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State Consumer Disputes Redressal Commission

New India Assurance Co.Ltd., vs Smt.Kantabai Baliram Ware, on 17 February, 2014

                                   1                         F.A.No. :303/2013




                               Date of filing:10.10.2013
                               Date of order:17.02.2014
MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL
COMMISSION, MUMBAI, CIRCUIT BENCH AT AURANGABAD.


FIRST APPEAL NO.: 303 OF 2013
IN COMPLAINT CASE NO. : 153 OF 2012
DISTRICT FORUM : BEED.


New India Assurance Co.Ltd.,
Through its Divisional Officer,
Adalat Road, Aurangabad,
Through its Divisional Manager.                ...APPELLANT


VERSUS


1.   Smt.Kantabai Baliram Ware,
     R/o Chikhali, Tq.Georai,
     Dist.Beed.

2.   The Manager,
     Deccan Insurance and Reinsurance
     Brokers Pvt.Ltd.,
     6, Parkhade Building, Bhanudasnagar,
     Behind Big Bazar Market,
     Akaswani, Aurangabad.

3.   The District Collector,
     Beed, Collector office,
     District Beed.                            ...RESPONDENTS.


           Coram :      Mrs.Uma S.Bora, Hon`ble Presiding
                        Member.

Mr.K.B.Gawali, Hon`ble Member.

Present : Adv.Smt.Maya Choudhary holding for Adv.Shri.S.V.Kulkarni for appellant, Adv.Shri.A.S.Pawase for respondent No.1.

O R A L JUDGMENT (Delivered on 17th February 2014) Per Mr. K.B.Gawali, Hon`ble Member.

1. This appeal is preferred by original opponent No.2 against the judgment and order dated 17.08.2013 passed by District Consumer Forum Beed in C.C.No.153/2012 whereby the complaint is partly allowed holding the appellant as liable for deficiency in service. For the better understanding appellant hereinafter is termed as "opponent insurance company" whereas respondent No.1 hereinafter termed as "complainant", the respondent No.2 which is appointed by Government herein after termed as "opponent insurance agency" and respondent No.3 as hereinafter termed as "opponent Collector".

2. It is the case of complainant that her husband namely Baliram Gitaram Gaware who was farmer was died on 11.10.2010 due to falling branch of tree on him while working in his agriculture land caused by storm associated with heavy rain. She contended that Government of Maharashtra had obtained insurance policy for the farmers in the State of Maharashtra and her husband being farmer was beneficiary of the said scheme. That, following his death as legal heir of deceased Baliram, she submitted her insurance claim to the opponent insurance company through Taluka Agriculture Officer and further through opponent insurance agency i.e. respondent No.2 herein. However, her claim was repudiated by opponent insurance company and therefore alleging deficiency in service on the part of opponent insurance company she filed complaint before the Forum seeking direction to the opponent insurance company to pay her insurance sum of Rs.1 lakh along with interest @ 18% p.a. and in addition, Rs.10,000/- for mental harassment and Rs.5000/- as cost of the complaint.

3. Respondent No.2 i.e. opponent insurance agency appeared before the Forum and filed written version contesting the claim of complainant. It was contended that its role was only to scrutinize the insurance proposal and submit the same further to the opponent insurance company and if there are incomplete papers to inform accordingly to the respondent NO.3 i.e. Collector for compliance etc. Therefore there was no deficiency in service on its part and complaint be dismissed to its extent.

4. Opponent insurance company also appeared before the Forum and filed its written version and resisted the claim of the complainant. It was contended that neither deceased Baliram nor the complainant had personally paid any premium to the insurance company and hence they are not its consumer. It was further contended that deceased Baliram was not died in accident and hence complainant was not entitled for the insurance claim as filed by her. Hence it was requested to dismiss the complaint.

5. District Consumer Forum after considering evidence on record and hearing parties to the dispute has partly allowed complaint and directed insurance company to pay to the complainant insurance of Rs.1 lakh along with interest @9% p.a. from the date of filing of complaint i.e 17.7.2012 within a period of 30 days form the date of receipt of order and also directed to pay Rs.3000/- as compensation towards mental harassment and Rs.2,500/- as cost of the complaint. It is held by District Consumer Forum that as per the report of Police Patil as well as panchanama drawn by revenue inspector and report submitted by him to the Tahasildar deceased Baliram was died due to falling of branch of neem tree on him as there was stormy wind associate with rain. Therefore death of Baliram was accidental and accordingly allowed the complaint and passed the impugned judgment and order.

