Before the District Consumer Disputes Redressal Forum, Rohtak.

                                                          Complaint No. : 238.

                                                          Instituted on     : 04.07.2014.

                                                          Decided on       : 15.03.2016.

Ishwar s/o Sh. Ram Singh r/o Mangat Dhingra Dairy Farm, Milk Chowk near Old Bus Stand, Rothak.

                                                          ………..Complainant.

                             Vs.

National Insurance Company Limited Rohtak through its Divisional Manager.

                                                     ……….Opposite party.

          COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.

BEFORE:  SH.JOGINDER KUMAR JAKHAR, PRESIDENT.

                   MS. KOMAL KHANNA, MEMBER.

                   SH. VED PAL, MEMBER.

Present:       Sh.O.P.Chugh, Advocate for the complainant.

                   Sh.A.S.Malik, Advocate for the opposite party.

                                      ORDER

SH. JOGINDER KUMAR JAKHAR, PRESIDENT :

1.                          The present complaint has been filed by the complainant with the averments that he got insured his buffalo from the opposite party bearing tag no.NIC/32880 for the sum assured Rs.60000/-. It is averred that the buffalo of the complainant had died on 28.07.2013 and P.M.R. was conducted by the concerned doctor on the same day.   It is averred that the complainant lodged claim and submitted all the documents with the opposite party but till today the claim has not been paid. Complainant also sent a legal notice to the opposite party on dated 10.01.2014 but to no effect and the opposite party has refused to pay any heed to the request of complainant. It is averred that the act of opposite party is illegal and amounts to deficiency in service. As such it is prayed that the opposite party may kindly be directed to pay Rs.60000/- alongwith interest, compensation and litigation expenses to the complainant.

2.                          On notice, opposite party appeared and filed its written statement submitting therein that the investigation was conducted by         Sh. Karamvir Singh Malik, which reflects that the said buffalo was sick for a period of 15 days before the death. She was not treated during that period. It is violation of terms and conditions of policy. It is denied that the said buffalo was not remained ill before death. It is averred that the claim has been settled after proper investigation and verification in the light of terms and conditions of the policy as: “No Claim”. All the other contents of the complaint were stated to be wrong and denied. Opposite party prayed for dismissal of the complaint with costs.

3.                          Both the parties led evidence in support of their case.

4.                          Ld. Counsel for the complainant in his evidence tendered his affidavit Ex.CW1/A, documents Ex.C1 to Ex.C5 and has closed his evidence. On the other hand, ld. Counsel for the opposite party has tendered affidavits Ex.R1, documents Ex.R2 to Ex.R5 and has closed his evidence.

5.                          We have heard learned counsel for the parties and have gone through the material aspects of the case very carefully.

6.                          It is admitted case of the parties that buffalo of the complainant has been insured with the opposite party for a sum of            Rs.60000/- having tag no.NIC/32880 as is proved from the Valuation Certificate Ex.C5.  It is also not disputed that the alleged buffalo had died on 28.07.2013 due to Tympany as is proved from the PMR Ex.C3. After the death of buffalo the complainant has filed the insurance claim with the opposite party but the same was repudiated by the opposite party vide its letter Ex.R2 on the ground that the description of buffalo died on 28.07.2013 does not match with the Health Certificate of policy.  

7.                          After going through the file and hearing the parties it is observed that as per the repudiation letter the reason for repudiating the claim is description of buffalo does not match with the insured buffalo whereas as per the written statement filed by the opposite party no such plea has been taken and the reason for repudiation is that the buffalo was sick for last 15 days. Hence there is contradiction between the reason of repudiation of claim as mentioned in the written statement and repudiation letter. Regarding the contention of opposite party as mentioned in the repudiation letter that the features of the dead buffalo does not match with the features of the insured buffalo, it is observed that as per PMR Ex.C3 the buffalo of the complainant having tag number NIC/32880 was died on 28.07.2013 and as per Health cum evaluation certificate Ex.R3 buffalo having tag no. NIC/32880 was insured and other body features mentioned in this document tally with the PMR. Hence from the documents placed on record it is proved that the buffalo having tag NIC/32880 was died which was insured with the opposite party. In this regard reliance has been placed upon the law cited in 2014(3)CLT 445 titled as The Oriental Insurance Company Limited & others Vs. Navrattan whereby Hon’ble Haryana State Commission, Panchkula has held that: “Insurance claim-Buffalo-Repudiation-On the ground that the dead buffalo was not the same which was insured-Held-the Post Mortem examination report reveals that the marks of identification of the dead buffalo are the same which have been mentioned in the Insurance policy-Insurance liable” as per  2004(1)CPC 573 titled National Insurance Company Limited and another Vs. Roop Dass and another, Hon’ble State Commission, Punjab, Chandigarh has held that: “Claim of dead buffalo filed but repudiated- District Forum held that particulars of deceased buffalo did tally with buffalo described at Serial No.1 in the Health Certificate annexed with document of policy-Repudiation of claim on the basis of postmortem report cannot be sustained as tag was not found tied to the body of buffalo at the time of postmortem-Appeal dismissed with costs”. Regarding the plea taken by the opposite party in its written reply regarding sickness of buffalo, no document has been placed on record by the opposite party. Moreover as per copy of PMR Ex.C3, the General Condition of the body of buffalo was Good and the cause of death of buffalo is “Tympany”. As such the buffalo was not suffering from any disease prior to its death and as such no treatment record was presented by the complainant.   In view of the aforesaid law which are fully applicable on the facts and circumstances of the case it is observed that the repudiation of claim by the opposite party is illegal and amounts to deficiency in service and the complainant is entitled for the insurance claim.

8.                          In view of the facts and circumstances of the case it is directed that opposite party shall pay the insured sum of Rs.60000/-(Rupees sixty thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 04.07.2014 till its actual realization and shall also pay a sum of Rs.3000/-(Rupees three thousand only) as litigation expenses to the complainant maximum within one month from the date of order failing which the awarded amount shall carry further interest @ 12% p.a. from the date of decision. Complaint is disposed of accordingly.

9.                          Copy of this order be supplied to both the parties free of costs.

10.                        File be consigned to the record room after due compliance.

Announced in open court:

15.03.2016.         

                                                         ................................................

                                                          Joginder Kumar Jakhar, President

                                                          ..........................................

                                                          Komal Khanna, Member.

                                                                        …………………………………..

                                                          Ved Pal, Member