Haryana

Yamunanagar

CC/419/2012

Neelam Rani W/o Mahinder Singh - Complainant(s)

Versus

National Insurance Co.Ltd. - Opp.Party(s)

Ravinder Sohi

29 Jul 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR

                                                                                    Complaint No.419  of  2012.

                                                                                    Date of institution:30.4.2012.

                                                                                    Date of decision: 29.7.2016.

 

Smt. Neelam Rani age 40 years wife of Sh.Mahinder Singh, resident of village Rapoli, P.O.Bhagu Majra, tehsil Jagadhri, Distt. Yamuna Nagar.

                                                                                                                                                          …Complainant.

                                                       Versus

 

1.         National Insurance Company Limited, Branch Office Near Fountain Chowk, Yamuna Nagar  through its Branch Manager.

2.         Punjab National Bank, Branch Kheri Lakha Singh, Distt. Yamuna Nagar through its Branch Manager.

                                                                                                                                                          … Respondents.

 

BEFORE:         SH. ASHOK KUMAR GARG, PRESIDENT

                        SH. S.C.SHARMA, MEMBER.

 

Present: Sh. Ravinder Sohi, Advocate, counsel for complainant.   

              Sh. Karnesh Sharma, Advocate, counsel for OP No.1.

              Sh.Pardeep Walia, Adv. for OP No.2.

 

ORDER

 

1.                     The complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 praying therein that respondents (herein after referred as OPs) i.e. OP No.1 be directed to make the payment of sum assured of the deceased buffalo and also to pay compensation as well as litigation expenses.  

2.                     Brief facts of the present complaint, as alleged by the complainant, are that under the dairy farming scheme launched by the government, she purchased a buffalo and insured the same with the OP No.1 after getting the said buffalo inspected from the Government Veterinary  Surgeon vide policy No.420402/47/10/94000002, Tag number was given to said buffalo. Unfortunately, the said buffalo died on 30.4.2011 despite best treatment.  Post mortem was got conducted from the Government Veterinary Surgeon.  After the death of buffalo immediately the complainant intimated Punjab National Bank, Kheri Lakha Singh Branch (OP No.2) from whom the loan was taken and on intimation the OP No.1 has sent its surveyor who surveyed the spot and obtained photographs and necessary documents from the complainant for completing the formalities of claim.  The complainant furnished the claim form along with all relevant documents with the OP No.1, they sent a letter dated 20.5.2011 to the complainant requiring some documents for claim.  According, to the letter, the complainant submitted all the documents immediately and the OP No.1 assured the complainant that they will release the claim very soon.  After a lapse of more than one month, the OP No.1 again sent a letter dated 29.6.2011 vide which the OP No.1 wrongly and arbitrarily repudiated the claim of the complainant on the ground that that the intimation of the death was given on 3.5.2011 and further stated that the tag was not in the ear of the dead cattle, it constitute deficiency in service on the part of the OP No.1.  Hence, this complaint.

3.                     Upon notice, Ops appeared and filed their written statements separately.  The Op No.1 filed the written statement taking some preliminary objections such as the complaint is not maintainable; the claim of the complainant repudiated on the legal and valid grounds; the complainant has not come to the Forum with clean hands; the complaint is bad for jon joinder and mis joinder of necessary parties; the complainant has no locus standi; a false and fraudulent complaint has been filed and the facts of the case are reproduced that Punjab National Bank A/c M/s Jai Ganesh Self Help Group village Rapoli, P.O.Bhagumajra, Distt. Yamuna Nagar had purchased an insurance policy under “Cattle Insurance” vide policy no.420402/47/10/9400000313 effective from 6.10.2010 to 5.10.2013 and insured 20 buffalos of different persons.  The policy contains terms and conditions which were accepted and agreed to by the insured at the time of purchasing the insurance policy.  There is special conditions in the said policy “No Tag No Claim,” certified copy of policy is Annexure R.2.  The OP-Insurance Company was informed with regard to the death of buffalo of Neelam Rani on 30.4.2011 by PNB, Kheri Lakha Singth vide its letter dated 2.5.2011, copy of intimation letter is Annexure R.3.  On receiving the intimation, the OP-Insurance Company registered the claim and Mr.Sumit Goel, Mechanical Engineer, Surveyor and Loss Assessor was deputed for facts finding report, who submitted his report on 7.6.2011 (Annexure R.4).  The surveyor and investigator opined that the description of said animal differs in the description described by the insured and in the health certificate.  Secondly, the ear tag produced broken in two pieces, thirdly not allowing spot survey to be conducted by the under writers and not keeping the animal at the address as described in the health certificate.  All these are violations of the policy conditions, so the claim of the insured does not stand and can be considered as “No Claim”.  During investigation, the Investigator had also obtained a written statement of the complainant and one Sonu s/o Sh. Salinder.  As per the statement of the insured, the ear tag was not intact in the ear of the carcass and the colour of the deceased buffalo was black, black tail and the horn were curved. Statement of complainant is Annexure R.5. Copy of statement of Sonu is Annexure R.6 and health certificate is Annexure R.7.  The alleged buffalo died on 30.4.2011 and intimation was given to the company on 3.5.2011 after disposing the carcass.  The OP-Insurance Company was not given any opportunity to inspect the carcass.  Further, as per the version of the Investigator, the identification of the deceased animal does not tally with the identification of the insured animal and ear tag was not intact at the time of death.  On merits reiterated the stand taken in the facts of the case and lastly prayed for dismissal of complaint as there is no deficiency in service on the part of the OP-Insurance Company.

