Punjab

Patiala

CC/14/271

Sukhpal Singh - Complainant(s)

Versus

Bajaj Allianz G I C - Opp.Party(s)

Sh Karamjit Singh

25 Mar 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PATIALA.

 

                                        Complaint No. CC/14/271 of 30.09.2014.

                                        Decided on:        25.03.2015.

 

Sukhpal Singh, aged 40 years S/o. Sh. Mohinder Singh, resident of Village Dargapur, Tehsil Nabha, Distt. Patiala

                                                                            Complainant.

                                                Versus

Bajaj Allianz General Insurance Company Ltd., Branch Office SCO-147, Feroze Gandhi Market, Ludhiana, through its Branch Manager.

                                                                           Opposite  party.

Complaint under Section 12 of the Consumer Protection Act.

 

                                      QUORUM

 

                                      Sh. D.R. Arora, President.

                                      Smt. Neelam Gupta, Member.

                                     

Present:                          Sh. K.S. Thind counsel for the complainant.

Sh. Amit Gupta counsel for the O.P.         

                                                 

ORDER

 

D.R. ARORA:

1.       The complainant had got his 25 cows insured with the O.P vide policy no.OG-13-1203-5003-00000022 for the period 26.12.2012 to 25.12.2015 and the cows were given the identification marks vide chips no.900108000011101 to 900108000011126 and tag no.28475 to 28485 and 28487 to 28500 for the sum insured of Rs.13,75,000/-  i.e. each cow for Rs.55,000/-.

2.       Before issuing the insurance policy a veterinary health certificate of the cows was issued by M/S. Guru Ramdas Chipping Company Regd. Gurdev Enclave, Sanouri Adda, Patiala.

3.       One cow bearing micro chip no.900108000011126 and tag no.28475 HFC breed had died on 01.11.2013, regarding which the complainant had informed the O.P through its Manager Sh. Gurpreet Singh on 01.11.2013 at about 9 A.M, who had deputed Dr. P.S. Mann to conduct the medical examination/post mortem on the dead cow. Investigation regarding the death of the cow was conducted by the O.P but the O.P failed to pay the claimed amount. On 28.02.2014, the O.P informed the complainant vide its letter that the claim had been repudiated and closed as “No Claim”. At this the complainant got the O.P served with a legal notice dated 05.05.2014 got sent through Sh. Baljit Singh Josan, Advocate but no reply thereto was sent by the O.P. The act of the O.P in not having disbursed the claim amount resulted into the harassment and mental agony experienced by the complainant. Accordingly, the complainant brought this complaint against the O.P. under Section 12 of the Consumer Protection Act, 1986 (for short the Act) for a direction to the O.P to pay the claim amount of the insured cow and to pay the complainant a sum of Rs.1 Lac by way of compensation on account of harassment and mental agony experienced by him.

4.       On notice, the O.P appeared and filed the written version. It is admitted by the O.P that the complainant had got his 25 cows insured with the O.P as per veterinary health certificate dated 26.12.2012 vide policy no.0G131203500300000022 for the period 26.12.2012 to 25.12.2015 , including the cow in question bearing micro chip no.900108000011126 and tag no.28475.

5.       It is also admitted by the O.P that the intimation regarding the death of one cow was received by the O.P, who had deputed Dr. P.S. Mann to conduct the medical examination and PMR on the cow. Thereafter the O.P had deputed Er. N.S. Dhillon for investigation, who also submitted the report. The claim of the complainant being not payable, the same was repudiated by the competent authority and the complainant was duly informed about the same vide letter dated 28.02.2014 containing the grounds therefor “1. That as per the investigation and the video graphic received it is observed that Ear Tag was never ever being allowed to put in the ear of animal to be insured. Further it has also been observed that no any tag was found in the ear of died animal. The ear tag as submitted was applied with the help of applicator after the death of the animal by your side to take undue benefit of the Policy in hand. 2. The description of the alleged dead animal completely mismatch with the Health Certificate records of the animal insured with us. Given the facts put on records by the Investigator it is observed that the claim is being pursued on fictitious grounds to take undue advantage of the Ear Tag & Policy in hand which warrants actions under set rules & laws of the Country”. The O.P has controverted the other allegations of the complaint. It  has also raised certain legal objections, interalia, that the Forum does not have jurisdiction to try the complaint as the policy was obtained by the complainant from the branch office of O.P at Ludhiana and the entire communication was made by the complainant with the O.P at Ludhiana and that the complainant indulges in commercial activity and therefore same is not covered under the Act. Ultimately, it was prayed to dismiss the complaint.

6.       In support of his complaint, the complainant produced in evidence Ex. CA, his sworn affidavit along with Ex. C1 to Ex. C7 and the complainant closed his evidence. On the other hand, on behalf of the O.P, its counsel tendered in evidence, Ex. OPA, the sworn affidavit of Sh. Gurpreet Singh, Assistant Manager of the O.P at Ludhiana, Ex. OPB, the sworn affidavit of Er. N.S. Dhillon, the Investigator of the O.P, Ex. OPC, the sworn affidavit of Sh. Navjeet Singh, Senior Legal Executive, Bajaj Allianze General Insurance Co. Ltd., SCO-14, 4^th Floor, Sector 5, Panchkula along with documents Ex. OP1 to Ex. OP15 and closed its evidence.

