State Consumer Disputes Redressal Commission
United India Insurance Co.Ltd. , vs Smt.Swaroopa Dadarao Khsirsagar, on 25 August, 2011
1 F.A.No.:408/2011
Date of filing :03.08.2011
Date of order :25.08.2011
MAHARASHTRA STATE CONSUMER DISPUTE REDRESSAL
COMMISSION,MUMBAI, CIRCUIT BENCH AT AURANGABAD.
FIRST APPEAL NO. :408 OF 2011
IN COMPLAINT CASE NO.:07 OF 2011
DISTRICT CONSUMER FORUM : NANDED
United India Insurance Co.Ltd. ,
Through its Deputy Manager,
Aurangabad Division, having office at
Osmanpura Circle,
Station Road, Aurangabad. ...APPELLANT
(Org.Opp.No.1)
VERSUS
1. Smt.Swaroopa Dadarao Khsirsagar,
R/o Koli, Tq.Hadgaon,
Dist.Nanded.
2. Taluka Agriculture Officer,
Office of the Agri.Officer,
At Post Hadgaon, Tq.Hadgaon,
Dist.Nanded.
3. Kabal Insurance Broking Services Pvt.Ltd. ,
Shop No.2, Disha Alankar Complex,
Town Centre, Cannaught,
CIDCO, Aurangabad. ..RESPONDENTS
(No.1-Org.Complainant,
No.2 & 3-Org.Opp.No.4 & 3)
CORAM : Mr.D.N.Admane, Hon`ble Presiding Judicial
Member.
Mrs.Uma S.Bora, Hon`ble Member.
Mr.K.B.Gawali, Hon`ble Member.
Present : Adv.Shri.S.S.Rathi for appellant, O R A L O R D E R Per Mr.K.B.Gawali, Hon`ble Member.
1. Present appeal is filed by United India Insurance Co.Ltd. through it`s Divisional Office at Aurangabad which was original opponent NO.3 against the judgment and order dated 6.7.2011 passed by Dist.Forum, Nanded in complaint case No.111/2011. Present 2 F.A.No.:408/2011 respondent No.1 was the original complainant (hereinafter termed as "complainant"), respondent NO.2 was the original opponent No.4 and respondent No.3 was original opponent No.3.
2. The facts leading to his appeal are briefed as under.
That, the complainant`s husband Dadarao Baburao Kshirsagar was the farmer having agriculture land admeasuing 1.62 hector from Gut No.70 of village Koli, Tq.Hadgaon, Dist.Nanded. That, husband of complainant died due to road accident on 22.5.2010. The incident was reported to the police and accordingly spot panchanama, inquest panchanama was carried out alongwith post-mortem of the deceased. It was contended by complainant that her husband being farmer at the time of his death was beneficiary of the insurance scheme namely "Farmer`s Individual Accident Insurance policy" obtained by Government of Maharashtra for the farmers in the State. That the period of policy was 15.08.2009 to 14.08.2010 and during the policy period her husband died on 22.5.2010. It was her case that subsequent to the death of her husband she had filed insurance claim of Rs.1 lakh to the appellant Insurance Company through respondent No.2 & 3. However the Insurance Company rejected the said claim vide letter dated 18.03.2011 on the ground that incomplete documents and claim submitted after due date i.e. 14 Nov.2010. She therefore submitted the complaint to the Dist.Forum seeking directions to the appellant Insurance Company to pay her insured sum of Rs.1 lakh alongwith interest @ 15% from the date of death of deceased i.e. 22.5.2010. In addition the amount of Rs.50,000/- for the mental agony and Rs.5000/- towards cost of the complaint.
3. Appellant Insurance Company appeared before the Forum and defended the claim of the complainant . It was contended that there was no proof to show that Dadarao Kshirsagar was farmer at 3 F.A.No.:408/2011 the time of death and that the documents of 7/12 and 8A were of later date of the policy.
4. Dist.Forum after going through the papers and hearing the parties allowed the complaint and directed Insurance Company to pay claim amount of Rs.1,00,000/- alongwith interest @ 9% p.a. from the date of complaint i.e. 10.4.2011 within a period of 30 days. In addition it was also directed to pay Rs.5000/- towards mental agony and Rs.2000/- towards cost. All these amount be paid to the complainant within a period of 30 days, failing which, interest of @10% is required to be paid.
5. Aggrieved by the said judgment and order passed by the District Forum, present appeal is filed by Insurance Company.
6. Matter was listed for admission hearing on 25.08.2011. Adv.Shri.S.S.Rathi appeared for appellant. We heard advocate for appellant and decided to dispose of the matter at admission stage. Learned counsel for the appellant submitted that as per condition of the policy the claim was required to be submitted with the Insurance Company within 90 days from the last date of the policy i.e. 14 th Nov.2010. However the claim was submitted after the said date. It was further submitted that respondent did not file the record to show that deceased was farmer on the commencement date of the policy. As per condition of the policy the beneficiary of the said policy should be a farmer on the date of commencement of the policy. Therefore learned counsel contended that in the instant case since the deceased husband of the respondent was not farmer on the commencement of the policy, appellant Insurance Company has rightly repudiated the insurance claim and there was no deficiency in service.
4 F.A.No.:408/20117. We have perused the record and also considered the argument advanced by learned counsel for the appellant. It is revealed from the repudiation letter that the grounds given for the repudiation are incomplete document and claim received after due date. No details regarding incomplete documents are given. However as revealed from the argument put forth by learned counsel for the appellant 7/12 extract record submitted alongwith claim proposal pertain to date of 18.3.2010. That, policy period is from 15.8.2009 to 14.08.2010. The contention of Insurance Company is that there is no record to show that deceased husband of the respondent was a farmer on the commencement date of the insurance policy i.e. on 15.8.2009. In fact in the extract of 7/12 dated 18.3.2010 which is on record there are cultivation entries for the year 2004-05 to 2009-10. The name of the deceased husband i.e. Dadarao Baburao Kshirsagar is there in the ownership column and cultivation entry shows that he was in possession of the said land bearing Gut No.17 of village Koli, Tq.Hadgaon, Dist.Nanded from 2004-05 to 2009-10. It is thus established that on the date of the commencement of the insurance policy the deceased husband of the respondent was the farmer. However appellant Insurance Company neglected this fact and wrongly repudiated the claim.
8. The second ground for repudiation is that the claim was submitted after a period of 90 days from the last date of the policy. In fact Government of Maharashtra has obtained this insurance policy for the welfare of the farmers of the State. Appellant Insurance Company should have considered this object and ought not to have rejected the claim on this technical ground. In fact this period of 90 days as provided for submission of the claim is not mandatory but directory.
9. In view of the aforesaid observations it is proved that by not accepting insurance claim of the complainant the appellant Insurance 5 F.A.No.:408/2011 Company committed deficiency in service. We therefore find no merit in the appeal filed by Insurance Company . All these aspects and facts have been considered by the Dist.Forum and has rightly passed the impugned judgment and order. We are therefore not inclined to interfere the said judgment and order. Hence we pass the following order.
O R D E R 1. Appeal is dismissed summarily. 2. No order as to cost.
3. Copies of the judgment be issued to both the parties.
K.B.Gawali, Mrs.Uma S.Bora D.N.Admane Member Member Presiding Judicial Member Mane