Haryana

Karnal

65/2013

Gurpreet Singh Sandhu S/o Gurdial Singh Sandhu - Complainant(s)

Versus

National Insurance Company Limited - Opp.Party(s)

Atul Malhotra

15 Jan 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.  

                                                          Complaint No.65 of 2013

                                                          Date of instt.: 4.02.2013

                                                          Date of decision: 15.01.2016

 

Gurpreet Singh Sandhu son of Shri Gurdial Singh Sandhu resident of village and Post office Peont, tehsil Nissing District Karnal.

 

.                                                                   ……..Complainant    

                                      Vs.

National Insurance Company Limited, Divisional Office at Santokh Market, above  State Bank of Patiala, Railway Road, Karnal through its Divisional Manager.

                                                                           ……… Opposite Party

 

                     Complaint u/s 12  of the Consumer

                     Protection Act.

 

Before          Sh.K.C.Sharma……….President.                

                   Sh.Anil Sharma…….Member.

 

Present:-        Sh.Atul Malhotra Advocate for the complainant.

                   Sh.Inderjeet Sachdeva Advocate for the Opposite Party

ORDER:                 

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986, on the averments that he got insured his cow with the Opposite Party on 12.10.2011, vide insurance policy No.420500/47/11/9400000170/11, which was valid from 12.10.2012 to 11.10.2012. The insured value of the cow was assessed as Rs.50,000/- as per health certificate.  The Opposite Party issued the tag no.  NIC-76281 for the said cow. Unfortunately, the said cow died on 15.7.2012 due to illness. Post mortem on the dead body of the cow was conducted by the veterinary Surgeon, Govt. Veterinary, Hospital, Jundla. Thereafter, he lodged claim with the Opposite Party for the payment of the insured amount vide claim No.9490000042/12 and completed all the formalities, but his claim was rejected on 13.12.2012 on the basis of wrong report of the investigator.   In fact, the tag fixed in the ear of the cow was found intact by the investigator and the same was deposited  with the Insurance company as per their advice.  Therefore, repudiation of the claim by the Opposite Party  was illegal and the same amounted to deficiency in services on the part of Opposite Party ,which caused him mental pain and harassment apart from financial loss.

2.                 Notice of the complaint was given to the Opposite Party, who appeared and filed written statement controverting the claim of the complainant. Objections have been raised that the complaint is not legally maintainable; that the complainant is estopped by his acts and conduct from filing the present complaint; that the complainant has no cause of action to file the present complaint and that the complainant has not approached this Forum with clean hands.

          On merits, the factum of insurance of the cow has not been disputed. It has been submitted that as per the investigation report, description of the deceased cow did not  relate to the insured cow, because as per health certificate the insured cow was having black colour with second lactation, whereas the investigator reported that deceased cow was of  dark brown colour having third lactation and the  tail  was long. Therefore, the claim of the complainant was not covered under the terms and conditions of the insurance policy and accordingly, the claim was repudiated and the complainant was intimated, vide letter dated 3.12.2012.  The comments sent by the complainant were also considered, but the same were not found satisfactory and he was intimated in that regard, vide letter dated 3.12.2012.It has been asserted that the claim of the complainant was rightly and legally repudiated as per terms and conditions of the insurance policy and there was no deficiency in services on the part of the Opposite Party.

3.                 In evidence of the complainant, his affidavit Ex.CW1/A and the documents  Ex.C1 to Ex.C5 have been tendered.

4.                 On the other hand, in evidence of the Opposite Party, affidavit of Shri R.K.Goshwami, Assistant Manager, Ex.,O1/A and documents Ex.OP1/B to Ex.OP1/E have been tendered.

5.                 We have appraised the evidence on record,  the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

 

6.                 There is no dispute between the parties regarding the fact that cow of the complainant was insured with the Opposite Party and  insured value was Rs.50,000/-. As per the case of the complainant, the said cow died on 15.7.2012 and post mortem on the dead body was conducted by the Veterinary Surgeon.  On the other hand, the Opposite Party has submitted that as per the report of the investigator, there was difference in description of  the insured cow and the dead cow, therefore, the Opposite Party was not liable to pay any amount to the complainant as per the terms and conditions of the insurance policy.