7.       The parties failed to file the written arguments. We have heard the learned counsel for the parties and gone through evidence on record.

8.       Ex.C1 is the letter dated 28.2.2014 written by the Op to the complainant  in respect of claim No.OC-14-1203-5003-00000068 and policy No.OG-13-1203-5003-00000022 and informed him,

• “ That as per the Investigation and the Video graphic received it is observed that Ear Tag was never ever being allowed to put in the ear of animal to be Insured. Further it has also been observed that no any tag was found in the ear of died animal. The Ear tag as submitted was applied with the help of applicator after the death of the animal by your side to take undue benefit of the Policy in hand.
• The description of the alleged dead animal completely mismatch with the Health Certificate records of the animal Insured with Us. Given the facts put on records by the Investigator it is observed that the claim is being perused on fictitious grounds to take undue advantages of the Ear Tag & Policy in hand which warrants actions under set rules & law of the Country

In view of above observations & discrepancies, kindly be intimated that the said claim is being repudiated and accordingly closed as “No Claim” at our end without any further correspondence being entertained at our end”

9.       Thus, it would appear that the Op filed the claim of the complainant as ‘No Claim’ firstly on the ground that the ear tag was never allowed to be put in the ear of the dead animal and which was applied with the help of the applicator after the death of the animal and secondly on the ground that the dead animal completely mis matched with the health certificate of the animal insured.

10.     First of all, we make a comparison of the features of the insured cow in question bearing tag No.28475 with the help of the veterinary certificate Ex.C3 and the features noted by the Veterinary Surgeon namely Dr.P.S.Mann in his spot inspection report Ex.OP4. The features of the insured cow bearing tag No.28475 in Ex.C3 have been given as under:

1.       Colour                  black & white

2.       Horn                     Dehorned

3.       Forehead              white

4.       Colour of ears      black

5.       Udder                             white

6.       SOT                     white

The similar features have been noted by the Veterinary Surgeon in his report Ex.OP4.Therefore, one fails to understand as to how it could be said that the dead cow completely mismatched with the insured cow. Surprisingly Dr.N.S.Maan, Veterinary surgeon in his said inspection report,Ex.OP4 has clearly written, “ In my opinion the dead cow is the same insured animal” This leaves no amount of doubt to say that the dead cow was the insured one with the OP.

11.     As regards the ground taken up by the  OP for filing the claim as “No Claim” that the tag was never allowed to be worn by the dead cow and that the same was applied with the help of the applicator after the death of the cow, the op has not lead any evidence in this regard having produced the photograph of the dead cow.  The report Ex.OP12, submitted by the Investigator Er.N.S.Dhillon is attached with the photo copies of the photographs which are black and white and no effort was made to highlight the tag worn by dead cow and rather no original photograph of the dead cow is produced. Any statement to have made by the Investigator Er. N.S.Dhillon in his sworn affidavit Ex.OPB that one Mr.Jaswinder Singh had told him that the insured had put a tag in the ear of the dead cow with the help of the applicator can not be of any avail to the Op firstly, because the OP has not produced in evidence the sworn affidavit of Mr.Jaswinder Singh and secondly , as discussed earlier, the photograph of the dead animal bearing the tag has not been produced and thirdly  the very tag has not been produced for being examined to appreciate the plea of the OP because in case the tag had been applied afresh the condition of the same would have spoken for itself. We are therefore, of the considered view that the OP has repudiated the claim of the complainant without any basis because the identity of the dead animal stands admitted in the spot inspection report made by Dr.P.S.Mann Veterinary surgeon and Physician Dog  Clinic Shastri Nagar,Ludhiana in his report Ex.OP4.

12.     As regard the objections raised by the OP that the Forum lacks territorial jurisdiction, it is suffice to note that live stock is maintained by the complainant in village Dargapur Tehsil Nabha District Patiala i.e. the subject matter of the insurance policy falls within the jurisdiction of this Forum. The inspection of the dead cow was also made by Dr.P.S.Mann in village Dargapur, District Patiala. Moreover, the claim of the complainant was repudiated by the OP vide letter dated 28.2.2014,Ex.C1, which was received by the complainant at his address of village Dargapur Tehsil Nabha District Patiala and therefore, this Forum has got the jurisdiction to try the complaint.

13.     As an upshot of our aforesaid discussion, we accept the complaint and direct the OP to disburse the claim of the complainant regarding the insured amount of Rs.55000/- with interest @9% per annum from the date of the repudiation of the claim i.e.w.e.f.28.2.2014 till final payment. In view of the facts and circumstances of the case the complaint is accepted with costs assessed at Rs.4000/-.The order be complied with by the OP within one month on receipt of the copy of the order.

Pronounced.

Dated: 25.03.2015.

 

                                                Neelam Gupta                D.R. Arora

                                                Member                         President