State Consumer Disputes Redressal Commission
National Insurance Company Ltd vs Mrs. Vaishali Murlidharji Kawre on 14 November, 2025
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
CIRCUIT BENCH NAGPUR
FIRST APPEAL NO. SC/CB2/27/A/37/2019
NATIONAL INSURANCE COMPANY LTD
PRESENT ADDRESS - HAVING ITS REGIONAL OFFICE AT 5TH FLOOR, FIDVI TOWERS,
OPP. SARAF CHAMBERS, SADAR, NAGPUR-441 001., AND HAVING ITS BRANCH OFFICE
AT SAKET, LAKSHMI BHAWAN, DHARAMPETH NAGPUR-440 012 NAGPUR,MAHARASHTRA.
NATIONAL INSURANCE COMPANY LTD
PRESENT ADDRESS - HAVING ITS DIVISIONAL OFFICE AT BHAU SHIROLE BHAWAN, 4TH
FLOOR, PMT BUILDING, DECCAM GYMKHANA, SHIVAJI NAGAR, PUNE-431
004,MAHARASHTRA.
.......Appellant(s)
Versus
MRS. VAISHALI MURLIDHARJI KAWRE
PRESENT ADDRESS - R/O. ADYAL TAH. PAUNI DIST. BHANDARA,MAHARASHTRA.
TALUKA AGRICULTURE OFFICER
PRESENT ADDRESS - PAUNI DIST. BHANDARA,MAHARASHTRA.
.......Respondent(s)
BEFORE:
HON'BLE MRS. KALYANI KAPSE , PRESIDING MEMBER
HON'BLE MS. SHAILA D. WANDHARE , MEMBER
FOR THE APPELLANT:
ADV. ASHISH W. PAUNIKAR FOR THE APPELLANT.
FOR THE RESPONDENT:
ADV. UDAY P. KSHIRSAGAR FOR THE RESPONDENT.
DATED: 14/11/2025
ORDER
(Delivered on 14/11/2025) Per Mrs KalyaniKapse, Hon'ble Presiding Member
1. The present appeal is preferred by the Appellants namely National Insurance Company through its Regional Manager, Nagpur and Divisional Manager, Pune against the Order and Judgement dtd 17/11/2018 in Complaint No. CC/59/2017 passed by learned District Consumer Dispute Redressal Forum, Bhandara (The Forum) under section 15 of the Consumer Protection Act, 1986. (for the sake of brevity "The Act".
2. The learned Forum at Bhandara has partly allowed the complaint filed under section 12 of the Act and hence this appeal under section 15 of the Act.. The brief facts of the appeal mentioned herein below. (Parties are hereinafter referred as per their original nomenclature i.e. the present Respondent as Complainant and present Appellant National Insurance Co. Ltd. as Opposite Party for better appreciation)
3. It is the case of Complainant that the Government of Maharashtra in order to provide compensation to all farmers who sustain bodily injury resulting into death, permanent disablement or loss of limb enter into tripartite agreement. The policy is known as Gopinath Munde Farmers Accident Insurance Policy. Farmers whose names are included in 7/12 extracts are the beneficiaries. Respondent No.1/ original complainant filed the complaint that her husband Shri. Murlidhar G. Kaware died due to drowning on 24/03/2016 and therefore sought compensation of Rs. 2 lakhs as per the Farmers Accident Insurance Policy. Claim is rejected by the Insurance Company. She has approached the Forum.
4. Notices were served to Opponents. By way of Written Version (W.S.) Opposite Party No. 2 by general denials and defences restricted the claim of the Complainant. In reply Opposite Party No.2 submitted that the it was denied that her husband drowned on 26/06/2018. In its special statement, it was stated that on verification of the police documents, as per the death report of Police Station Karadi,which makes it clear that the deceased committed suicide and not an accident. As per the terms and conditions of the policy, an insurance claim cannot be1.approved in a suicide case. The opposite insurance company rejected the insurance claim of the complainant subject to the terms and conditions of the insurance, in which it was stated that they did not provide any defective service to the complainant and requested the respondent No. 2 Insurance Company to dismiss the complaint against them.
