BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.252 of 2014

Date of Instt. 01.08.2014

Date of Decision :05.02.2015

Balwinder Pal aged about 39 years son of Ram Parkash, R/o Village Jalla Singh, Kartarpur District Jalandhar.

..........Complainant

Versus

1. National Insurance Company Ltd, Branch Office, Kartarpur, Tehsil & District Jalandhar.

2. National Insurance Company Ltd, Branch IV, NN-2, Patel Chowk, Jalandhar. 144001.

3. National Insurance Company Ltd, Registered & Head Office-3, Middleton Street, Kolkata-700071.

.........Opposite parties

Complaint Under Section 12 of the Consumer Protection Act.

Before: S. Jaspal Singh Bhatia (President)

Ms. Jyotsna Thatai (Member)

Present: Sh.SP Laddi Adv., counsel for complainant.

Sh.RK Bhardwaj Adv., counsel for opposite parties.

Order

J.S Bhatia (President)

1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, against the opposite parties on the averments that the complainant insured the two buffaloes/cattle on 30.7.2013 with the opposite party No.1 for a total sum of Rs.80,000/- i.e one buffalo/cattle insured for a sum of Rs.40,000/- and the premium was fixed amounting to Rs.3596/- for two buffaloes/cattle and the complainant paid the said premium to the opposite party No.1 for a period from 30.7.2013 to 29.7.2014, under policy No.40111047139400000004, and Tag No.437, 438. Out of the above said two buffaloes, one buffalo died all of a sudden on 14.4.2014. The complainant approached the office of opposite party No.1 and requested to make the payment to the tune of Rs.40,000/- i.e insured amount of one buffalo, but the opposite party No.1 did not accept the genuine request of the complainant and thereafter, the complainant visited the office of opposite party No.2 but the opposite party No.2 did not accept the genuine request of the complainant. On such like averments, the complainant has prayed for directing the opposite parties to pay him the insured amount of Rs.40,000/-. He has also claimed compensation and litigation expenses.

2. Upon notice, opposite parties appeared and filed a written reply pleading that the present complaint is not maintainable against the answering opposite parties and is liable to be dismissed as the same has been filed without any cause of action by the complainant. The claim of the complainant was rejected on the investigation report by the company surveyor and other related documents being contravene to the policy terms and conditions. It is noteworthy to add that in the report of surveyor, it has been observed that " Ear tag not found/intact while spot survey and identification mark of forehead and switch of tail was not same as mentioned in the vetinery certificate and claim form". Under the circumstances the opposite parties were not liable to compensate the complainant, hence his claim was refused by the answering opposite parties vide letter dated 23.5.2014. The complainant himself has violated the terms and conditions of the policy conditions. It was a policy condition that "Tag should be surrendered at the time of claim otherwise it will be treated as no claim". However, the complainant intentionally and deliberatively violated the terms and conditions of the policy conditions. They denied other material averments of the complainant.

3. In support of his complaint, learned counsel for the complainant has tendered affidavit Ex.CW1/A alongwith copies of documents Ex.C1 to Ex.C8 and closed evidence.

4. On the other hand, learned counsel for opposite parties has tendered affidavits Ex.OPW1/A, Ex.OPW1/B and Ex.OPW2/A alongwith copies of documents Ex.R1 to Ex.R-12 and closed evidence.

