DISTRICT CONSUMER DISPUTES REDRESSAL FORUM: BHADRAK
Dated the 30th day of October, 2018
Present 1. Shri Raghunath Kar, President
2. Shri Basanta Kumar Mallick, Member
3. Afsara Begum, Member
C.D Case No. 50 of 2016
Sri Satya Narayan Rout
S/o Late Judhistir Rout
At/Po: Deopada
Ps: Bhandaripokhari
Dist: Bhadrak
……………………. Complainant
(Versus)
1. Branch Manager, The New India Assurance Co. Ltd.
At/Po/Dist: Bhadrak
2. The Secretary, Naami SCS Ltd.
At/Po: Naami
Via: Manjuri Road
Ps: Bhandaripokhari
Dist: Bhadrak …………………………..Opp. Parties
Advocate For the Complainant: Sri B. Sahoo (B)
Advocate For the OP No. 1: Sri A. Chand
Advocate For the OP No. 2: Sri B. M. Pati & Others
Date of hearing: 24.07.2017
Date of order: 30.10.2018
SRI RAGHUNATH KAR, PRESIDENT
That, the complainant has alleged against the OP having aggrieved with his deficiency of service caused towards him. The complainant purchased one cow bearing tag No. NIA/550800/20933 being financed by the OP No. 2 for Rs 30,000/- on dt. 20.06.2014 and according to the condition of sanction the cow was insured by the OP No. 1 through the financer/OP No. 2 bearing policy No. 55080147140400000051 upon payment of necessary premium from the loan account of the complainant. The above cow of the complainant was seen ill on dt. 03.09.2014 and it was treated up to dt. 10.09.2014 and during treatment the cow died. After the death of the cow the PM was conducted by the veterinary doctor of Bhandaripokhari Veterinary Center and reported the death was caused due to illness. After the death of the insured cow as above, the claim was intimated through the OP No. 2 for claiming the insurance benefit from the OP No. 1. After receipt of the claim from the OP No. 2, the OP No. 1 asked the bank to supply the policy number again and the same was also sent in due course immediately to the OP No. 1 on dt. 25.09.2014 through mail followed by Regd. post dt. 22.11.2014. After getting the post mortem report from the veterinary centre, again the claim was lodged before the OP No. 1 on dt. 25.02.2015. But after a long lapse of time the insurance office/OP No. 1 had intimated on dt. 15.06.2015 that the risk of the policy is beyond the policy condition for which the OP No. 1 rejected the claim. The OP No. 2 is being the financer asking for payment of the loan without collecting the insurance claim for which the complainant is facing mental agony. The complainant went to the office of the O.Ps several times and he had spent a huge amount for collecting PM report and other claim materials and suffered huge expenses in to the matter. The O.Ps are not responding the complainant and as such he suffered financial loss. The O.Ps have not paid any heed to the claim of insurance and the self same act is a deficiency in service under provision of CP Act.
The cause of action of this dispute arose when the OP refused to settle the claim of insurance on 15.06.2015 and demanded to pay off the loan amount within the jurisdiction of this Forum.
The complainant has sought for the following reliefs.
The OP may be directed to pay the claim amount to the complainant, the OP may be directed to pay compensation of mental agony and suffering as well as the cost of the litigation which is amount to Rs 50,000/- in aggregate.
On the other hand the OP No. 1 has appeared through his advocate in the Forum and filed the written version as follows. That, there is no deficiency of service as well as the case is not maintainable in present Forum. The OP has also denied that the complainant is not a consumer. The complainant and the OP No. 2 having colluded filed the present dispute case in order to defraud as OP No. 1. The complainant and OP No. 2 suppressing the material facts manager to obtain policy from this O.Ps who has no acknowledge that the insured cow was suffering from some diseases which tentamounts to violation of policy condition and as such the claim of the complainant is baseless and unfounded. The complainant and OP No. 2 taking the veterinary doctor to their confidence could manage to obtain the policy in an unfair means and as such the dispute case is liable to be dismissed. As per the admission of the complainant in Para No- 5 that the cow was suffering from illness from 03.09.2014 and treated up to 10.09.2014 and in such backdrop the proposal for insurance was submitted with this OP on 04.09.2014, after the commencement of suffering is nothing but a criminal conspiracy to cheat the Govt. of India subsidiary i.e. this OP.
That this OP states that it has been categorically written in the policy as hereunder. “Death due to diseases contracted prior to and within 15 days of commencement of risk are not payable to for non scheme cattle”. This OP has rightly repudiated the claim as it is not covered under the policy as per terms of policy agreed between the parties to a contract. That it further transpires from the documents that the proposal was submitted for insurance on 04.09.2016 and policy covers the risk from 05.09.2016 to 04.09.2017 subject to the condition mentioned above. The averments made in Para No- 6 of the petition to the effect that the OP No. 2 is the promoter of this OP is baseless. The complainant has taken finance from the OP No. 2 and purchased the cow on 20.06.2014 but the proposal was sent for insurance on 04.09.2014 with V.S report and the cow died on 10.09.2014. Besides the above fact complaint petition and other documents show that the OP No. 2 is in hand in gloves with the complainant and managed to take the veterinary doctor to his confidence and foisted this false and fabricated baseless case to swindle the Govt. of India subsidiary with an ill intention to defraud this OP who is prepared to pay the genuine claims only. Hence he has prayed for the dismissal of this complaint.