6. Aggrieved by the said judgment and order present appeal is filed by opponent insurance company. Adv.Miss.Maya Choudhary holding for Adv.Shri.S.V.Kulkarni was present for appellant, Adv.Shri.A.S.Pawase present for complainant. We heard both the counsel and also perused the papers. It was contended by Adv.Miss.Choudhary that the death of complainant's husband namely Baliram was not proved to be accidental death. Secondly, proposal submitted was incomplete i.e. copy of FIR, spot panchanama, inquest panchanama, post-mortem report etc. were not enclosed along with proposal and hence the claim of complainant could not be settled. She therefore contended that there is no any deficiency in service on the part of opponent insurance company. However, District Consumer Forum without appreciating defense of the opponent insurance company has wrongly passed the impugned judgment and order which requires to be set aside.

7. On the other hand, learned counsel Shri.Pawase for respondent No.1 i.e. complainant submitted that insurance proposal along with all the documents was submitted through proper channel to the insurance company. He further submitted that from the police report and revenue inspector , it is very much clear that death of deceased Baliram was due to fallen of the part of tree on him as there was stormy wind associated with heavy rain. Therefore his accidental death is being very well proved. District Consumer Forum has rightly passed the impugned judgment holding opponent insurance company as committed deficiency in service in not settling the claim of the complainant. He therefore requested to confirm the impugned judgment and order passed by District Consumer Forum.

8. We have perused the papers i.e. copy of complaint, written version filed by insurance company, report of Police Patil, panchanama as drawn by revenue inspector and report submitted to the Tahasildar, Gevrai etc. 5 F.A.No. :303/2013

9. The only question which arises for our consideration is whether deceased husband of complainant was died due to accident i.e. by falling part of tree on him as alleged by the complainant. From perusal of papers specially report of Police Patil as well as spot panchanama dated 12.10.2011 as drawn by concern Talathi and also report of revenue inspector on the same date i.e. 12.10.2011 submitted to Tahasildar, Gevrai it reveals that deceased Baliram while working in his field on 11.10.2011 there was stormy wind associated with heavy rain due to which branch of neem tree was parted from said tree and fallen on the deceased Baliram due to which he died on the spot. Therefore it is very much clear that his death was not natural but accidental. Respondent No.3 i.e. Collector, Beed vide letter dated 19.11.2013 had authorized the District Agriculture Officer, Beed to submit the say on behalf of him. Accordingly District agriculture Officer has submitted say vide letter dated 11.12.2013 in this Commission. From the perusal of this written say filed by District Agriculture Officer it appears that deceased Baliram was died on 11.10.2011 accidentally by falling part of tree on him as there was heavy rain associated with stormy wind. Further it is observed that complainant had submitted the claim proposal through Agriculture Officer to its office by letter dated 7.12.2011 and the same proposal was further submitted by District Agriculture Officer to opponent insurance agency i.e. respondent No.2 herein by letter dated 22.12.2011. District Agriculture Officer, Beed has also submitted a copy of Government Resolution dt.5th March 2011 along with its annexure as per proforma 'D' attached to the said Government resolution at Sr.No.12. It is observed that in case of accidental death required documents including report of Police Patil. Hence in the present case Police Patil has already submitted report and therefore from this report and other documents such as spot panchanama conducted by Talathhi and report submitted by revenue inspector to Tahasildar it is evident that deceased Baliram was died 6 F.A.No. :303/2013 accidentally as mentioned above. Hence only because there was no Police panchanama or post-mortem report etc. no conclusion can be drawn as death was not accidental. In fact as mentioned above on the basis of record available it is very much clear that his death was accidental. Therefore complainant was entitled for the insurance claim under the said policy and by not settling the claim, the opponent insurance company can be said to have committed deficiency in service.

10. In view of aforesaid facts and observations we do not find any reasons interfering the impugned judgment and order passed by District Consumer Forum. As the appeal of the opponent insurance company is being devoid of any merits, same requires to be dismissed. Hence the following order.

                                 O   R        D   E   R


   1.     Appeal is dismissed.
   2.     No order as to cost.
   3.     Copies of the order be sent to both the parties.


   Sd/-                                                Sd/-
K.B.Gawali                                          Uma S.Bora,
 Member                                           Presiding Member

Mane