 

7.                 The learned counsel for the Opposite Party vehemently argued that as per the health certificate, the colour of the insured cow was black and the same was having second lactation and the shape and size of the tail were not mentioned, but as per the report of investigator, the deceased cow was of dark brown colour having third lactation and the tail was long. In this way, the description of  the deceased cow did not tally with the description given in the health certificate issued for the insured cow and as such the insurance company was not liable to pay any amount to the complainant and his claim was rightly repudiated.

 

8.                 The copy of the health certificate Ex.C4 indicates that  five cows of the complainant were examined by the Veterinary Surgeon,  Govt. Veterinary Hospital, Jundla and the same were insured by the Opposite Party,   with an insured value of Rs.50,000/- each, for a total amount of Rs.2,50,000/-.The description of the cows were also given by the Veterinary Doctor. The tag numbers issued by the Opposite Party were also mentioned at Serial Number 11. The post mortem on the dead body of the cow was conducted by the Veterinary Surgeon, Govt. Hospital, Jundla  15.7.2012 itself and the copy of the post mortem is Ex.C5. The description of the deceased cow was given in the Post mortem report. The colour was mentioned as black and the same was having third lactation.  He even reported that tag no. NIC 76261 was found intact. In the health certificate Ex.C4, the colour of the cow having tag No. NIC 76261 was mentioned as black.  The difference was that in the health certificate it was mentioned that cow was having second lactation, but in the post mortem it was mentioned that the same was having third lactation.  Health certificate was issued before insurance of the cow on 12.10.2011, whereas the post mortem was conducted on 15.7.2012.It was also mentioned in the post mortem report  that deceased cow was having a  calf of ten days. Thus, there was no difference in the number of lactation in the health certificate and the post mortem report, because a period of nine months had elapsed since insurance and cow could have third lactation during that period.  In the health certificate  the shape and size of the tail were  not mentioned, therefore, it is immaterial that investigator found that tail was long therefore, his observation does not show that there was any difference of  the tail of the insured and the deceased cow.

 

9.                 The Opposite Party has not produced the report of investigator. Even no affidavit of the investigator has been filed to prove that he found difference in the description of the insured cow and the deceased cow.  No colour photographs of the deceased cow have been produced to show that the same was of dark brown colour.  Therefore, under such circumstances, the report of the investigator is not sufficient to falsify the report of the post mortem  conducted by the Veterinary Surgeon, Govt. Veterinary Hospital, Jundla.  Moreover, it is not the case of the Opposite Party that investigator found that there was no tag in the ear of the deceased cow or the tag was tampered. The doctor who conducted the post mortem, specifically mentioned in the post mortem report that tag no. NIC-  76261 was found intact. The tag fixed in the ear of the cow could be most material  fact, which could be sufficient to establish  the identity of the insured cow. Under such, circumstances, the plea of the Opposite Party that the physical description of the insured cow and the deceased cow did not tally, cannot be accepted. Consequently, repudiation of the claim of the complainant by the Opposite Party was not legally justified and the same amounted to deficiency in services on the part of the Opposite Party.

 

10.               As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Party to make the payment of Rs.50,000/- to the complainant alongwith interest at the rate of 9% per annum from the date of filing of the present complaint i.e. 4.2.2013  till its actual realization. The complainant shall also be entitled for a sum of Rs.5500/- for the mental agony and harassment suffered by him and for the litigation expenses.  The Opposite Party shall make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
dated:15.01.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

 

Present:-        Sh.Atul Malhotra Advocate for the complainant.

                   Sh.Inderjeet Sachdeva Advocate for the Opposite Party

 

 

                   Arguments heard. Vide our separate order of the even date, the present complaint has been accepted. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced
dated:15.01.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.