Case Note & Summary
The petitioner, Latabai wd/o. Raosaheb Deshmukh, filed a writ petition challenging the communication dated 10.3.2015 of respondent No. 4 Insurance Company by which her claim under the Shetkari Janta Apghat Vima Yojna (Farmers' Accident Insurance Scheme) was rejected. The Insurance Company gave two reasons for rejection: (i) on the date of the accident (28.11.2014) the deceased was riding a motorcycle but was not holding a valid driving licence, and (ii) alcohol was detected in his body when the post mortem was conducted. The Insurance Company informed that accidental deaths in which these two circumstances are noticed are not covered by the Government Policy and also by the Insurance Policy. The Court carefully went through the scheme prepared by the State Government. The first Government Resolution (G.R.) was issued on 19.8.2004 and by it to some extent relief to farmers was provided. The Court observed that the scheme is a welfare scheme for farmers and the Insurance Company cannot impose additional conditions beyond those in the Government Resolution. The Court held that the Insurance Company cannot deny coverage under a government scheme for farmers unless the policy expressly excludes such conditions. The Court allowed the petition and directed the Insurance Company to pay the claim amount with interest at the rate of 6% per annum from the date of the claim till realization. The Court also directed the Insurance Company to pay costs of Rs. 10,000 to the petitioner.
Headnote
A) Insurance Law - Government Scheme - Shetkari Janta Apghat Vima Yojna - Claim Rejection - The Insurance Company rejected the claim of the petitioner on the grounds that the deceased was not holding a valid driving licence and alcohol was detected in his body. The Court held that the scheme is a welfare scheme for farmers and the Insurance Company cannot impose additional conditions beyond those in the Government Resolution. The Court allowed the petition and directed the Insurance Company to pay the claim amount with interest. (Paras 1-10) B) Insurance Law - Interpretation of Policy - Welfare Scheme - The Court held that the Insurance Company cannot deny coverage under a government scheme for farmers unless the policy expressly excludes such conditions. The scheme must be interpreted liberally to benefit the farmers. (Paras 3-8)
Issue of Consideration
Whether the Insurance Company can reject the claim of the petitioner under the Shetkari Janta Apghat Vima Yojna on the grounds that the deceased was not holding a valid driving licence and alcohol was detected in his body at the time of accident.
Final Decision
The Court allowed the petition and directed the Insurance Company to pay the claim amount with interest at the rate of 6% per annum from the date of the claim till realization. The Court also directed the Insurance Company to pay costs of Rs. 10,000 to the petitioner.
Law Points
- Insurance claim under government scheme for farmers cannot be rejected solely on grounds of lack of valid driving licence or presence of alcohol unless policy expressly excludes such conditions
- Scheme of insurance for farmers is a welfare scheme and must be interpreted liberally
- Insurance company cannot impose additional conditions beyond those in the government resolution
