Haryana

StateCommission

A/25/2015

ORIENTAL INSURANCE CO. - Complainant(s)

Versus

ANUJ KUMAR - Opp.Party(s)

D.C.KUMAR

10 Aug 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :       25 of 2014

Date of Institution:     10.01.2014

Date of Decision :      10.08.2015

 

The Oriental Insurance Company Limited, Branch Office, Pehowa Chowk, Kaithal through its authorized signatory B.S. Negi, Regional Manager, LIC Building 2^nd Floor, Jagadhri Road, Ambala Cantt, Haryana.

                                      Appellant-Opposite Party

Versus

 

Sachin Kumar s/o Sh. Raghubir Singh, Resident of Village Dherdu, Tehsil and District Kaithal (Haryana).

                                      Respondent-Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri B.M. Bedi, Judicial Member.

                             Shri Diwan Singh Chauhan, Member                                                                                                                                         

Present:              Ms. Ruchi Verma, Advocate appearing on behalf of Shri J.P. Nahar, Advocate for appellant.

                             Shri N.S. Dhillon, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

By filing the instant appeal, The Oriental Insurance Company Limited (for short ‘the Insurance Company’)-Opposite Party, has challenged the order dated November 20^th, 2013, passed by District Consumer Disputes Redressal Forum (for short ‘District Forum’), Kaithal, whereby it directed the Insurance Company to pay 35,000/- to the respondent-complainant alongwith interest at the rate of 8% per annum from the date of repudiation of claim, that is, September 21^st, 2011 till its realization and Rs.2200/- as litigation expenses.

2.      Undisputed facts of the present case are that the complainant got his eleven cows and one buffalo insured with the Insurance Company for Rs.35,000/- each, vide Insurance Policy (Exhibit C-3) for the period from June 3^rd, 2011 to June 2^nd, 2012. One of the insured cows, bearing tag No.OIC-RO-AMB-30203, died on June 6^th, 2011, due to Trypanosomiasis. The complainant informed the Insurance Company. Post Mortem Examination of the dead cow was conducted on the same day, that is, June 6^th, 2011 by Veterinary Surgeon, Chuhar Majra, Kaithal. The claim being lodged was repudiated by the Insurance Company vide letter dated September 21^st, 2011 (Exhibit C-6) stating therein that the description, lactation and age of the dead cow did not tally with the health certificate (Exhibit C-2). Aggrieved thereof, the complainant filed complaint under Section 12 of the Consumer Protection Act, 1986 before the District Forum.

3.      The opposite party contested complaint by filing reply wherein it reiterated the fact stated in the repudiation letter Exhibit C-6. It was also stated that death of animal due to illness during first 15 days from the date of issuing the policy was not covered.

4.      After evaluating the evidence of the parties, the District Forum accepted the complaint and issued direction to the Insurance Company as detailed in paragraph No.1 of this order.

5.      A perusal of Exhibit C-2 (Health Certificate) and Post Mortem Report (Exhibit C-5) clearly shows that the features of the dead cow tally with the insured cow. Besides, the tag found fixed in the ear of cow also proved identity of cow. Therefore, the Insurance Company was not justified to say that the dead cow was not the same which was insured with the Insurance Company.

6.      The plea raised by the appellant-Insurance Company that the cow died due to illness within 15 days from the date of issuing the policy, is also not tenable.  A perusal of the extract of medical literature (Annexure A-7) shows that Trypanosomiasis is not a disease, it is caused due to biting of tsetse flies. In other words, the death of the cow was on account of biting of tsetse flies, which is a poisonous insect. The exclusion clause is only with respect to the death of animal due to some disease within 15 days from the date of issuing the policy. Therefore, the instant case did not fall in the exclusion clause. The District Forum has rightly allowed the complaint.

7.      In the result, no case for interference is made out. Hence, the appeal is dismissed.

8.      The statutory amount of Rs.21,811/- deposited at the time of filing the appeal be refunded to the complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

Announced 10.08.2015

(Diwan Singh Chauhan) Member

(B.M. Bedi) Judicial Member

(Nawab Singh) President

CL