Haryana

Charkhi Dadri

CC/49/2023

PRIYANKA - Complainant(s)

Versus

IFFCO-TOKIO GENERAL INSURANCE CO. LTD. THROUGH ITS MANAGER - Opp.Party(s)

Sh. Rahul Kumar

11 Dec 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHARKHI DADRI

                                                              Complaint No.: 49 of 2023.

                                                              Date of Institution: 24.3.2023.

                                                               Date of Order: 11.12.2024

Priyanka wife of Sh. Vikash, Resident of village Dudhwa, Charkhi Dadri, Haryana. Mobile No.9991232558

                                                                                    ….Complainant.

                                                Versus

1. IFFCO TOKIO General Insurance Co. Ltd. Plot No.3, Sector-29 Gurugram-122001 through its Manager.
2. Manager, IFFCO TOKIO General Insurance Co. Ltd. IFFCO Sadan C1, Distt. Center, Saket, New Delhi-110017

…...Opposite parties.

                        COMPLAINT UNDER THE CONSUMER PROTECTION ACT.

 

Sitting:           Hon’ble Shri Manjit Singh Naryal, President,

                        (Proceeded under Section 64 of the Consumer Protection Act, 2019

 

Present:          Shri Rahul Kumar, Advocate for complainant.  

Shri Vinod Kumar Chahar, Advocate for the OPs.

 

ORDER

1. The case of the complainant in brief, is that he was owner of a Murrah Buffalo which was insured from opposite party under Pashu Dhan Micro Policy Scheme for a sum of Rs.85,000/- vide insurane receipt/invoice No.1-2NYV218X and policy No.59270313 and  paid the premium amount of Rs.1913/- for the period w.e.f. 23.1.2023 to 22.1.2024. It is further alleged that the opposite parties inserted an ear tag No.100907894028 in the ear of the insured Buffalo. Unfortunately, the Buffalo of complainant died on 29.01.2023 and Post Mortem was conducted by the Veterinary Surgeon, Govt. Veterinary Hospital, Chirya. It is further alleged that complainant informed the opposite parties regarding death of Insured Buffalo. The insurance company sent surveyor, who obtained all necessary information. After completion of formalities, he submitted claim form but no attention was paid by opposite parties in the matter even on several visits. It was further averred that on 06.03.2023 complainant received a  closure letter  dt.22.02.2023 in which OP company denied the claim by saying “as per policy exclusions, any claim arising due to diseases contracted within 15 days from the inception of the policy is not covered therefore your claim is not admissible as per policy terms & conditions, hence claim is being repudiated as no claim”. Till date the insurance company has failed to pay the claim amount. The complainant further alleged that due to the act and conduct of the opposite parties, he had to suffer mental agony, physical harassment and financial losses. Hence, it amounts to deficiency in service on the part of opposite parties and as such, he had to file the present complaint.

2.                Opposite parties on appearance filed the contested written statement and contested the claim of the complainant on the sole ground that the claim of the complainant was repudiated as Buffalo died within waiting period of 15 days. So, the insurance claim was rightly repudiated and as such, the complaint of the complainant is liable to be dismissed with costs.

3.                The complainant in support of his case has filed his affidavit Ex.CW-1/A & Ex.CW-2/A and documents Ex. C1 to Ex.C-20 and closed the evidence on 22.8.2023.

4.                 On the other hand, learned counsel for the OPs have tendered affidavit Ex.RW-1/A and documents Ex.R1 to Ex. R4 and closed the evidence on 06.05.2024.

5.                We have heard the arguments advanced by learned counsel for both the parties. All the documents have been perused very carefully and minutely.

6.                 After hearing the learned counsel for both the parties and having gone through the material available on the records, I am of the considered view that the complaint of the complainant deserves acceptance, as there is deficiency in service on the part of the opposite parties because the claim of the complainant was wrongly and illegally repudiated on the ground that Buffalo died in the waiting period of 15 days. It is admitted fact that from the perusal of the exception  clause of the Insurance Policy Ex.C2 is that “any death due to Lumpy Skin Disease is excluded from the Scope of cover” but Ex.C4 and Ex.C9 Post  Mortem  Report, Ex.C5 Death Certificate/Panchnama reveals that the cause of death of animal  was due to “Acute Ruminal Tympany” which is not effected on the exclusions clause because Lumpy Skin Disease (LSD) is a viral disease and contagious disease that effects cattle and Buffaloes and spread through insect bites. Whereas Ruminal Tympany or Bloat disease occurs in ruminant animals in which gas accumulates in the stomach, which causes the stomach to swell. In this disease, the animal has difficulty breathing and stop eating if the gas continues to accumulate, the animal may die. Both diseases are totally different to each other. As far as closure letter Ex.R1 with respect to the lockin period of 15 days for contracted disease is concern that is also not cover the disease mentioned hereinbefore. Moreover it is pertinent to mention here that the copy of terms and conditions of the Insurance Policy in which the exception clause is mentioned was not supplied to the complainant at the time of issuing of the Insurance Policy. Moreover the Health Certificate is Ex.C8 and Ex.R4 issued at the time of issuing the Insurance Policy certified by the Veterinary Surgeon reveals that Buffalo wherein Tag No.100907894028 was checked and found healthy in all respect. In this way it is confirmed that the Buffalo was not suffering with any pre-existing disease and cause of death was sudden attack. In this way the complainant had no intention of committing any fraud with the insurance company.

7.                It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act.

                   It is admitted fact that Buffalo was insured with the opposite parties for a sum of Rs. 85,000/- for the period of 23.01.2023 to 22.01.2024. As such as discussed above, I am of the convinced view that the claim of the complainant was wrongly repudiated. Hence, the complainant has suffered the mental as well as physical agony and financial losses. Hence, it amounts to deficiency in service on the part of opposite parties. Therefore, the complaint of the complainant is allowed with costs and the complainant is entitled to the sum insured and opposite parties are directed to:-

1. To pay Rs. 85,000/- (Eighty Five Thousand) to the complainant along with interest @ 9% p.a. from the date of filing of complaint i.e.24.3.2023 till its final realization.
2. To pay Rs. 20,000/- (Rs.Twenty Thousand only) as compensation towards pain and mental agony.
3. To pay Rs.10,000/- (Rs. Ten Thousand only) as litigation expenses. 

8.                The above order be complied within 45 days from the date of receipt the copy of this order, failing which further interest @12% will be paid on all above amount mentioned in clause no. i to iii by the OPs for the delayed period. 

9.                If the order of this Commission is not complied with, then the complainant shall be entitled to file execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the defaulting party will be liable for prosecution under Section 72 of the said Act which provides punishment of imprisonment for a term which shall not less than one month, but which may extend to three years or with fine, which shall not be less than twenty-five thousand rupees, but which may extend to Rs. one lac or with both. Copies of this order be sent to the parties free of costs as per rules and this order be promptly uploaded on the website of this Commission. File be consigned to the record room after due compliance.