State Consumer Disputes Redressal Commission
The Oriental Insurance Co Ltd vs Rajendra Baburao Chawan on 25 June, 2024
1 A/771/2022
Date of filing :10.10.2022
Date of order :25.06.2024
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
FIRST APPEAL NO. : 771 OF 2022
IN COMPLAINT CASE NO.: 474 OF 2020
DISTRICT CONSUMER COMMISSION : AURANGABAD
The Oriental Insurance Co.Ltd. (D.O.II) ...APPELLANT
ABC Complex, Besides Prozone Mall, (Adv.K.M.Loya)
Waluj, At Aurangabad
Through it's Divisional Manager,
Santosh P.Kalse,
R/o Aurangabad.
VERSUS
Rajendra Baburao Chawan, ...RESPONDENT
R/o Gadana, Tq.Khultabad, (Adv.P.A.Kuber)
Dist.Aurangabad.
CORAM : Milind.S.Sonawane, Hon'ble Presiding Member.
Nagesh.C.Kumbre, Hon'ble Member
JUDGMENT
(Delivered on 25/06/2024) Per N.C.Kumbre, Hon'ble Member.
The appellant has challenged in this appeal, Judgment and order passed by the District Consumer Commission, Aurangabad in C.C.No.474/2020 dated, 26.07.2022.
For the sake of brevity the appellant is herein after referred as opponent and respondent is herein after referred as complainant as per their status in consumer complaint and 2 A/771/2022 District Consumer Commission, Aurangabad is herein after referred as District Commission.
2. Brief facts giving rise to this appeal are as under :-
Complainant Rajendra Baburao Chavan is an agriculturist having agricultural land Gut No.189 at Gadana Tq.Khultabad Dist. Aurangabad. The above land Gut No. 189 has been purchased by complainant through sale deed on 11.02 2019 and it was recorded in the name of complainant vide mutation entry no.1281 dated 25.02.2019 and approved on 14.03.2019. On 06.05.2019 complainant while working on the fodder cutting machine accidently caused injury to the fingers of his right hand and he lost all the fingers. After treatment, Medical Officer issued 43 % disability certificate to complainant. The incident was reported to concern Police Station vide MLC no.15574/A5415/DrBSM/1. Therefore, complainant submitted the claim proposal with opponent under the insurance scheme known as Gopinath Mundhe Farmers Insurance Scheme with opponent for the period of 08.12.2018 to 07.12.2019 through Taluka Krishi Adhikari, but on 22.03.2021 said claim was repudiated by opponent on the ground that complainant has not filed the F.I.R and Disability photo along with the claim. As such complainant filed consumer complaint due to deficiency in service committed by opponent towards him, claiming Insurance amount Rs.1,00,000/- along with interest and Rs.20,000/-for physical and mental harassment and for cost of litigation.
Complainant submitted copy of claim proposal along with all relevant revenue records, 7/12 extract of gut no. 189, copy of 3 A/771/2022 mutation entry no. 1281, disability certificate issued by Dr.Bembde dated 04.07.2019, disability certificate dated 16.07.2019, policy cover note, Government Resolution (in short G.R.) dated 01.12.2018, dated 04.12.2009, and copy of Govt. circular dated 05.03.2011 etc.
3. Opponent appeared before the District Commission and filed written statement, thereby resisted the complaint and denies the allegations. It is submitted by opponent that complainant is not consumer of opponent as he has purchased the agricultural land gut no.189 on 11.02.2019 i.e. after issuance of said policy and therefore complainant is not insured with opponent and pray for dismissal of complaint.
4. On hearing the counsel of both parties and considering the entire evidence on record, District Commission allowed the complaint and directed the opponent to pay to complainant insurance amount Rs. 1,00,000/- from date of repudiation of claim i.e. 22.03.2021 with 12 % p.a. interest till its realization, within 30 days from receipt of order, Rs.5,000/-for physical and mental harassment and Rs.2,500/- for cost of litigation.
5. Feeling aggrieved by the judgment and order, opponent came to this Commission in appeal. Adv. K.M.Loya for opponent and Adv. P.A.Kuber for complainant were present. We heard both of the advocates.
4 A/771/2022
6. Adv. Loya for opponent argued and submitted by way of their pleading and written notes of arguments that, policy was issued for the period from 08.12.2018 to 07.12.2019. Complainant has purchased land gut no.189 on 11.02.2019 and mutation entry was recorded in the name of complainant on 14.03.2019 i.e. after date of inception of policy. Therefore complainant is not registered farmer on the date of commencement of policy and opponent has not received premium in respect of complainant. It is further submitted by opponent that, as per tripartite agreement and G.R. dated 01.12.2018 only registered farmers are entitled for claim and therefore repudiation of claim by opponent is legal. It is further submitted that the Commission below has not considered the above facts and passed the impugned judgment and order which deserves to be quashed and set aside. Adv. Loya for opponent filed copy of tripartite agreement for the year 2018-19.
