DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.
Complaint No. 629
Instituted on: 24.10.2016
Decided on: 12.04.2017
Mohd. Saleem son of Ali Mohd R/O Village Awaspura, Tehsil Malerkotla, Distt. Sangrur.
…Complainant
Versus
1. Indian Overseas Bank, Near Malerkotla Stadium, Malerkotla through its Branch Manager, Distt. Sangrur.
2. Universal Sompo General Insurance Co. Ltd. Having its Regd. Office: Unit No.401, 4th Floor, Sangam Complex, 127, Andheri Kurla Road, Andheri (East) Mumbai through its M.D.
3. Universal Sompo General Insurance Co. Ltd. Zonal Office: SCO-9, First Floor, Above Central Bank of India, Sector 10, Panchkula (Haryana) through its General Manager.
..Opposite parties
For the complainant : Shri Mohd. Izhar, Adv.
For OP No.1 : Shri Mukesh Kumar Meena.
For OP No.2&3 : Shri Vinay Jindal, Adv.
Quorum: Sukhpal Singh Gill, President
Sarita Garg, Member
Vinod Kumar Gulati, Member
Order by : Sukhpal Singh Gill, President.
1. Shri Mohd. Saleem, complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that the complainant got insured his three cows from Ops number 2 and 3 through OP number 1 vide policy number 3016/56143936/00/000 for the period from 6.5.2016 to 5.5.2017 and at the time of insurance the Ops checked the cows and issued tag numbers 871712, 871713 and 871714 to the respective animals.
2. Further case of the complainant is that on 02.08.2016, one cow of the complainant bearing tag number 871712 died due to illness and as such the information was given to the OP number 2 and the post-mortem on the dead body of the cow was also got conducted from Local Veterinary Hospital, Malerkotla. The grievance of the complainant is that though the complainant completed the formalities and submitted the documents required for the purpose, but the Ops repudiated the claim of the complainant vide letter dated 8.8.2016 by mentioning that the death of cow is due to “Plueropneuonia” as such the claim is not payable. Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the Ops be directed to pay to the complainant the insurance claim amount of Rs.50,000/- along with interest and further claimed compensation and litigation expenses.
3. In reply filed by the OP number 1,it has been stated that the complainant took a dairy loan of Rs.1,01,000/- from the OP number 1 on 19.6.2013 and it is also admitted that three cows were got insured from OP number 2 and 3 and that the cows were duly checked at the time of insurance. The other allegations levelled in the complaint have been denied in toto.
4. In reply filed by OP number 2 and 3, legal objections are taken up on the grounds that the complaint is not maintainable, that the claim of the complainant has rightly been repudiated vide letter dated 8.8.2016 as per the terms and conditions of the policy as the cow in question died due to Pluerophnemonia, which is not covered under the policy, that after receipt of the intimation, the investigator was appointed to investigate the claim and that the complainant has concealed the material facts from the Forum and that the complaint is false and without any basis. On merits, it has been admitted that the complainant got insured three cows from OP number 1 and accordingly the policy was issued for the period from 6.5.2016 to 5.5.2017 along with its terms and conditions. It has been further stated that the claim of the complainant has rightly been repudiated as the same was not covered under the policy of insurance.
5. The learned counsel for the complainant has produced Ex.C-1 copy of insurance policy, Ex.C-2 copy of claim form, Ex.C-3 copy of PMR, Ex.C-4 copy of repudiation letter, Ex.C-5 copy of legal notice, Ex.C-6 affidavit, Ex.C-7 copy of bank account mandate, Ex.C-8 copy of discharge voucher, Ex.C-9 copy of consent to acceptance, Ex.C-10 copy of account statement and closed evidence. On the other hand, the learned counsel for OP number 1 has produced Ex.OP1/1 affidavit and closed evidence. The learned counsel for the OP number 2 & 3 has tendered Ex.OP2&3/1 to Ex.OP2&3/11 documents and affidavit and closed evidence.
6. We have carefully perused the complaint, version of the opposite parties, evidence produced on the file and also heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits dismissal, for these reasons.
7. It is an admitted case between the parties that the complainant availed the services of the Ops number 2 and 3 by getting insured his three cows under the policy in question for the period from 6.5.2016 to 5.5.2017. It is also not in dispute that the cow bearing tag number 871712 died due to illness on 2.6.2016. It is further not in dispute that the complainant lodged the claim with the Ops number 2 and 3 and submitted all the required documents, but the grievance of the complainant is that the OP number 2 and 3 has wrongly repudiated the rightful claim of the complainant vide letter dated 8.8.2016 on the ground that the cow died with the disease “Plueropneumonia” which is not covered under the policy of the insurance for animals. Now, the only question before this Forum for determination is whether the claim has rightly been repudiated or not.
8. Ex.OP3/2 is the copy of claim note regarding the cow in question, wherein it has been clearly mentioned that a milch cow bearing tag number USGI-871712 died on 2.6.2016 and the post-mortem on the dead body was conducted and the cause of death was opined due to Pleuropneumonia, which is not covered under the policy terms and conditions. We have also perused the copy of post-mortem report, which is on record as Ex.OP2&3/5, wherein it has been clearly stated that the lungs of the cow in question were filled with Pleuropneumonia, wide spread lungs and the cause of death is said to be the same. Ex.OP2&3/8 is the copy of investigation report submitted by Auto Investigators, Zirakpur Mohali, wherein in the conclusion portion it has been opined that the claim be paid in view of the terms and conditions of the policy. We have also perused the copy of terms and conditions of the policy for cattle and livestock, wherein it has been clearly mentioned that death by Pleuropneumonia is not covered under the policy, whereas in the present case, it is proved on record that the cow in question died due to Pleuropneumonia, which is not covered under the terms and conditions of the policy. Further we may mention that in the post-mortem report the concerned doctor has mentioned that the animal in question died due to severe bacterial infection and severe respiratory defect i.e. Pleuropneumonia, which is not covered under the terms and conditions of the policy. As such, we are of the considered opinion that there is nothing wrong in repudiation of the claim of the dead cow belonging to the complainant and the same has been done by the Ops in view of the terms and conditions of the insurance policy.
9. In view of our above discussion, we dismiss the complaint of the complainant. However, the parties are left to bear their own costs. A copy of this order be issued to the parties free of cost. File be consigned to records.
Pronounced.
April 12, 2017.
(Sukhpal Singh Gill)
President
(Sarita Garg)
Member
(Vinod Kumar Gulati)
Member
