Punjab

Rupnagar

CC/15/20

Inderjit Singh - Complainant(s)

Versus

National Insurance Company - Opp.Party(s)

Sh. Varinder Kumar, Adv

27 Jul 2015

ORDER

ORDER

                                       MRS. NEENA SANDHU, PRESIDENT

                   Sh. Inderjit Singh has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Party (hereinafter referred to as ‘the O.P.’). In the amended complaint, he has prayed for issuance of the following directions to the O.P.:-

i)       To pay the insurance claim of Rs.23,000/- (i.e. Rs.8000/- of one goat & Rs.5000/- each of three goats), as assessed by its officials,

ii)      To pay Rs.20,000/- as compensation on account of mental agony, physical harassment & financial loss suffered by him.  

 

iii)     To pay Rs.10,000/- as litigation expenses.

 

 

2.                In brief, the case of the complainant is that he was running the business of dairy farming and had purchased 17 goats after taking loan from the Punjab National Bank, branch Gharuan, Tehsil Kharar, District SAS Nagar, Mohali and got the said goats insured with the O.P. by paying premium on 17.01.2014. Accordingly, the O.P. had issued the insurance policy, valid for the period from 17.01.2013 to 16.01.2014. At the time of insurance, the said goats were duly tagged by the said insurance company. Unfortunately, after about one month of the date of issuance of the said insurance policy, some disease had spread over, due to which, four goats (two goats of black colour, one of black &white colour and one black spotted white) out of the said 17 insured goats had died. The goat bearing tag No.53675 was insured for a sum of Rs.8000/- and the other three goats were insured for a sum of Rs.5000/- each, as per the said insurance policy. He gave information about the death of the said four goats to the O.P., who deputed the doctors, who had come at the spot and conducted the post mortem of the dead goats, as per the directions of the O.P. Thereafter, he submitted his claim before the O.P. and completed all the formalities as per its directions. On 21.01.2014, the O.P. issued a letter to him vide which he was directed to explain his position and the said direction was complied with. Thereafter, the O.P. told him that the insurance claim amount would be sent to to the Punjab National Bank Branch Gharuan, Tehsil Kharar, District Mohali. On 28.10.2014, when he went to enquire about the same from the said bank, its officials told him that the O.P. had not sent even a single penny in his account. Thereafter, he again visited to the office of the O.P. to enquire about the insurance claim amount, but in spite of his repeated requests, the O.P. had not released the claim amount and had been putting off the matter on one pretext or the other. He is a poor person and has no other source of income except the above said business of dairy farming. The O.P. is unnecessary harassing him and the said act of the O.P. amounts to deficiency in service, due to which he has suffered mental agony, physical harassment and financial loss. Hence, this complaint.

 

3.                On being put to notice, the O.P. filed written version taking preliminary objections; that the insurance policy in question was issued subject to its terms and conditions and that the present complaint is false, frivolous and vexatious, as such, the same is liable to be dismissed. On merits, it is admitted that the complainant had obtained one insurance policy No.404701/47/12/9400000437 covering the goats, which were duly tagged vide Tags No.53569-NIC to 53675-NIC for the period from 17.01.2013 to 16.01.2014, but it is stated that the said policy was issued strictly subject to its terms & conditions. It is admitted that during the currency of the said policy, the complainant had submitted claims in respect of goats bearing Tag No.53675-NIC and Tag No.53663-NIC and the claim amounts in respect of said goats were paid. It is further stated that the complainant had also submitted claim with regard to the death of another goat on 30.08.2013. Accordingly the competent authority deputed Dr. H.K. Chauhan, Investigator, to verify the loss. The complainant had also submitted one livestock claim form alongwith veterinary certificate and valuation certificate, besides post mortem report. The investigator had submitted his report dated 29.10.2013 to the insurance company, in which he has stated that—

“Comparison of physical identifications as stated in health certificate of the goat tagged NIC 53673 to 53678 with those captured of the dead goat, which had intact ear tag with NIC 536 readable as the ear tag was partially chewed by other goats, reveal that the dead goat’s physical identification viz. body colour which is black spotted white and not black and white and shape size of horns etc.

