
(2) Appeal No.A/11/528 is hereby allowed.
(i) Impugned order dated 06/04/2011 is hereby set aside.
(ii) The Opponent Insurance Company is directed to make payment of Rs.1,00,000/- [Rs.One Lac only] to the complainant with interest @9%p.a. from the date of filing of the consumer complaint i.e. 29/10/2010 within a period of 45 days from the date of this order, failing which additional penal interest @3% p.a. will be payable on the amounts ordered to be paid.
(iii) The Opponent Insurance Company to bear its own costs and amount of Rs.10,000/- [Rs.Ten Thousand only] shall be paid as costs of litigation to the complainant.
(3) Appeal No.A/11/529 is hereby allowed.
(i) Impugned order dated 06/04/2011 is hereby set aside.
(ii) The Opponent Insurance Company is directed to make payment of Rs.1,00,000/- [Rs.One Lac only] to the complainant with interest @9%p.a. from the date of filing of the consumer complaint i.e. 29/10/2010 within a period of 45 days from the date of this order, failing which additional penal interest @3% p.a. will be payable on the amounts ordered to be paid.
(iii) The Opponent Insurance Company to bear its own costs and amount of Rs.10,000/- [Rs.Ten Thousand only] shall be paid as costs of litigation to the complainant.
(4) Appeal No.A/11/530 is hereby allowed.
(i) Impugned order dated 06/04/2011 is hereby set aside.
(ii) The Opponent Insurance Company is directed to make payment of Rs.1,00,000/- [Rs.One Lac only] to the complainant with interest @9%p.a. from the date of filing of the consumer complaint i.e. 29/10/2010 within a period of 45 days from the date of this order, failing which additional penal interest @3% p.a. will be payable on the amounts ordered to be paid.
(iii) The Opponent Insurance Company to bear its own costs and amount of Rs.10,000/- [Rs.Ten Thousand only] shall be paid as costs of litigation to the complainant.
(4) Appeal No.A/11/836 is hereby allowed.
(i) Impugned order dated 29/04/2011 is hereby set aside.
(ii) The Opponent Insurance Company is directed to make payment of Rs.1,00,000/- [Rs.One Lac only] to the complainant with interest @9%p.a. from the date of filing of the consumer complaint i.e. 22/12/2010 within a period of 45 days from the date of this order, failing which additional penal interest @3% p.a. will be payable on the amounts ordered to be paid.
(iii) The Opponent Insurance Company to bear its own costs and amount of Rs.10,000/- [Rs.Ten Thousand only] shall be paid as costs of litigation to the complainant.
Pronounced Dated 21st July, 2015.
[ P.B.Joshi] PRESIDING MEMBER [ Dhanraj Khamatkar] MEMBER pgg