BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.
Complaint No.167 of 2013
Date of instt.2.04.2013
Date of decision:12.02.2015
Mehak Singh son of Shri Jai Singh resident of village Mussepur tehsil Indri district Karnal.
……..Complainant.
Vs.
National Insurance Company Ltd. through its Branch Manager, Branch office, Santokh Market, Railway Road, Karnal Haryana.
…..Opposite Party.
Complaint u/s 12 of the Consumer
Protection Act.
Before Sh.Subhash Goyal……..President.
Sh.Subhash Chander Sharma……Member.
Present:- Sh.Karan Singh Mandhan Advocate for the complainant.
Sh.K.D.Goyal Advocate for the OP.
ORDER
The complainant has filed the present complaint against the Ops u/s 12 of the Consumer Protection Act on the allegations that on 1.11.2012 the complainant had purchased a policy in the sum of Rs.one lakh for insurance of his two buffalos and Ops after physicial verification of the cattles issued the insurance policy No. 420500/47/12/9400000759 dated 1.11.2012 valid upto 31.10.2013 and issued the tag No. NIC-KNL 09396 and NIC-KNL-09397 to the cattles. On 5..11.2012 one of his buffalo having tag No. NIV-KNL-09396 fell ill and the complainant got the treatment from the Veterinary Surgeon GVH, Kalsora district Karnal but ultimately the buffalo of the complainant died and post mortem of the cattle was conducted bearing
No.21 dated 18.11.2012. The complainant also gave information to the OP in this respect. The complainant lodged the claim with respect of death of his buffalo with the OP and completed all the formalities but the claim of the complainant has not been paid which amounts to deficiency in services on the part of the OP. Thus, the complainant has filed the present complaint against the OP alleging deficiency in services on the part of the OP and has also sought compensation for the harassment caused to him. He has also tendered his affidavit in support of the averments made in the complaint.
2. On notice the OP appeared and filed its written statement raising the preliminary objections that the complaint was not maintainable and that there was no deficiency in services on the part of the OP.
On merits, insurance of the cattle of the complainant has not been denied by the OP but it was contended that the complaint was not maintainable as it falls within the exclusion clause of fifteen days according to which the company was not liable to pay the claim in the event of death of the insured animal due to disease occurring within 15 days from the commencement of the risk. Thus, it was contended that there was no deficiency in services on the part of the OP and dismissal of the complaint has been sought.
3. We have heard the learned counsel for the parties and have gone through the case file very carefully.
4. Therefore, from the facts and circumstances of the case, evidence on the file and the arguments advanced by the learned counsel for the parties, it emerges that the complainant has filed the present complaint against the OP on the allegations that he got his buffalo insured from the OP in the sum of Rs.50, 000/- and the policy was issued which was valid w.e.f. to 1.11.2012 to 31.10.2013 and the Tag bearing No. NIC-KNL-09396 was issued. The said insured buffalo fell ill and died on 17.11.2012 and post mortem examination was conducted vide Ex.C2 and the complainant lodged the claim with the OP but the same was repudiated vide Ex.C3.
However, as per contention of the OP the claim has rightly been repudiated in view of exclusion clause of the policy that if the insured animal died due to disease occurring within 15 days from the date of commencement of the ricks, then the OP was not liable to indemnify the loss in view of Ex.OP5.
5. Therefore, after going through the evidence and circumstances of the case, there is no dispute that insured buffalo bearing tag No. NIC-KNL-9396 died on 17.11.2012 around 5.00PM on account of illness i.e. during the subsistence of the policy Ex.C1. The claim has been repudiated on account of alleged exclusion clause mentioned in the policy Ex.C1 that if the death has taken place within 15 days due to illness from the date of commencement of the risk, the company was not liable to indemnify.
However, after going through the insurance policy Ex.C1 it seems that the said exclusion clause is meant for taking place of the death due to illness within fifteen days from the commencement of the risk and in case of accidental death, the insurance company was liable to indemnify the loss. In the instant case, the insurance policy Ex.C1 commenced w.e.f. 1.11.2012 to 31.10.2013 and the death of the cattle has taken place on 17.11.2012 as shown in the post mortem report Ex.C2. Therefore, the death has taken place after the expiry of fifteen days as stipulated in the insurance policy Ex.C1 and as such repudiation of the claim by the OP vide Ex.C3 was not sustainable in the eyes of law and as such we hold that there was deficiency in services on the part of the OP in not paying the claim to the complainant.
6. Therefore, as a sequel to our above discussion, we accept the present complaint and direct the OP to make the payment of the sum insured to the complainant alongwith interest @ 9% per annum from the date of filing of the present complaint i.e.2.04.2013 till its actual realization. The complainant shall also be entitled for a sum of Rs.5000/- for the harassment caused to him and a sum of Rs.2200/- towards legal fee and litigation expenses. The OP 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
12.2.2015 (Subhash Goyal)
President,
District Consumer Disputes
Redressal Forum, Karnal.
(Subhash Chander Sharma)
Member
Present:- Sh.Karan Singh Mandhan Advocate for the complainant.
Sh.K.D.Goyal Advocate for the OP.
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
12.2.2015 (Subhash Goyal)
President,
District Consumer Disputes
Redressal Forum, Karnal.
(Subhash Chander Sharma)
Member