5. The leamed Forum, thereafter recorded the evidence led by the Complainant as well as Opposite party. The learned Forum, also went through the documents filed by both the parties as well as written notes of arguments. After appreciating the oral and documentary evidence the leamed Forum, has partly allowed the Complaint and thereby directedthe Opposite Party to pay an amount of Rs 2,00,000/- to respondent No.1/complainant from 13/06/2017 with 9% interest, cost of Rs 10,000/- towards physical and mental agony and litigation cost of Rs 5000/-
6. Being aggrieved by the said order, the present Appeal is being filed on the following Grounds. Government of Maharashtra in order to provide compensation to all farmers who sustain bodily injury resulting solely and directly from accidents caused by external violent and visible means resulting in specific contingencies such as death, permanent disablement or loss of Limb entered into an tripartite agreement through the Commissioner (Agriculture), Government of Maharashtra, M/s Bajaj Capital Insurance Broking Private limited the licensed broker under the insurance regulatory and development authority and appellant insurance company as the third party. The policy is known as Gopinath Munde Farmers Accident Insurance Policy (hereinafter referred to as the Insurance policy in question).
7. Insurance policy lays down the procedure with regard to the submission of documents, exclusions to which the policy would not be applicable etc. Individual farmer do not pay any premium amount to insurance company {such cost is borne by the government of Maharashtra) and neither insurance company receives any premium from them. Farmer whose names are included in 7/12 extracts are the beneficiaries. As individual farmer does not pay any amount/policy premium, he is not a consumer within the definition of consumer protection act and therefore the provisions the act of 1986 is not applicable to him.
8. Complainant has nowhere specified as to what work the deceased had at the well. In the absenceof any pleading the only inference that can be drawn is that complainant's husband committed suicide and therefore claim is not payable.
9. The other ground of appeal is that the learned Forum ought to not considered Complaint itself was not maintainable in view of clause 7 of GR of 26 November 2015. Clause 7 contemplates that in case the insurance company rejects the claim for any reason, the applicant has to get in touch with the broker who on behalf of the beneficiary/claimant will file application with the authorities mentioned therein however the broker shall not be entitled for any remuneration either from the state government or from the farmer. Complaint is thus not maintainable in view of clause 7 of the government resolution and on that basis also the same is liable to be dismissed.
10. The tripartite agreement entered between the parties are binding upon all of them including the applicant as beneficiary and for whom the government of Maharashtra has signed the same. The terms and conditions clearly provide the exclusion clause and the claim for suicide or attempt to commit suicide is excluded therein. In the present complainant's deceased husband had committed suicide by jumping into well. Crime detail form submitted by police authorities also points out that the deceased committed suicide. Case.
11. Complainant has nowhere specified as to what work the deceased had at the well. In the absence of any pleading the only inference that can be drawn is that complainant's husband committed suicide and therefore claim is not payable.
12. Appellants prayed to allow the appeal and quash and set-aside the impugned order passed by District Consumer Forum, Bhandara on 17/11/ 2018 in consumer case number CC/59/2017 (Mrs. Jayashree P. Kaware Versus National Insurance Co. and 2 others) and dismissed the complaint.
13. We have heard Mr. Ashish W. Paunikar, learned advocate for the Appellant and Mr. Uday P. Kshirsagar learned advocate for the Respondent.
14. We have carefully gone through the documents and papers and written notes of argument filed by the respondents which are placed on the record. On the basis of the facts stated above following points arises for determination with our findings recorded against the same as under.
Sr. No. Points for Determination Findings
01 Whether the impugned order dated In the Negative
17/11/2018 passed by the learned District
Consumer Dispute Redressal Forum,
Bhandara in Complaint case No. 59/2017
suffers from any infirmity or illegality and
needs any interference?
02 What order? As per final order
REASONS
As to Para No. 1 and 2-
15. That the Respondent no.1 was original complainant before Consumer Dispute Redressal Forum, Bhandara. This Respondent No.1 had filed the complaint before the Forum against the present respondents for non settlement of his claim under Farmer's Personal Accident Insurance Policy issued by the Maharashtra Government for the benefit of family of farmer. The Appellant had repudiated the said claim on ground that the husband of Respondent no.1 had committed suicide by jumping into well and hence the Respondent no.1 had filed the complaint before the Consumer Forum, Bhandara. The Forurn has allowed the complaint on ground that insurance co. had not proved beyond doubt that deceased had committed suicide due to some reason.
