Haryana

Karnal

156/2013

Mandeep Singh S/o Jaswant Singh - Complainant(s)

Versus

National Insurance Company Ltd - Opp.Party(s)

Sh. Umed Singh

24 Feb 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.     

                                                                Complaint No.156 of 2013                                                                               

                                                                Date of instt.: 22.3.2013

                                                                 Date of decision:24 .02.2016

 

Mandeep Singh son of Jaswant Singh resident of village  Bhaini Kalan tehsil and District Karnal.

                                                                   ……..Complainant.

                                      Vs.

National Insurance Company Limited, Divisional Office at Santokh Singh Market, 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 Umed Singh Advocate for the complainant.

                     Sh.Sanjiv Vohra 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 buffalo with the      Opposite Party for insured value of Rs.40, 000/- vide insurance policy No.94000023/11.  The Opposite Party issued tag No. 76391 regarding the said insured buffalo. Unfortunately, the buffalo died on 27.5.2012 due to electric current. Post mortem was conducted by the Veterinary Surgeon, Karnal. He lodged claim with the Opposite Party and completed all the formalities. However, the Opposite Party postponed the matter on one pretext or the other and sent letter dated 7.3.2013 requiring him to submit some documents despite the fact that all the documents were already submitted. Finally, the Opposite Party refused to pay the claim which amounted to deficiency in services and unfair trade practice, due to which he suffered mental pain and agony apart from financial loss.   

 

2.                Notice of the complaint was given to the Opposite Party, who appeared and filed written statement disputing the claim of the complainant. Objections have been raised that the complaint is not maintainable in the present form; that the complainant is estopped from filing the present complaint by his own acts and conduct; that the complainant has not approached this Forum with clean hands and that complicated question of law and facts are involved, which cannot be decided in a summary manner.

 

                        On merits, the factum of insurance of the buffalo of the complainant has not been disputed. It has been submitted that the complainant was asked to submit the required documents vide letter dated 3.12.2012 and subsequent reminders dated 18.1.2013 and 7.3.2013 but the complainant did not submit the same. As per the intimation, the cause of death of buffalo was due to fall, whereas in the claim form and post mortem report, it was mentioned that the cause of death of the buffalo was infection/disease. Therefore, under such circumstances, the claim of the complainant was rightly closed by the Opposite Party and there was no deficiency in services or unfair trade practice on its part.

 

3.                      In evidence of the complainant, he filed his affidavit  and  examined Dr. Arvind Kumar, Veterinary Surgeon of Govt. Veterinary Hospital, Karnal, who proved the copy of the post mortem report Ex.CW1/A.

 

4.                     On the other hand in evidence of the Opposite Party, affidavit of Shri R.K. Goswami, Assistant ManagerEx.O1 and documents Ex.O2 to Ex.O6 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.                The buffalo of the complainant was insured with the Opposite Party for insured value of Rs.40,000/-.As per the case of the complainant, the said buffalo died on 27.5.2012. He submitted claim with the Opposite Party and completed all the formalities, but the Opposite Party refused to pay  the claim to him.

 

7.                The learned counsel for the Opposite Party vehemently argued that in the application of the complainant, the copy of which is Ex.O6, it was submitted that buffalo had died due to fall, but in the complaint it has been pleaded that buffalo died due to electric current and in the claim form and post mortem report, it was mentioned that buffalo died due to infection/disease. Thus, the stand of the complainant is not consistent regarding cause of death of the buffalo. It has further been contended that the complainant was asked to submit certificate of Sarpanch regarding the death of the buffalo  complete  column 27 and 14 claim  form and produce treatment chart, vide letters dated 3.12.2013, 14.1.2013 and 7.3.2012 but the complainant did not submit these documents, therefore, his claim was rightly closed by the Opposite Party.

 

8.                The copy of the application moved by the complainant to the Opposite Party Ex.O6 shows that the buffalo died due to fall. The said application was moved by the complainant on 28.5.2012 whereas the death had occurred on 27.5.2012. As per the post mortem report, the copy of which is Ex.CW2/A, buffalo died due to infection alongwith pneumonia and other problems. The cause of death could not  known only after the post mortem report prepared by the Veterinary Surgeon.  Prior to that the complainant might not be knowing about the disease with which buffalo was suffering. In his presence the  buffalo might have fallen down and then died. Therefore, in such a situation it cannot be said that there was contradiction regarding the cause of death as mentioned in the application of the complainant and the post mortem report.  In para no.5 of the complaint it has been pleaded that buffalo suffered electric current and lateron died. It appears that such pleading could be due to inadvertence or negligence of the counsel  for the complainant, who drafted the complaint, but the complainant cannot be made to suffer on that account because  the post mortem report  prepared by the Veterinary Surgeon  could only  disclose the exact cause of death of the  buffalo. Under such circumstances, we are of the opinion that buffalo of the complainant had in fact died on account of infection, pneumonia and other problems.        

 

 

9.                It is pertinent to mention that there is no dispute regarding the death of the insured buffalo.  Merely, the complainant did not produce the certificate of the Sarpanch or treatment record of the buffalo could not be the grounds to close claim of the complainant. The insurance company could not repudiate the claim on technical grounds when the claim is, otherwise, established to be genuine. Therefore, repudiation of the claim of the complainant on such technical grounds amounted to deficiency in services.

 

10.               As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Party to make the payment of Rs.40, 000/- to the complainant within a period of thirty days from the date of receipt of the copy of this order, failing which the complainant shall be entitled to interest @ 9% per annum after the expiry of 30 days of the passing of this order till realization. The complainant shall also be entitled for a sum of Rs.3300/- for the mental agony and pain suffered by him and for the litigation expenses.  The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
dated:24.02.2016

                                                               (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

 

 

 

Present:-        Sh Umed Singh Advocate for the complainant.

                     Sh.Sanjiv Vohra 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:24.02.2016

                                                               (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.