Baljeet Singh aged 36 years s/o S.Mager Singh, resident of House no.44, Kasabad, Tehsil and District Ludhiana.

.…Complainant

Versus 

1. ICICI Lombard General Insurance Company Ltd. ICICI Bank Towers, Plot no.12, Financial District, Nanakaramguda, Gachibowli, Hyderabad, Andhra Pradesh, through its Director/M.D.

2. ICICI Lombard General Insurance Company Ltd., Mall Road, Ludhiana, through its Manager.

…..Opposite parties 

COMPLAINT UNDER SECTION 12 OF THE

CONSUMER PROTECTION ACT, 1986.

Quorum:    Sh.R.L.Ahuja, President

                    Sh.Sat Paul Garg, Member

                    Smt.Babita, Member

Present:     Sh.Navdeep Sharma, Advocate for complainant.

                   Sh.Rajeev Abhi, Advocate for OPs.

ORDER

 (SAT PAUL GARG, MEMBER)

1.               Present complaint under Section 12 of The Consumer Protection Act, 1986 (herein-after in short to be referred as ‘Act’) has been filed by Sh.Baljeet Singh s/o S.Mager Singh, resident of House no.44, Kasabad, Tehsil and District Ludhiana (herein-after in short to be referred as ‘complainant’) against ICICI Lombard General Insurance Company Ltd. ICICI Bank Towers, Plot no.12, Financial District, Nanakaramguda, Gachibowli, Hyderabad, Andhra Pradesh, through its Director/M.D and others (herein-after in short to be referred as ‘OPs’)- directing them to make the payment of the claim amount of Rs.65,333/- to the complainant besides compensation to the tune of Rs.25,000/- for the physical as well as mental pain, agony, harassment and humiliation, to pay Rs.5000/- as litigation expenses to the complainant alongwith any other additional or alternative relief to which, the complainant may be found entitled.

2.                Brief facts of the complaint are that complainant availed Insurance Policy no.4057/72283306/00/QQQ for his cattle from the OPs against TAG no.335229 allotted to the cattle of the complainant. However unfortunately the cattle of the complainant suffered from Foreign Body Syndrome (Traumatic Raticulopericarditis, TRP) ingest foreign objects and due to the said disease the cattle of the complainant died on 30.6.14. There was no negligence or carelessness on the part of the complainant and his family in maintaining the said cattle. The concerned doctor Dr.Parshant Singla, Veterinary Officer, Civil Vety Hospital, Ludhiana in his report D. No.46 dated 4.9.14 has also opined that there is no fault on the part of the complainant or his management in the death of the cattle. He found the case to be genuine and recommended for claim. After the death of the cattle the complainant lodged claim with the Ops, vide Cattle Insurance Claim no.GEN000126356. However, to the utter shock and surprise of the complainant, the OPs have repudiated the claim of the complainant, vide their letter dated 8.8.14 wrongly holding that the death of the cattle occurred due to ‘Mismanagement of farm or Stable”. There was no mismanagement or Stable on the part of the complainant, as it is very much clear from the report of the expert i.e. the concerned doctor. The OPs have repudiated the claim of the complainant in a wrongly and illegal manner in order to deprive the complainant of his rightful claim. Claiming the above act as deficiency in service on the part of the OPs, the complainant has filed this complaint.

3.                On notice of the complaint, OPs appeared through their counsel and filed written statement taking preliminary objections that the present complaint is barred u/s 26 of the Consumer Protection Act; the present complaint is not maintainable since immediately on the receipt of the claim it was duly registered, entertained and processed. The complainant had obtained the insurance policy from the OPs, which is a contact in itself and the parties are bound by the terms and conditions of the policy. It is one of the condition in the insurance policy that ‘company shall not be liable under the policy for compensating the insured for any loss or damage in the following events:-

Exclusions:

Death dud to mismanagement of farm or stable”

After the receipt of the documents from the complainant and after making through investigation and after the receipt of the report of the said investigator and after scrutinizing the documents placed in the claim file and after applying the mind by the officials of the OPs, the claim of the complainant was repudiated as no claim by the OPs, vide their letter dated 8.8.14 on the grounds that the death of the cattle has occurred due to mismanagement of farm and negligence and the said cause of death is excluded from the coverage under the policy wording which is reproduced as under:-

“Company shall not be liable under the policy for compensating the insured for any loss or damage in the following events;-

Exclusions:

Death due to mismanagement of farm or stable”.