16. The respondent No.1 states that the Forum has rightly and judiciously allowed the claim as Forum has relied on the citation The New India Assurance co. V/S M.S.Venkatesh Babu IV(2011) CPJ 243 wherein The Hon'ble National Commission held that F.I.R. as also statements recorded by the police cannot be used by insurance company in support of its case since F.I.R. as also statements recorded by the police are not substantive piece of evidence. In the present case also the District Forum Bhandara rightly refused to rely on F.I.R. and statements recorded by the police and placed reliance on affidavit filed by Respondent No.1 and was not subjected to any cross examination by this Appellant. The respondent No.1 also wants to rely on citation The New India Assuarance Co. V/S Shrimati Hausabai Panalal Dhoka, 2007(3) CPR142 (Maharashtra) wherein the Hon'ble Maharashtra State Commission has held that statement of witnesses recorded by the police during the investigation of criminal case would not be evidence unless such person was examined before the Forum. Even charge filed by the police against the person who did not have driving license by itself would not prove case of Insurance Co. it is therefore crystal clear the Consumer Forum had appreciated the evidence judiciously and did not erred in its judgment.
17. The District Forum, Bhandara also rightly relied upon citation in Bajaj Allianze General Insurance Co.V/S Jaywantabai Nathanbhai Monpara (NC) IV (2014) CPJ 42 Wherein the Hon'ble National Commission held that even though deceased was suffering from Schizophrenia there was no evidence to prove that she actually committed suicide by jumping into well. Appellant had misconceived the evidence on record with the result the repudiation of claim is erroneous on the face of the record. On this ground alone the order passed by the District Consumer Redressal Forum Bhandara is liable to be sustained.
18. It is observed that the District Consumer Redressal Forum, Bhandara rightly held that Appellant had not placed any substantial and cogent evidence to prove that husband of respondent No.1 had actually committed suicide and he was under
such condition which forced him to suicide. The Appellant had not placed any affidavit of any person who is eye witness nor filed any papers to prove that the husband of Respondent no.1 had taken such step due to any illness, debt. The appellant had not adduced evidence of a person who stated before police that deceased had committed suicide as he was under some tensions. The appellant had not placed any suicide note to corroborate the story of suicide. That the appellant had repudiated the claim of respondent No. 1 on hyper technical ground and this scheme is for welfare of family of farmer who died in an accident and the appellant is behaving in lukewarm and obstructive attitude towards this scheme and genuine and honest claim of the widow is defeated by appellant on highly technical ground so the main objective of this scheme to protect the family of farmer who suddenly died in accident and since he was bread earner of family the family should not come on street.
19. It is pertinent to note here that in Vyankatesh Babu (Supra) wherein The Hon'ble National Commission held that F.I.R. as also statements recorded by the police cannot be used by insurance company in support of its case since F.I.R. as also statements recorded by the police are not substantive piece of evidence. on this ground only District Forum Bhandara rightly refused to rely on F.I.R. and statements recorded by the police and placed reliance on affidavit filed by Respondent No.1.
20. State Consumer Commission, Mumbai in the case of First Appeal No.- A/06/231 "Branch Manager, United India Insurance Co-Versus-Smt. Subhadra Gaike Order dated 21/09/2011, it has been stated that the deceased was spraying pesticides on the crops in the field and the poison entered his body through the nostrils through inhalation, which is proved by the evidence on record. According to the statement of the opposing insurance company, no evidence has been filed regarding the fact that the deceased had committed suicide, therefore, since the deceased had an accident, the heirs of the deceased are entitled to get the benefits of the Janata Shetkari Accident Insurance Scheme after his death. In the case in hand also, the opposite insurance company claims that the deceased committed suicide and for that reason they rejected the insurance claim of the complainant. In this regard, they have not submitted any substantial and cogent evidence before the Court and have concluded that the deceased committed suicide only on the basis of the police documents, which is wrong from the above-mentioned Judgments of the Hon'ble Supreme Courts. According to the police report, the conclusion that the deceased committed suicide is not acceptable without any eyewitness evidence. Until eyewitness evidence is presented, it cannot be concluded that the deceased committed suicide just because it is mentioned in the police report. Therefore, the opposite insurance company has concluded that the deceased committed suicide without any eyewitness evidence.
21. Hence in our considered view the grounds on which appellant has filed the instant appeal is not maintainable in the eyes of law. We find no illegality, infirmity or jurisdictional error in the impugned order passed by the Additional District Commission, Nagur. The appeal being devoid of merit is accordingly dismissed. Hence we pass the following Order-
//ORDER//s i. Appeal is hereby dismissed. Order/Judgement dated 17/11/2018 passed by the learned District Consumer Dispute Redressal Forum, Bhandara in Complaint Case No.59/2017 stands confirm.
ii. No order as to cost.
iii. Copy of this order be furnished to both the parties free of cost ..................J KALYANI KAPSE PRESIDING MEMBER ..................J SHAILA D. WANDHARE MEMBER