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Farmer’s widow’s claim of Rs 2 lakh under Maharashtra government scheme justified: Consumer panel

A consumer committee here has directed an insurance company to pay a claim of Rs 2 lakh under a Maharashtra government scheme to the wife of a farmer who died in a road accident in 2017.

The District Consumer Disputes Redressal Commission, South Mumbai, in an order dated April 18, said the insurance company “failed in its responsibility” to the state government by “arbitrarily” rejecting the woman’s claim.

The complainant, the wife of a farmer from Solapur, said her husband died in an accident on November 25, 2017, while returning home from a vegetable market in the area.

The farmer was seriously injured after being hit by a state transport bus. He was rushed to a nearby hospital, where doctors declared him dead, according to the complaint.

After coming to know of their policy under the ‘Gopinath Munde Farmers Accidental Insurance Scheme’ introduced by the Maharashtra government, the woman filed a claim with the concerned authorities. However, the insurance company ‘deliberately’ and malafidely failed to honor her genuine claim and this amounted to deficiency in service, the woman said in her complaint and approached the commission.

The Oriental Insurance Company, chosen by the state government through a notification, said the deceased farmer was over 75 years of age and therefore not eligible for the claim.

A farmer between the ages of 10 and 75 is eligible for benefits under the scheme.

The insurer further argued that the claim was rightly rejected because documents were submitted after the stipulated period of 90 days.

The commission, after hearing both the parties and the documents, said that in the police FIR, the year of birth of the deceased was 1972 and the post-mortem report mentioned his age as about 70 years.

No documentary evidence was submitted by the insurance company showing that the deceased was 75 years old, the insurance company said.

The committee therefore concluded that in the absence of evidence from the insurance company, the age of 70 stated in the police reports is correct.

It was highly objectionable to mention the age of the deceased above 75 years without any corroborating documentary evidence, the order said.

Regarding late submission of documents, the committee said that the government notification dated November 25, 2016 (for the scheme) clearly states that the insurance company is required to accept the claims even after 90 days of delay if there are valid reasons.

The insurance company did not explain why the claim received after the grace period was denied, the insurance company said.

The commission said upon receiving the documents that it was entirely the insurance company’s responsibility to process the claim.

“Unfortunately, it has emerged that the opposite party number 1 (insurance company) has failed in its responsibility imposed on it as per the government notification,” the committee noted.

”In view of these findings, we conclude that the opposing party (insurance company) wrongly denied the complainant’s insurance claim and is therefore not justified,” the report said.

The rejection order of June 21, 2018 is therefore ‘arbitrary and bad as a matter of law’, according to the committee.

The complainant is entitled to claim Rs 2 lakh with penalty interest at the rate of 6 percent per annum from the date of rejection (June 21, 2018) till realization, the complainant said.

The committee also asked the insurance company to pay the complainant compensation of Rs 20,000 for mental agony and Rs 5,000 for legal costs.

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)