          Thus, from the above stated facts, it can be concluded that the death claim lodged by insured Sh. Inderjit Singh r/o village Gharuan of his goat is not genuine especially relating to physical identification and thus not payable.”

 

                   After receipt of the said report, a letter dated 21.2.2014 was issued to the complainant to explain his position in that regard, but he had failed to give reply. On 21.3.2014, reminder was also issued to him, but even then no reply was received from him, as such, the O.P. had left with no option but to close the claim file as “No Claim” vide order dated 9.4.2014. Hence, there is no deficiency in service on the part of the O.P. and no claim amount is payable to the complainant and complaint filed by him is liable to be dismissed. Rest of the allegations made in the complaint have also been denied and a prayer has been made for dismissal of the same.

 

4.                On being called upon to do so, the complainant tendered his affidavit of the complainant, Ex. CW1/A, photocopies of documents Ex.C1 & C2 and closed the evidence. On the other hand, the learned counsel for the O.P. tendered affidavit of Sh. Gurnam Singh, Senior Branch Manager, Ex. OP-1, affidavit of Sh. H.K. Chauhan, surveyor, Ex. OP-2, photocopies of documents Ex. OP-3 to Ex. OP-42 and closed the evidence.

 

5.                We have heard the learned counsel for the parties and gone through the record of the file carefully.

 

6.                Admittedly, 17 goats purchased by the complainant were duly insured with the O.P. vide policy No.404701/47/12/9400000437 (Ex. C2) for the period from 17.1.2013 to 16.1.2014 and the same were allotted tag numbers 53659 NIC to 53675 NIC, as detailed in the said policy, for identification purposes. As per version of the complainant, due to spreading of some disease, out of the said insured goats, four goats had died and claims for the same were duly lodged with the O.P., but they did not pay any claim amount to him. Whereas, the stand of the O.P. is that, it had already disbursed the claim amount in respect of the dead goat bearing tag No.53663 NIC on the basis of the investigation report dated 18.2.2013 submitted by the investigator duly appointed in that case. From the investigation report dated 18.2.2013(Ex. OP-20), it is apparent that the investigator had assessed the claim amount at Rs.4000/- and accordingly, the O.P. had disbursed the said amount to the complainant vide disbursal voucher dated 22.3.2013(Ex.OP-15). Since the O.P. has already paid the claim amount to the complainant, therefore, the complaint, so far as the same has been filed for payment of the claim amount in respect of the said goat bearing tag No.53663 NIC needs no determination.

 

7.                It is further the version of the O.P. that the complainant had also lodged claim in respect of another goat bearing tag No.53675 NIC, which had died on 8.9.2013. Investigator was also duly appointed to investigate the said claim, who submitted his report dated 29.10.2013(Ex. OP-29), on the basis of which the claim amount of Rs.4500/- was paid vide disbursal voucher dated 11.3.2015(Ex.OP-40) in respect of the said goat insured vide tag No. 53675 NIC. Admittedly, on receipt of claim in respect of goat bearing tag No.53675 NIC, which had died on 8.9.2013, the investigator had submitted his report on 29.10.2013(Ex. OP-29), whereas the amount of Rs.4500/- was disbursed to the complainant on 11.3.2015 i.e. after a delay of 1 year 4 months approximately, even after submission of report by the investigator and no reason, whatsoever, for the said delayed payment has been explained by the O.P. Therefore, to that extent, the O.P. has committed deficiency in service and is liable to compensate the complainant, adequately, for the mental agony, physical harassment & financial loss suffered by him, alongwith litigation expenses.

