Haryana

StateCommission

A/566/2019

THE ORIENTAL INSURANCE COMPANY LTD. AND ANOTHER - Complainant(s)

Versus

BALRAJ - Opp.Party(s)

ALANKRIT BHARDWAJ

05 Jan 2023

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

 

                                                      First Appeal No.566 of 2019

                                                 Date of Institution: 11.06.2019

                                                          Date of final hearing: 05.01.2023

Date of pronouncement: 13.02.2023

 

1. The Oriental Insurance Company Limited through its Incharge/Manager, Oriental House, A-25/27, Asaf Ali Road, New Delhi-110002.
2. The Oriental Insurance Company Limited through its Regional Manager, 2^nd Floor, LIC Building, Jagadhari Road, Ambala Cantt. 133001.
3. The Oriental Insurance Company Limited through its Branch Manager, Division Office, R-204, Model Town, Sonipat-131001.
4. The Oriental Insurance Company Limited through its Branch Manager, Shyam Complex, Bahadurgarh-124507.
5. The Oriental Insurance Company Limited through its Branch Manager, Near D-Park, Model Town, Delhi Road, Rohtak-124001.

…..Appellants

Versus

Balraj son of Sh. Om Parkash, age 43 years, resident of 692/21, Kalish Colony, Rohtak

…..Respondent

CORAM:    S.P. Sood, Judicial  Member

                    Suresh Chander Kaushik, Member

                   

Present:-    Mr. Alankrit Bhardwaj, Advocate for the appellants.

                   Mr. Gaurav Gupta, Advocate for the respondent.

 

                                                 ORDER

S P SOOD, JUDICIAL MEMBER:

          The present appeal No.566 of 2019 has been filed against the order dated 22.04.2019 of the District Consumer Disputes Redressal Forum, Rohtak (In short Now “District Commission”) in complaint case No.469 of 2017, which was allowed.

2.       The brief facts of the case are that on 09.12.2016 complainant purchased livestock (cattle) policy of his four buffalos at District Rohtak vide policy No.1069927 for a period of one year and paid Rs.100/- to the agent of OP No. 5 and remaining amount was paid by the Haryana Govt. On 06.12.2016, opposite party (OP) Nos. 4 & 5 got  conducted medical tests of four buffalos of complainant from government veterinary doctors at Rohtak and issued the Health Evaluation Certificate and affixed identity tags bearing No.160018/17474004 in the right ear of the said buffalos. OP No.3 considered sum insured value of one buffalo as Rs.60,000/- and issued livestock (cattle) policy to the complainant. On 13.12.2016 at about 09:30 am one buffalo of complainant died due to trypanosomiasis, which was purely a natural death. He informed about this development to the officials of OP No.5 on 14.12.2016 who got conducted postmortem of deceased buffalo. He visited office of OP Nos.3 and 5 on 14.12.2016 and 16.12.2016 seeking the claim of deceased buffalo, but OP No. 3 did not pay any heed. OP No. 1 & 2 had already cleared the claim but OP No. 3 had ignored the same. Faced with this situation, he got issued legal notice dated 22.07.2017 to OPs but all in vain. Thus, there being deficiency in service on the part of the O.Ps, hence the complaint.

3.      In its written version, OPs raised preliminary objections with regard to alleged deficiency in service, for want of jurisdiction, complainant being estopped by his own act and conduct and misjoinder. On merits, OPs submitted that as per report of the investigator the alleged buffalo was insured on 09.12.2016 and died on 13.12.2016 which clearly shows that already ailing buffalo was got insured with a view to fetch false claim. The tag was inserted after the death of said buffalo and claim of the complainant was repudiated as “No Claim”.  Thus, there being no deficiency in service on the part of the OPs so requested to dismiss the complaint.

4.      After hearing both the parties, the learned District Commission, Rohtak has allowed the complaint vide order dated 22.04.2019, which is as under:-

“In the present case, the opposite parties have failed to prove that the buffalo was already suffering from any disease at the time of insurance and this fact has not been mentioned anywhere in the investigation report or in the post mortem report issued by the concerned Veterinary Surgeon. Moreover the Veterinary Surgeon had issued a certificate which is health cum valuation certificate regarding the buffalo on 09.12.2016 which is Ex.C8. This document itself proves that the buffalo was hale and hearty on 09.12.2016.  Hence the claim has been repudiated on false and flimsy grounds.

8. In view of the above, complaint is allowed and opposite parties are hereby directed to pay the cost of buffalo i.e. Rs.60000/-(Rupees sixty thousand only) as mentioned in documents Ex.C9 and Ex.C10 alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 16.08.2017 till its realization and shall also pay Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision.”

5.      Feeling aggrieved therefrom, O.Ps-appellants have preferred this appeal.

6.      This arguments have been advanced by Sh.Alankrit Bhardwaj, the learned counsel for the appellants as well as Sh. Gaurav Gupta, the learned counsel for respondent. With their kind assistance the entire record of appeal as well as the original record of the District Commission including whatever the evidence has been led on behalf of  both the parties has also been properly perused and examined.

7.      Learned counsel for the appellant argued that on 09.12.2016 livestock (cattle) policy was issued to the complainant and as per terms and conditions of the policy claim would not be entertained in the event of death due to disease(s) contracted within 15 days of commencement of risk. The buffalo of the complainant died on 13.12.2016 due to trypanosomiasis and as per the research of institute of International Cooperation in Animal Biologics Research 2018 animal trypanosomiasis was a parasitic disease that causes serious losses in livestock from anemia, loss of conditioned effect on reproduction. As per report of the investigator the alleged buffalo was insured on 09.12.2016 and died on 13.12.2016 which clearly shows that ailing buffalo was got insured with a view to fetch false claim and such the claim of insured was rightly repudiated as “No Claim”. The complainant was not entitled for the claim amount as prayed for. So learned District commission fell an error while allowing this complaint.

8.      Learned counsel for the respondent argued that before issuance of the policy, medical examination of buffalo was got conducted from registered veterinary doctors who had duly issued the Health Evaluation Certificate and after the said medical examination appellants have issued the policy. Learned District Commission has rightly allowed the complaint of the complainant and prayed for dismissal of the appeal.  

9.       It is undisputed that the buffalo died during the subsistence of the policy.  It is also undisputed that   on 09.12.2016 veterinary doctor had issued health certificate regarding the said buffalo of complainant.  It is also not disputed that after death, the post mortem was conducted by the veterinary surgeon on 14.12.2016 and during post mortem the doctors have found that the buffalo had died due to trypanosomiasis i.e.natural death.  Since, the buffalo was died during the subsistence of the policy, why appellants have repudiated the claim of the complainant.     Since the doctor himself issued the health certificate to the complainant regarding his buffalo on 09.12.2016, it means that on that date, the buffalo of the complainant was hale and hearty.  The appellants have wrongly rejected the claim of the complainant. The learned District Commission has rightly allowed the claim of the complainant. The learned District Commission had committed no illegality while passing the order dated 22.04.2019.  The appeal is also devoid of merits and stands dismissed.

10.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant-respondent against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

11.    A copy of this order be provided to all the parties free of cost as mandated by the Consumer Protection Act, 2019. This order be uploaded forthwith on the website of the Commission for the perusal of the parties.

12.    Application(s), pending, if any, stands disposed off in terms of the aforesaid order.

13.    File be consigned to record room.

 

13^th February, 2022            Suresh Chander Kaushik            S. P. Sood                                                                Member                                             Judicial Member    

S.K

(Pvt. Secy.)