4.                     The OP No.2 filed the written statement taking some preliminary objections that the complaint is not maintainable; the complainant has no locus standi; the complainant is illegal stopped by her own act and conduct; there is no relationship of consumer and supplier between the parties; the matter is not covered under the C.P.Act; the complainant has concealed the true and material facts and on merits alleged that the complainant has verbally intimated the OP-bank on 2.5.2011 with regard to death of buffalo and the OP-bank had given the intimation to the OP No.1 to appoint a surveyor and to enquire about the matter.  The OP No.1, in his letter dated 29.6.2011, mentioned that the buffalo of the complainant died on 30.4.2011 and intimation in this regard was given to OP No.1 on 3.5.2011, after disposing the dead body of the said buffalo, so the question of taking any photographs by Op No.1 does not arise at all.  There is no deficiency in service on the part of the OP-bank and lastly prayed for dismissal of complaint.

5.                     In support of his case the counsel for complainant tendered into evidence affidavit as complainant as Annexure C.X, Photocopy of letter dated 2.5.2011 as Annexure C.1, Photocopy of letter dated 2.5.2011 from OP No.1 as Annexure C.2, Photocopy of repudiation letter dated 29.6.2011 as Annexure C.3 and closed the evidence on behalf of complainant.

6.                     On the other hand the counsel for OP No.1 tendered into evidence affidavit of Shri Parveen Arora, A.O. as Annexure R.X, Photocopy of repudiation letter dated 29.6.2011, Certified copy of Insurance Policy as Annexure R.2, Photocopy of letter dated 2.5.2011 as Annexure R.3, Photocopy of Surveyor report as Annexure R.4, Photocopy of intimation given by the complainant to the bank as Annexure R.5, Photocopy of statement of Sonu s/o Salinder as Annexure R.6, Photocopy of Postmortem report as Annexure R.7 and closed the evidence on behalf of Op No.1.  However, the evidence of OP No.2 was closed by Court order vide order dated 7.9.2015.

7.                     We have heard the learned counsel for the parties and gone through the pleadings as well as documents placed on the file carefully and minutely.  It is not disputed that the OP No.2-PNB obtained an Insurance policy bearing no.420402/47/1094000002 covering the risk of 20 buffalo of different persons for Rs.24500/- each valid from 6.10.2010 to 5.10.2013 from the OP No.1-Insurance company.  It is also not disputed that OP No.2-bank intimated the OP No.1-Insurance Company in respect of death of one buffalo belongs to the complainant Smt. Neelam Rani w/o Sh.Mahinder Singh, which is duly evident from the letter dated 2.5.2011 (Annexure C.1) issued by the Punjab National Bank to the OP NO.1-Insurance Company.  It is also not disputed that alleged buffalo died on 30.4.2011 which is duly evident from the copy of postmortem report (Annexure R.7).  Learned counsel for complainant argued at length that genuine claim of the complainant has wrongly been repudiated by the National Insurance Company whereas the claim of the complainant was duly supported with the post mortem report.  Learned counsel for complainant further argued that claim of the complainant has been repudiated by the OP No.1-Insurance Company out of which one ground is that no opportunity was given for physical inspection of the dead body/carcass of the alleged buffalo.  As the buffalo in question was died on 30.4.2011 at about 5 P.M. and on that day there was Saturday and on next day being Sunday a holiday, complainant could not inform the Insurance Company as well as bank, so the complainant informed the bank on the next day i.e. 2.5.2011 and the OP No.2-Bank informed the OP No.1-Insurance Company on the same day vide its letter dated 2.5.2011 (Annexure C.1), so there was no delay on the part of the complainant.  Learned counsel for the complainant argued that Veterinary Doctor has duly mentioned the tag number bearing no.NIC-00263 in the postmortem report (Annexure R.7) and almost all the particulars of the dead buffalo was tallied with the insured buffalo and lastly prayed for acceptance of complaint.

