State Consumer Disputes Redressal Commission
The National Insurance Co Ltd vs Latika Dastagir Sayyad on 6 November, 2024
1 A/37/2021
Date of filing :11.01.2021
Date of order :06.11.2024
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
AURANGABAD.
FIRST APPEAL NO. : 37 OF 2021
IN COMPLAINT CASE NO.: 200 OF 2019
DISTRICT CONSUMER COMMISSION : BEED
The National Insurance Co.Ltd. APPELLANT
Through its Manager, (Adv.S.V.Kulkarni)
Through its Divisional Office,
Hazari Chambers, Padampura,
Railway Station Road,
Aurangabad 431 001.
VERSUS
1. Smt.Latika @ Latifa Dastagir Sayyad, ....RESPONDENT
R/o Malhivra Tq.Georai, (Adv.V.P.Savant)
Dist.Beed.
2. Taluka Krushi Adhikari,
Taluka Krushi Adhikari Office,
Georai, Tq.Georai, Dist.Beed.
CORAM : Milind.S.Sonawane, Hon'ble Presiding Member.
Nagesh.C.Kumbre, Hon'ble Member
JUDGMENT
Per Nagesh.C.Kumbre, Hon'ble Member.
The appellant has challenged in this appeal the impugned judgment and order passed by the District Commission, Beed (in short District Commission) in C.C.No.200/2019 dated 06.11.2020, wherein 2 A/37/2021 present appellant is opponent no.2, respondent no.1 is complainant and respondent no.2 is opponent no.1.
2. Brief facts giving rise to this appeal are as under :-
The husband of respondent no.1 Dastagir Ambir Sayyad (in short deceased) was an agriculturist having agricultural land in Gut No.30 at Malhivra Tq. Georai. Dist. Beed. On 14.02.2016 wild animal, Hyena (Taras) attacked on deceased and taken various bites on his body. Deceased was admitted in private hospital at Narsapur, then in the Government Hospital and later on in Sassoon Hospital, Pune and during treatment died on 07.03.2016. The incident was reported to Rajgad Police Station and accidental death A.D.No.16/2016 was registered. Police conducted necessary investigation/inquiry. On the relevant date deceased was covering under the Insurance Scheme Known as Gopinath Mundhe Farmers Insurance Scheme with appellant for the period of 14.08.2015 to 13.08.2016,therefore respondent no.1 submitted the claim proposal with appellant through respondent no.2, Taluka Krishi Adhikari. On 31.01.2019 appellant repudiated the claim of respondent no.1 on the ground that the death of deceased was natural and not accidental and the claim was not within limitation. As such respondent no.1 filed consumer complaint due to deficiency in service committed by appellant towards her, claiming Insurance amount Rs. 200,000/-
along with interest, Rs. 10,000/-for physical and mental harassment and Rs. 5000/- for cost of litigation. Respondent no.1 submitted copy of all police investigation/inquiry papers, Medical treatment papers of deceased, copy of claim proposal, 3 A/37/2021 copies of relevant revenue records and repudiation letter of appellant dated 31.01.2019 etc.
3. Appellant appeared before the District Commission and filed written statement, thereby resisted the complaint and denies the allegations. It is submitted by appellant that the death of deceased was natural and not accidental. Deceased was not agriculturist at the time of commencement of policy. The insurance claim was not filed within limitation by respondent no.1 and therefore the claim was rightly repudiated by appellant and there is no deficiency in service on the part of appellant and prayed for dismissal of complaint. Respondent no.2 was appeared before the District Commission but not filed written statement.
4. On hearing the counsel of both parties and considering the entire record, District Commission allowed the complaint and held that appellant is liable for deficiency in service towards respondent no.1 and directed to pay respondent no.1 Rs.2,00,000/- as insurance amount within 30 days from the date of order else liable to pay interest at 8 % p.a., Rs.3000/- for physical and mental harassment and Rs. 1000/- for cost of litigation
5. Feeling aggrieved by the impugned judgment and order, appellant came to this Commission in appeal. Adv.S.V.Kulkarni for appellant and Adv.V.P.Savant for respondent no.1 were present. Respondent no.2 has been duly served but not given appearance before this Commission therefore appeal is proceeded ex-parte against him. We heard both of the advocates.
4 A/37/2021
6. Adv.S.V.Kulkarni for appellant argued and submitted by way of their pleading and written notes of arguments that, the death of deceased is natural and therefore the risk of the deceased was not covered under the policy. As per medical reports the cause of death of deceased is due to lung disease called Interstitial Pneumonitis therefore the death of deceased is natural and not accidental. It is further submitted that appellant had rightly repudiated the claim and not committed deficiency in service towards respondent no.1. The Commission below has not considered these facts at the time of adjudicating the case and passed the impugned order which needs to be quashed and set aside. Adv.Kulkarni filed copy of tripartite agreement dated 24.02.2016.
7. On the other hand, Adv. Savant for respondent no.1 argued and submitted by way of written notes of arguments that deceased was registered farmer at the time of commencement of policy. Deceased was died due to injuries caused in the attack of forest animal Hyena (Taras). The death of deceased is accidental and not natural. It is further submitted that commission below has consider evidence on record and rightly adjudicated the case and there is no necessity to interfere in the order.
8. We have gone through the appeal compilation, impugned judgment and order, pleading and written notes of arguments on record. On perusing the 7/12 extract and mutation entry no. 461 on record it appears that, the deceased was farmer at the time of inception of policy. As per the police papers and medical 5 A/37/2021 treatment case papers of deceased, it appears that on 14.02.2016 the forest animal, Hyena (Taras) attacked on deceased and taken various bites on his body. Deceased was admitted in private hospital at Narsapur and then in the Government Hospital and later on in Sassoon Hospital, Pune and died on 07.03.2016 during treatment. As per case papers dated 14.02.2016 of Siddhivinayak Hospital Narsapur, M.L.C. 5290 dated 06.03.2016 and medical treatment papers Sassoon Hospital Pune,, copy of Pune Municipal Corporation Transfer book dated 06.03.2016 and post mortem report of deceased, it appears that deceased sustained multiple facial injuries due to bite of unknown animal. In the case history also it is observed that deceased sustained bite mark and CLW over the left hand, multiple bite mark over facial region and bleeding through the wounds. As per above initial diagnosis it appears that the injuries caused to deceased was due to attack of wild animal.
9. It reveals from the police papers that, after inquiry in accidental death No.16/2016, police forwarded summary report to S.D.M. Saswad with remark that deceased was died due to the infection of liver because of bite injuries of wild animal and on 31.01.2019 said summary report was approved. It reveals from order dated 16.03.2019 issued by forest department that compensation was granted to deceased as he was died due to attack of wild animal, Taras. Under such circumstances, though the cause of death of deceased is Interstitial Pneumonitis but it may be the result of injuries caused to deceased due to attack and bite of wild animal. Therefore we are of the view that the 6 A/37/2021 death of deceased is caused due to the attack and bite injuries of wild animal, and death of deceased is accidental and covered under the said insurance policy.
10. In view of aforesaid discussion we are of the opinion that, the District Commission has rightly allowed the consumer complaint. We do not find any infirmity and illegality in the impugned judgment and order passed by the District Commission. Therefore, we do not find it necessary to interfere in the said order. Consequently, the appeal deserves to be dismissed. In the fact and circumstances of the case there is no order as to cost. Hence, we pass the following order.
ORDER
1. The appeal is dismissed.
2. No order as to cost.
3. Copy of this judgment be given to both the parties free of cost.
Sd/- Sd/- N.C.Kumbre M.S.Sonawane Member Presiding Member MBM