7. Adv. Kuber for complainant argued and submitted by way of written notes of arguments that agricultural land gut no. 189 at Gadana has been purchased by complainant on 11.02.2019 and on 25.02.2019 concern Talathi registered mutation entry no. 1281 in the name of complainant and same is approved on 14.03.2019. It is further submitted that complainant is farmer and therefore entitled for insurance claim. It is submitted by complainant that, opponent has not opposed the complaint before the District Commission on the ground that the complainant was not farmer at the time of commencement of policy. Opponent has wrongly repudiated the claim as there is no 5 A/771/2022 exclusion clause as per the grounds of repudiation. It is also submitted that the District Commission has rightly adjudicated the matter and therefore there is no need to interfere in the impugned judgment and order. Adv. Kuber for complainant relied on following judgments.
(i) Hon'ble Supreme Court in Civil Appeal No.2059/2015, Saurashtra Chemicals Ltd. versus National Insurance Co. Ltd.
(ii) Hon'ble National Commission in Rev. Petition No. 1999/2019, The Branch Manager, Reliance Life Insurance Company Ltd. Versus Usha Soni etc. But it appears that fact and circumstances of these cases and case in hand is distinguishing.
8. We have gone through the appeal compilation, impugned judgment and order, pleading and written notes of arguments on record and also thoughtfully consider the arguments of parties. The only point of controversy is that, weather at the time of commencement of policy complainant was registered farmer and he was having agricultural land in his name or not. On perusing the mutation entry no.1281 dated 25.02.2019 filed by complainant on record, it appears that agricultural land gut no. 189 at Gadana has been purchased by complainant on 11.02.2019 through sale deed from owner of said land namely, Raosaheb Kashinath Adhane and mutation entry was recorded in the name of complainant on 14.03.2019 i.e. after date of inception of policy. As per Tripartite agreement it appears that date of inception of policy is 10.12.2018. It is argued by 6 A/771/2022 complainant that opponent never opposed the complaint before District Commission on the ground that the complainant was not a farmer on the date of commencement of policy. On perusing the written statement of opponent filed before District Commission, it appears that the complaint has been opposed and objected by opponent on the ground that the complainant is not registered farmer at the date of inception of policy. As such on this point we are not agree with the submission of complainant. It is also argued by complainant that, Opponent has wrongly repudiated the claim as there is no exclusion clause as per the grounds of repudiation but the copy of letter of repudiation is not on record.
9. As per tripartite agreement 2018-19, clause I (C) farmer means person registered as farmer in Maharastra as evidenced by 7/12 extract. In clause II (1) of said agreement the eligibility criteria is the farmers name should be in the land record register i.e.7/12 extract on the date of issuance of policy. The same criteria for insurance claim also appear from G.R. dated 01.12.2018 clause 2, and G.R. dated 04.12.2009 in clause 1. As per G.R. dated 01.12.2018 it appears that Government paid the premium to opponent for 1.37 crore registered farmers whose name were mentioned in 7/12 extract. The incident occurs on 06.05.2019 and Complainant submitted the claim with opponent for Gopinath Mundhe Farmers Insurance Scheme for the period 08.12.2018 to 07.12.2019 and for which the policy was issued on 10.12.2018. Therefore as per eligibility criteria provided in tripartite agreement and G.R. dated 01.12.2018 the name of complainant should be in the land record on the date of issuance 7 A/771/2022 of policy i.e. on 10.12.2018, but it appears that on 14.03.2019 the land was recorded in the name of complainant which is after the date of commencement of policy i.e. 10.12.2018. Therefore it appears that the District Commission in the impugned judgment and order wrongly held that complainant is registered farmer and entitled for insurance claim.
10. In Civil Appeal No. 6277/2004 United India Insurance Company Ltd. Versus M/S Harchand Rai Chandan Lal 2004 CJ(SC) 1486 in para 6 it was observed that .....The policy is the contract between the parties and both parties are bound by the terms and contract....... and it is also observed that, the term 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....... As per above observation we agree with the submission of opponent that as the complainant was not a registered farmer at the date of policy inception and therefore there is no deficiency in service committed by opponent towards complainant on repudiating the claim.
11. In view of aforesaid facts and discussion we are of the opinion that, the District Commission has committed an error in appreciating evidence on record. The District Commission in the impugned judgment and order ignored above important facts. Hence, the impugned judgment and order are liable to be quashed and set aside. In the fact and circumstances of the 8 A/771/2022 appeal there is no order as to cost. Hence, we pass the following order.
ORDER.
1. The appeal is allowed.
2. The impugned judgment and order passed by the District Commission, Aurangabad in C.C.No.474/2020 dated 26.07.2022 is hereby quashed and set aside. Consequently complaint is dismissed.
3. There is no order as to cost.
4. Copy of this judgment be given free of cost to both parties.
Date : 25/06/2024 Place: Aurangabad.
Sd/- Sd/-
N.C.Kumbre M.S.Sonawane
Member Presiding Member