8.                     On the other hand the learned counsel for the Ops hotly argued that claim of the complainant has rightly been repudiated by the OP No.1-Insurance Company vide its letter dated 29.6.2011 (Annexure C.3/R.1).  Learned counsel for Ops draw out attention towards investigator report dated 7.6.2011 (Annexure R.4) and argued that the Investigator Sh.Sumit Goel has specifically mentioned in his report that the description of the dead animal differs in the description prescribed by the Insurance Company and as mentioned in the health certificate and has also further mentioned that ear tag produced by the complainant at the time of inspection was broken in two pieces and also has mentioned in his report that complainant has not provided any opportunity to spot survey and has lastly recommended the claim for no claim being violation of the terms and conditions of the Insurance Policy.  Learned counsel for Ops lastly prayed for dismissal of complaint.

9.                     After hearing the learned counsel for the parties and going through the pleadings as well as documents placed on the file, we are of the considered view that there is deficiency in service on the part of the OP-Insurance Company.  The claim of the complainant has wrongly been repudiated by the OP No.1-Insurance Company vide its letter dated 29.6.2011.  From the perusal of the investigator report (Annexure R.4), it is clearly evident that complainant/insured has stated to the investigator/surveyor that she could not informed the Insurance Company as well as OP No.2-bank in time i.e. on the same day as on that day there was holiday of Saturday and next day there was holiday of Sunday.  Explanation given by the complainant seems justified and no rebuttal has been placed on the file by the OP-Insurance Company, so arguments advanced by the counsel for the OP-Insurance Company that no opportunity was given to the OP-Insurance Company to inspect the carcass of dead buffalo and there was violation of terms and conditions of the Insurance Policy has no weight-age.  Moreover, OP-Insurance Company have no local office in the village of the complainant as the complainant belongs to rural area i.e. Village Rapoli, P.O.Bhagu Majra which is for away from the City Yamuna Nagar.  Further arguments advanced by the learned counsel for the OP No.1 that there was no tag tagged in the ear of the dead buffalo is not tenable as the Veterinary Surgeon has duly mentioned the tag number in the post mortem report as NIC-00263 which is duly evident from the post mortem report (Annexure R.7).  Further argument on the point of that particular of the dead buffalo was not tallied with the insured buffalo is also not tenable as OP-Insurance Company has totally failed to place the health certificate to prove its version and in the absence of any health certificate it can not be said that particular of the insured buffalo was not tallied with the alleged buffalo.  It is pertinent to mention here that OP-Insurance Company has deputed Sh.Sumit Goel, Mechanical Engineer as Surveyor and Loss Assessor whereas in such type of cases Veterinary Doctor or other qualified person in this particular field can be appointed as Investigator not Mechanical Engineer, on this angle also repudiation done by the OP-Insurance Company is also not justified. 

10.                   Resultantly, in view of the circumstances noted above, as the buffalo of the complainant died during currency of Insurance Policy, which is duly evident from the copy of postmortem report, hence, we have no option except to partly allow the complaint of the complainant and the OP-Insurance Company is directed to pay insured amount i.e. Rs.24,500/- along with interest @7% from the date of filing of this complaint i.e. 30.4.2012 till its realization and further to pay Rs.2000/- as compensation and litigation expenses. Order be complied within 30 days after preparation of copy of this order failing which complainant shall be entitled to invoke the jurisdiction of this Forum as per law. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court.29.7.2016.                                                                                                                                                                                                              

                                                                                   

 

                                                                                                                     (ASHOK KUMAR GARG)

                                                                                                                PRESIDENT

                                        (S.C.SHARMA)

                                           MEMBER.