                   There is as such no deficiency in service of negligence on the part of the OPs. Complicated question of law and facts are involved, which requires elaborate evidence both oral and documentary and it is only the civil court of competent jurisdiction who can try and decide the present complaint. The complaint cannot be decided by this Forum in a summary manner; the complainant is estopped by his own act and conduct from filing the present complainant, since the complainant is not coking to the Forum with clean hands and has concealed the material facts from this Forum. On merits, denying the contents of all other paras of the complaint, OPs prayed for the dismissal of the complaint.

4.                Ld. Counsel for complainant has adduced the evidence by way of duly sworn affidavit of complainant Sh.Baljeet Singh Ex.CA, wherein the same facts have been reiterated as narrated in the complaint and affidavit of Dr.Prashant Single, Veterinary Officer, Civil Veterinary Hospital, Village Bagga Khurd, District Ludhiana Ex.CB and also attached documents Ex.C1 to Ex.C16. On the other hand, Ld. Counsel for OPs has adduced the evidence by way of duly sworn affidavit of Smt.Meenu Sharma, Manager, Legal, ICICI Lombard General Insurance Co. Ltd. SCO 501, Sector 70, Mohali and its Branch Office at The Mall, Ludhiana Ex.RA, wherein, the same facts have been reiterated as narrated in the written statement and attached affidavit of Sh.Daljinder Singh, Surveyor and Investigator (Cattle Insurance) s/ol Sh.Gurmeet Singh, r/o Dalip Nagar, ward no.12, Mandi Gobindgarh Ex.RB and also attached documents Ex.R1 to Ex.R18.

5.                Case was fixed for arguments. Ld. Counsel for complainant filed written arguments, wherein, reiterating the facts of the complaint averred that the complainant has fully proved his case by way of oral as well as documentary evidence. In order to prove his case, the complainant himself stepped into the witness box as Ex.CW1 and exhibited the documents Ex.C1 to Ex.C16 and also examined Dr.Prashant Singla as CW2 who had deposed that there is not negligence or carelessness on the part of the complainant, which resulted into the death of the cattle and he has further recommended that the case of the complainant is fit for the grant of claim. Even the said doctor has proved the certificate/letter issued by him Ex.C8. The Ops have miserably failed to prove any negligence or mismanagement on the part of the complainant. In these circumstances the case of the complainant stands fully proved.

6.                Ld. Counsel for OPs filed written arguments, wherein, reiterating the same facts as narrated in the written statement, at the point of arguments submitted that Insurance policy is a contract in itself and the parties are bound by the terms and conditions of the policy. It is one of the condition in the policy that “company shall not be liable under the policy for compensating the insured for any loss or damage in the following events:

Exclusions:-

Death due to mismanagement of farm or stable”