5. We have carefully gone through the record and also heard the learned counsels for both the parties.

6. Ex.C1 is cattle insurance policy. It is not disputed that two buffaloes of the complainant were insured for Rs.40,000/- each under the above said policy. The buffaloes were having tag No.437 and 438, as per previous policy. According to the complainant, his one insured buffalo died on 14.2.2014 and he lodged claim with the opposite party insurance company but opposite party insurance company refused to pay the insurance amount to him. The opposite party insurance company repudiated the claim of the complainant vide letter dated 23.5.2014 Ex.R12. The claim of the complainant has been repudiated by the opposite party insurance company on the ground that at the time of survey, Sh.Sanjeev Kumar Surveyor and Loss Assessor did not find any ear tag and further the forehead of the dead buffalo was black and whereas as per claim form Ex.C3 the forehead was having white spot. Counsel for the complainant contended that from the postmortem report Ex.C-5 it is evident that at the time of postmortem of the dead buffalo there was ear tag No.437 and further there was white spot on the forehead of the buffalo. He further contended that these facts are mentioned in the postmortem report Ex.C5. On the other hand, it has been contended by learned counsel for the opposite parties that at the time of spot survey, there was no tag in the ear of the dead buffalo and further the forehead of the buffalo was black. He further contended that the surveyor has taken photographs of the dead buffalo which are Ex.R1 to Ex.R7 on record. He further contended that from the photograph Ex.R1, it is evident that there was no white spot on the forehead of the dead buffalo shown to the surveyor. He further contended that as per terms and conditions of the policy tag should be surrendered at the time of claim, otherwise it will be treated as no claim. He further contended that the surveyor has also filed affidavit Ex.OPW2/A in support of his report. He further contended that in the above circumstances, the dead buffalo can not be linked with the insured buffalo and further non surrendering of ear tag at the time of claim contravene the terms and conditions of the policy and as such the claim has rightly been rejected by the opposite party insurance company. We have carefully considered the above contentions advanced by learned counsel for both the parties. No doubt in the postmortem report Ex.C5 ear tag No.437 is mentioned and further in the said report white spot on the forehead are also mentioned but these things were not found by the surveyor at the time of spot survey. Ex.R8 is cattle spot survey report given by Sanjeev Kumar, Surveyor and Loss Assessor. In the survey report, it is specifically mentioned at serial No.7 that Ear tag not found and further at serial No.8 it is mentioned that Forehead is black. The insured buffalo was having tag No.437 and further white spot on its forehead. Both these things were not found by the surveyor at the time of spot survey. From the photograph Ex.R1 of the dead buffalo, it is evident that there was no white spot on the forehead of the buffalo. In support of his report, the surveyor has filed affidavit Ex.OPW2/A wherein it is mentioned that on 15.4.2014 he visited the village Jalla Singh where complainant showed him a dead buffalo and he clicked a few snaps of the buffalo which Ex.R1 to Ex.R7 and noted down the description. In his affidavit, the surveyor has further mentioned that during spot inspection, the tag was not found in the ears of the cattle for which the complainant did not give any satisfactory explanation. On the other hand, Dr.Karamjit Vetinary Officer who conducted the postmortem report, has not submitted his affidavit. We do not find any convincing reason to disbelieve the affidavit and surveyor report Ex.R8 submitted by the surveyor. Ex.C1 is cattle insurance policy. It was done as per previous policy, as in it tag No.437 and 438 as per previous policy are specifically mentioned. Previous policy is attached with Ex.R9 wherein it is specifically mentioned that tag should be surrendered at the time of claim, otherwise it will be treated as no claim. It is further mentioned in it that in the event of death of animal covered under the policy, claim shall not be entertained unless the ear tag/s are surrendered to the company. In the present case, at the time of spot survey, no ear tag was found. So as per terms and conditions of the policy in absence of any ear tag, the claim of the complainant has rightly been rejected by the opposite party insurance company. In their written reply, the opposite parties have specifically pleaded that in the report of surveyor, it has been observed that ear tag not found/intact while spot survey and identification mark of forehead and switch of tail was not same as mentioned in the vetinery certificate and claim form. The complainant tendered his affidavit Ex.CW1/A after filing of written reply by the opposite parties but still in his affidavit, the complainant has not given any explanation regarding non finding of ear tag by the surveyor at the time of spot survey. In his affidavit, the complainant has not said anything against the report submitted by the surveyor. On the basis of survey report, the opposite party insurance company has repudiated the claim of the complainant. Further as required under the terms and conditions of the policy, the ear tag was also not surrendered at the time of claim. So in the above circumstances, we have no hesitation to hold that opposite parties have rightly rejected the claim of the complainant.

7. In view above discussion, we hold that there is no merit in the present complaint and same is dismissed with no order as to cost. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.

Dated Jyotsna Thatai Jaspal Singh Bhatia

05.02.2015 Member President