The OP No. 2 has filed an objection against the complaint that it is not maintainable as well as it has no cause of action. The alleged cow was issued by the OP No. 1 through OP No. 2. The said cow was found ill on dt. 03.09.2014. The treatment was continued till the dt. 10.09.2014. According to the P.M report the cause of death was due to illness, that after death of the insured cow, the claim was intimated through the OP No. 2 for claiming the insurance benefit from the OP No. 1, that after receipt of the claim from the OP No. 2 the OP No. 1 asked to the bank to supply the policy and same supplied on 25.09.2014, and on 15.06.2015 that risk of the policy is beyond the policy condition for which OP No. 1 rejected the claim are all not correct and based on get up story.
The OP No. 2 has also stated that he and the OP No. 1 have caused no deficiency of service towards the complainant. He has denied all the allegations made against him by the complainant in his complaint. He has further prayed for dismissal of this complaint.
The O.Ps filed the following documents as per the list in shape of Xerox copies.
1. Insurance policy- 2 sheets.
2. One letter issued by B.B.C.C Bank Ltd.- 1 sheet.
3. One letter to B.B.C.C. Bank Ltd. on 11.09.2014- 1 sheet.
4. One letter to Secretary Naami S.C.S Ltd. issued by the New India Assurance Co. Ltd.- 1 sheet.
5. Livestock Insurance- 1 sheet.
6. One letter to New India Assurance Co. Ltd. issued by Tusar Kanta Das, Advocate Bhadrak- 2 sheets.
OBSERVATION
We have already perused the complaint as well as the documents and the written version filed by the complainant as well as the O.Ps. The complainant initiated an insurance policy under the authorization of the OP No. 1 vide policy No- 55080147140400000051. The complainant has purchased one cow bearing tag No- NIA/550800/20933 being financed by the OP No. 2 for Rs 30,000/- on dt. 20.06.2014 and according to the condition of sanction the cow was insured by the OP No. 1 through the financer/OP No. 2 being policy No- 55080147140400000051 upon payment of necessary premium from the loan account of the complainant. The above cow of the complainant was seen ill on dt. 03.09.2014 and it was treated up to dt. 10.09.2014 and during treatment the cow died. After the death of the cow the PM was conducted by the veterinary doctor of Bhandripokhari Veterinary Center are reported the death was caused due to illness. After the death of the insured cow as above, the claim was intimated through the OP No. 2 for claiming the insurance benefit from the OP No. 1. After receipt of the claim from the OP No. 2, the OP No. 1 asked the bank to supply the policy number and the same was also sent in due course immediately to the OP No. 1 on dt. 25.09.2014 through mail followed by Regd. post dt. 22.11.2014. After getting the post mortem report from the veterinary center, again the claim was lodged before the OP No. 1 on dt. 25.02.2015. But after a long lapse of time the insurance officer/OP No. 1 had intimated on dt. 15.06.2015 that the risk of the policy is beyond the policy condition for which the OP No. 1 rejected the claim.
On the contrary the O.Ps have stated some absurd averments in their respective written versions, which are not sustainable in the eyes of law. The complainant found that the cow was ill on 03.09.2014. The said cow was continues to be treated till 10.09.2014 and on the very day the cow died. The PM was conducted veterinary doctor of Bhandripokhari Veterinary Center where the cow died. According to the PM report the cow died at the time of treatment. The claim was intimated through the OP No. 2 for claiming insurance benefits from OP No. 1, after receipt of the claim from the OP No. 2 the OP No. 1 asked to the bank to supply the policy and same supplied on 25.09.2014, and on 15.06.2015 that risk of the policy is beyond the policy condition for which OP No. 1 rejected the claim. It is a fact that the complainant has obtained a policy bond from the OP No. 1 which is genuine and correct. The complainant has informed the matter before the OP No. 2 to obtain the claim amount. He has not caused any delay for informing the matter. The complainant has also observed all the procedures for obtaining the claim amount, but it is a matter of fact he has been deprived of that benefits. He has come to this Forum with clean hands. The OP No. 1 has caused deficiency of service towards the complainant and repudiated his claim. The claim of the complainant is legitimate. The complainant has not committed delay, rather it is a continues process. So this complaint free from delay. Hence it is ordered;
ORDER
The complaint be and the same is allowed against both the O.Ps. The OP No. 1 is directed to pay cost of the cow which is amount Rs 30,000/-. Both the O.Ps also directed to pay Rs 3,000/- towards mental agony and suffering, and to pay Rs 2,000/- towards cost of the litigation, to the complainant. The OP No. 1 is further directed to carry out this order within 30 days on receipt of the same.
This order is pronounced in the open Forum on this day of 30th October, 2018 under my hand and seal of the Forum.