                        The complainant has not taken the care of cattle in question and the cattle has died on account of carelessness and negligence of the complainants due to foreign body syndrome (Traumatice Raticulopericarditis, TRP), which is not covered under the policy obtained by the complainant from the OPs. Had the complainant had taken due care of the cattle then there is no occasion of ingest of the foreign object in the body of the cattle in question and the cattle would not have died due to foreign body syndrome. The claim of the complainant was repudiated on 8.8.14 and the alleged certificate if any, is obtained after the repudiation of the claim by the OPs on 4.9.14 and as such the alleged certificate if any has got no evidential value and is procured one for the purpose of filing the present complaint. Had Dr.Prashant Singla is of the alleged opinion he would have stated the said facts in claim form for cattle insurance dated 4.7.14 submitted by him to the Ops as well as in the postmortem certificate submitted on the prescribed proforma of OPs dated 4.7.14 but there is such observation of doctor as alleged by the complainant in the alleged certificate dated 4.9.14 submitted by Dr.Prashant Single. The claim of the complainant as such has been repudiated on the grounds which are legal, valid, enforceable and are in accordance with the terms and conditions of the policy. There is not deficiency in service on the part of the OPs. Ld. counsel for Ops has relied upon the judgements passed in cases titled as Ind Swift Ltd. Vs New India Assurance Co. Ltd.-2012 (IV) CPJ 148 by Hon’ble National Commission, New Delhi, Usha Sharma Vs New India Assurance Co. Ltd.-2012 (I) CPJ 488 passed by Hon’ble National Commission, New Delhi, United India Insurance Co. Ltd. Vs Harchand Rai Chandan Lal- 2004 (IV) 15 passed by Supreme Court, Deokar Exports Pvt. Ltd. Vs New India Assurance Co. Ltd.- 2009 (I) CPJ 6 passed by Supreme Court.

7.                We have gone through the pleadings of the complainant as well as defence taken by the OPs and gone through the written arguments submitted on behalf of both the parties and entire record placed on file.

8.                It is evident that the complainant availed Insurance policy bearing no.4057/72283306/00/QQQ for his cattle from the OPs against TAG no.335229. Though the Post Mortem report issued by Dr.Prashant Singla Ex.C6 reveals that cattle died due to Foreign Body Syndrome (Traumatic Raticulopericarditis, TRP) and modified this Post Mortem report further through Ex.C8, when the case was explained to doctor and according to which “Foreign body Syndrome (Traumatic Raticulopericarditis, TRP) is most common in nature dairy cattle. Cattle commonly ingest foreign objects because they do not discriminate against metal materials in feed and do not completely masticate feed before swallowing. This disease is common when green chop, silage and hay are made from fields that contain old rusting fences, or baling wire or when pastures are on areas or sited where building have recently been constructed, burned or torn down. The grain ration may also be a source due to accidental addition of metal. Honey comb like reticular mucosa traps sharp objections, Contraction of the reticulum promote penetration of the wall by the foreign object. Compression of the ruminoreticulum by the uterus in late pregnancy and straining during partition increase the likelihood of an initial penetration of the reticulum and may disrupt the adhesions caused by earlier penetration. The objects can penetrate the diaphragm and can enter pericardial sac causing pericarditis.” Unfortunately the cattle of the complainant suffered from Foreign Body Syndrome (Traumatic Raticulopericarditis, TRP) ingest foreign objects and due to the said disease the cattle of the complainant died on 30.6.14. There was no negligence or carelessness on the part of the complainant and his family in maintaining the said cattle. The concerned doctor Dr.Parshant Singla, Veterinary Officer, Civil Vety Hospital, Ludhiana in his report D. No.46 dated 4.9.14 has also opined that there is no fault on the part of the complainant or his management in the death of the cattle. He found the case to be genuine and recommended for claim. After the death of the cattle the complainant lodged claim with the Ops, vide Cattle Insurance Claim no.GEN000126356.

9.                Sequel to the above discussion, the present complaint is allowed, because the OPs have not been able to explain with cogent reason that there was mismanagement of the farm and stable. OPs are directed to settle and pay the claim of the complainant as per the terms and conditions of the policy. Further OPs are directed to pay Rs.2500/-(Two thousand five hundred only) as compensation and litigation expenses compositely assessed to the complainant. Order be complied within 30 days of receipt of the copy of the order, which be made available to the parties, free of costs. File be consigned to record room.

                   (Babita)                          (S.P.Garg)                      (R.L.Ahuja)

                   Member                           Member                         President

Announced in Open Forum.

Dated:28.04.2015 

Hardeep Singh