 

8.                It is further the version of the O.P. that the complainant had also lodged claim for another goat, which had died on 30.8.2013. The investigator was also duly appointed for investigation of the said claim, who had submitted his report dated 29.10.2013 (Ex.OP-8) wherein it was categorically mentioned that comparison of physical identifications as stated in health certificate of the goats bearing Tags No. NIC 53673 to 53678, with the photographs captured of the dead goat, which had intact ear tag, partially chewed by the other goats, readable as NIC 536 only, revealed that the dead goat’s physical identification viz. body colour which is black spotted white and not black and white & shape size of horns etc. did not match with any of the insured goats. From the perusal of photographs Ex. OP-4 to OP-6, it is revealed that the goat allegedly died was of black, having white spots. Perusal of photograph, Ex. OP-3, reveals that the ear tag was duly affixed on the said goat, but its complete number is not readable, therefore, no reliance can be placed on the said ear tag for identification purpose of the said dead goat. So far as the stand of the O.P. that the physical appearance of the dead goat did not match with that of the insured goat, is concerned, it is pertinent to mention here that the O.P. has placed on record the Health certificates Ex. OP 14, Ex.OP-34 & Ex.OP 22. The health certificate dated 12.1.2013, Ex. O.P.-14, which has been re-exhibited as OP-34, reveals that the same was issued in respect of the goats, which were insured vide tags No.53673/NIC to 53678/NIC. Perusal of the other health certificate dated 12.1.2013, Ex. O.P.22, reveals that it was issued in respect of the goats, which were insured vide tags No.53659/NIC to 53665/NIC. As per policy (Ex. OP-27), 17 goats of the complainant were insured and they were allotted Tag Nos. 53659 to 53675, but as stated above the above said health certificates cover only the goats, which were insured vide tags No.53659/NIC to 53665/NIC, 53673/NIC to 53678/NIC and the health certificate pertaining to goats bearing tags No. 53666/NIC to 53672/NIC has not been placed on record. The surveyor had also compared the physical identification of this goat only with that of the goats insured vide tags No. NIC53673 to 53678. Since the O.P. has not produced on record the health certificates of all the 17 insured goats having tag Nos. No.53659/NIC to 53675/NIC, in the absence thereof, no inference can be drawn that the dead goat was not the insured one. Thus, the O.P. was not justified in withholding the claim in respect of the said goat. Now the question that arises for consideration is as to what should be the quantum of the claim amount to be paid by the O.P. in respect of this goat, which had died on 30.8.2013. From the bare perusal of the copy of the insurance policy (Ex. OP-27), it is clear that the first 16 goats bearing tag Nos. No.53659/NIC to 53676/NIC were insured for a sum of Rs.5000/- each and only the 17^th goat bearing tag No.63675-NIC was insured for a sum of Rs.8000/-. The claim qua the said 17^th goat bearing tag No.63675-NIC has already been disbursed by the O.P. Therefore, it can safely be concluded that the instant goat was also insured for a sum of Rs.5000/-. Since this goat was also insured for a sum of Rs.5000/-, keeping in view the fact that the O.P. had already paid a sum of Rs.4000/- in respect of another goat bearing tag No.53663, which was also insured for a sum of Rs.5000/-, therefore, the O.P. is also held liable to pay a sum of Rs.4000/- in respect of this goat. Due to non-payment of the claim amount, the complainant must have suffered mental agony, physical harassment and financial loss, for which he is also entitled for compensation and litigation expenses.

 

9.                No doubt, the complainant has alleged that his four goats, out of 17 insured goats, had died, but he has not placed on record any document, on the basis of which it can be said to have been proved that in fact, his fourth goat had also died and he had lodged claim with the O.P. for the same. Accordingly, he is not entitled to payment of any claim amount in respect of his fourth goat, alleged to have been died.

 

10.              In view of the aforesaid discussion, we partly allow the complaint and direct the O.P. to pay to the complainant, in the following manner:-

i)   To pay the claim amount of Rs.4000/- in respect of the

      goat died on 30.08.2013,

                   ii)  To pay a sum of Rs.5000/- as compensation,

                   iii) To pay Rs.3000/- as litigation expenses.

 

The O.P. is further directed to comply with the above said directions within 45 days from the date of receipt of certified copy of this order.

 

11.              The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed & consigned to Record Room.

 

ANNOUNCED                                                                       (NEENA SANDHU)

Dated 27.07.2015                                       PRESIDENT

 

 

                                                (SHAVINDER KAUR)

                                                                     MEMBER.