Punjab

Rupnagar

CC/14/142

Jasvir Singh - Complainant(s)

Versus

ICICI Lombard General Insurance - Opp.Party(s)

Sh. Lachhmi Singh Chandel, Adv

13 May 2015

ORDER

ORDER

                             MRS. NEENA SANDHU, PRESIDENT

                   Sh. Jasvir Singh has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’ only) against the Opposite Parties (hereinafter referred to as ‘the O.Ps.’ only) praying for the following reliefs:-

i)       To pay the insured amount of Rs.50,000/-,

ii)      To pay Rs.20,000/- on account of mental agony & physical harassment caused to him,

iii)     To pay Rs.10,000/- as litigation expenses,

iv)     To pay interest @ 18% on the above said amounts w.e.f. the date of death of the cow till realization,

v)      To award any other relief, which this Forum may deem fit, in the interest of justice.

 

2.                In brief, the case of the complainant is that he had purchased 6 cows after obtaining loan from the O.P. No. 2. At that time, the O.P. No. 2 insisted him to get insured the said cows from the O.P. No. 1. Accordingly, he got insured the cows from the O.P. No. 1 for the sum insured of Rs. 50,000/- each, for the period from 16.01.2013 to 15.2.2016. At the time of effecting the said insurance, the O.P. No. 1, after being fully satisfied with the facts, had insured the cows and affixed the tags in their ears at his above said residence.  However,  on 17.12.2013, the cow bearing Tag No.100039744 had died. He informed about the same to both the O.Ps. and requested for payment of the claim amount as per the insurance policy. The post mortem of the said cow was conducted by the veterinary doctor and photographs indicating the ear tag were also taken by official of the insurance company. The claim intimation form alongwith the photographs, postmortem report & other documents was submitted to both the O.Ps. Thereafter, he had approached to the O.Ps., so many times, and requested to settle the claim, but to no use and finally the claim was rejected, without disclosing any ground for the same. Hence, this complaint. 

 

 3.               On being put to notice, the O.Ps. filed written statement, taking preliminary objections; that as the animal in question was not insured by the company, so the question of payment of the claim amount does not arise and that the complaint filed by the complainant being false, frivolous & vexatious is liable be dismissed with costs. On merits, it is admitted that the complainant had obtained one insurance policy No.4057/78118999 covering the cattle duly tagged vide Tag No. 10009744 for the period from 16.02.2013 to 15.2.2016 strictly subject to the terms and conditions of the policy; that he had lodged one claim alleging that the cow bearing tag No.100039744 had died on 17.12.2013 at 4.00 A.M. and that the complainant has submitted claim documents i.e. cattle claim form, post mortem certificate, treatment certificate of the cow to the insurance company. It is stated that the insurance company had deputed Sh. Gurdeep Singh, Surveyor, to assess/investigate the genuineness of the said claim. While processing the claim, it was observed that the particulars of the cattle insured vide the aforesaid tag number do not match with the particulars of health evaluation certificate submitted with the O.P., from which it stood clearly proved that the said animal was not insured under the policy, as such, his claim was repudiated vide  letter dated 07.03.2014. Rest of the allegations made in the complaint have also been denied and a prayer has been made that the same be dismissed.

 

4.                On being called upon to do so, the learned counsel for the complainant tendered affidavit of the complainant Ex. C1, photocopies of documents Ex. C2 & C3 and closed the evidence. On the other hand, the learned counsel for the O.Ps. tendered affidavit of Ms. Meenu Sharma, Legal Manager, Ex. OP1, photocopies of documents Ex. OP-2 to OP-8 and closed the evidence.

 

5.                We have heard the learned counsel for the parties and gone through the record of the file carefully.

 

6.                 At the outset, the learned counsel for the O.Ps. submitted that on perusal of the documents submitted by the complainant alongwith the claim form, it was found that the identity of the dead cow did not match with the health evaluation certificate, Ex. OP-2, issued by the O.P. No. 1, as such, the claim was repudiated vide letter dated 07.03.2014, rightly and the complaint is liable to be dismissed, with cost, being false, frivolous & vexatious.

 

7.                The learned counsel for the complainant submitted that on 17.12.2013 the insured cow bearing Tag No.100039744 had died. Postmortem of the said cow was got conducted from the veterinary doctor. Photographs indicating the ear tag were also taken by the official of the insurance company. The postmortem report & the photographs of the dead cow were submitted with the O.P. No.1 alongwith the claim form for settlement of the claim. However, inadvertently, he has placed on record the copy of insurance certificate of another cow bearing tag No. 100039745, instead of the said dead cow bearing Tag No.100039744, whereas the copy of insurance policy, produced on record by the O.Ps. relates to the dead cow bearing Tag No.100039744. However, the O.P. No. 1 repudiated the claim vide letter dated 07.03.2014 on the ground that the animal identity did not match with the health evaluation certificate issued at the time of inception of the policy, but the said O.P. has not disclosed on the basis of which document, it had arrived at a conclusion that the identity of the dead cow does not match with the description mentioned in the health evaluation certificate. Even the O.Ps. have not placed on record the copy of postmortem report, issued by the veterinary doctor, which was submitted to it at the time of lodging of the claim. From the photographs placed on record by the O.P., Ex. OP-3 to OP-6, the tag number of the cow is not visible, therefore, no reliance can be placed on the same. The O.P. No.1 has, thus, failed to prove that the identity of the dead cow does not match with the insured cow and has wrongly repudiated the genuine claim of the complainant.

 

8.                Admittedly, the claim lodged by the complainant has been repudiated by the O.P. No.1 vide its letter dated 7.3.2014 (Ex. OP-2) on the ground that the identity of the dead cow did not match with the health evaluation certificate. Nodoubt, the O.P. No.1  has placed on record a copy of Health Evaluation Certificate as Ex.OP-7, and the photographs Ex.OP-3 to OP-6. From the perusal of the said photographs, it cannot be said to have been proved that as to which cow the said photographs relate to, because in the said photographs, on the tag affixed in the ear of the said animal, the number of the tag is not visible. The O.P. No. 1 has not produced any other document, on the basis of which it is alleging that the identity of the dead cow did not match with the insured cow. The said O.P. has not even produced on record the copy of postmortem report, which was admittedly submitted to it by the complainant alongwith the claim form. Had the O.P. produced on record the postmortem report, which is an important document to match the description of the dead animal with that of the insured animal, then the description mentioned therein of the dead cow could have been easily compared with the description mentioned in the evaluation certificate of the insured cow produced on record by the O.P. No.1,  to arrive at a conclusion that the identity of the dead cow did not match with the insured cow bearing tag Tag No.100039744, as alleged by it. With these facts & circumstances, we do not hesitate to conclude that the O.P. No. 1 has failed to prove that that the identity of the dead animal did not match with the health evaluation certificate, and has wrongly repudiated the genuine claim lodged by the complainant in respect of the insured cow bearing Tag No.100039744.  Admittedly, the cow in question was insured for a sum of Rs.50,000/- vide insurance policy, Ex.OP-8. Consequently, the O.P. No.1 is liable to pay to the complainant the insured value of the said dead cow i.e. Rs.50,000/- alongwith interest. The O.P. No.1 is also liable to pay compensation for unnecessary mental agony & physical harassment caused to the complainant alongwith the litigation expenses suffered by him. So far as the complaint filed against the O.P. No. 2 i.e. ICICI Bank is concerned, no relief against it can be granted because no deficiency in service on its part has been proved and the claim amount against the insured cow is to be paid by the insurer i.e. O.P. No.1 only. Therefore, the complaint against O.P. No. 2 is liable dismissed.

 

9.                In view of the aforesaid discussion, we dismiss the complaint against O.P. No.2 and allow the same against the O.P. No.1, directing it in the following manner:-

i)       To pay to the complainant, the sum insured of Rs.50,000/- alongwith interest @ 9% P.A. w.e.f. from the date of repudiation of the claim i.e. 07.03.2014 till realization;

ii)      To pay Rs. 4000/- as compensation,

iii)     To pay Rs.3000/- as litigation expenses.

 

The O.P. No. 1 is further directed to comply with the above said directions within 45 days from the date of receipt of certified copy of this order.

 

10.              The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed and consigned to the Record Room.

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