Haryana

Yamunanagar

CC/351/2013

Anwar Hussain S/o Shifakat Ali - Complainant(s)

Versus

National Insurance Co .ltd. - Opp.Party(s)

N.S.Rana

17 Mar 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                    Complaint No. 351 of 2013.

                                                                                                    Date of institution: 06.05.2013

                                                                                                    Date of decision:  17.03.2017

Anwar Hussain aged about 25 years son of Shifakat Ali, resident of village Ganauli, Tehsil Chhachhrauli, District Yamuna Nagar.                                                                                                                                                                                           

                                                                                                                                                               …Complainant.

                                                Versus                                                

1. National Insurance Company Ltd. Divisional Office: 106, Railway Road, Ambala Cantt. through its Manager.
2. National Insurance Co. Ltd., Branch Office: Yamuna Nagar, through its Manager.                                                                                                                                                                                                                              …Respondents 

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                            SH. S.C.SHARMA, MEMBER

Present: Sh. Narender Singh Rana, Advocate, counsel for complainant.   

              Sh. Karnesh Sharma, Advocate, counsel for respondents.

 

ORDER (ASHOK KUMAR GARG PRESIDENT)

 

1.                         Complainant Anwar Hussain has filed the present complaint under section 12 of the Consumer Protection Act 1986.

2.                     Brief facts of the present complaint, as alleged by the complainant, are that complainant obtained a loan from the Punjab National Bank, Chhachhrauli for purchasing buffalos for dairy farm and after obtaining the loan, the complainant has purchased buffalos. The respondents (hereinafter respondents will be referred as OPs Insurance Company) had insured the buffalos of the complainant on 19.04.2011 for the period of three years valid w.e.f. 19.04.2011 to 18.04.2014. The OPs had also issued tags as per health certificate and issued a cover note bearing No. 420911188397 dated 19.04.2011. One buffalo bearing tag No. NIC-51193 was fallen ill and in this regard the complainant approached to OPs Insurance Company and told about the illness of the buffalo and he started the treatment of the said buffalo but ultimately on 07.06.2012 the said buffalo had died and on the same day he contacted to OPs Insurance Company and doctor Sukhvir Singh of Veterinary Hospital, Chhachhrauli, District Yamuna Nagar who has conducted the postmortem on the dead body of the said buffalo on 08.06.2012 in the presence of OPs Insurance Company and in the presence of other persons of the village Ganauli. The Ops Insurance Company had taken the photographs and completed all the formalities as required by the OPs Insurance Company and also assured to the complainant that the insured amount will be disbursed very soon. The sarpanch of the Gram Panchayat Ganauli has issued a certificate regarding the death of above tagged buffalo of the complainant and Manager of the Punjab National Bank had also issued a certificate of death verification of buffalo of complainant. The complainant visited several times in the office of the OPs Insurance Company and requested to make the payment of insured buffalo bearing tag No. NIC-51193 but they postpone the matter on one pretext or the other and lastly refused to make the payment of insured amount. Lastly, prayed for directing the OPs Insurance Company to pay the claim amount of Rs. 50,000/- on account of death of insured buffalo alongwith compensation as well as litigation expenses. Hence this complaint.

3.                     Upon notice, OPs appeared and filed its written statement  by taking some preliminary objections such as complaint is not maintainable; the claim of the complainant has been repudiated on the legal and valid ground and the complainant was informed about the fate of his claim vide registered letter dated 31.12.2012; this Forum has got no territorial jurisdiction to try, entertain and adjudicate the present complaint; the complaint is bad for non-joinder and mis joinder of necessary parties; complainant has not come to this Forum with clean hands; complainant has no locus standi to file the present complaint and on merit it has been admitted that the complainant had purchased an insurance policy and insured three cows and three buffalos vide insurance policy bearing No. 420402/47/11/9400000046 which was effective from 19.04.2011 to 18.04.2014. On receiving the intimation regarding the death of one buffalo bearing tag No. NIC/51193 on 06.06.2012, the OPs insurance company immediately registered the claim and started processing. The complainant was requested to submit necessary documents and the tag in question to the OPs Insurance Company and in this regard letters dated 27.08.2012, 26.09.2012 and lastly letter dated 12.10.2012 were written to the complainant but the complainant failed to comply with the letters of the OPs Insurance Company. The OPs Insurance Company further mentioned that a specific condition of the insurance policy is that the ear tag should be surrendered to the company at the time of claim otherwise the claim will be treated as “No Claim” Since, the complainant had violated the specific condition of the insurance policy stated above by not handing over the ear tag to the OPs Insurance Company, therefore, the claim of the complainant was repudiated on legal and valid ground.  Lastly, prayed for dismissal of complaint being no deficiency in service or unfair trade practice on the part of OPs Insurance Company. 

4.                     To prove the case, complainant tendered into evidence his affidavit as Annexure CW/A and documents such as Photo copy of certificate issued by Gram Panchayat as Annexure C-1, Photo copy of valuation certificate/ health certificate as Annexure C-2, Photo copy of livestock claim/ Veterinary Certificate as Annexure C-3, Photo copy of claim form as Annexure C-4, Photo copy of Bank’s advance certificate as Annexure C-5, Photo copy of death verification certificate as Annexure C-6, Photo copy of Postmortem report as Annexure C-7, Photo copy of receipt as Annexure C-8, Photo copy of insurance cover note as Annexure C-9, Photo copy of legal notice as Annexure C-10, Photo copy of postal receipt as Annexure C-11, Photo copy of Health Certificate as Annexure C-12 and closed his evidence. 

5.                     On the other hand, counsel for the OPs  Insurance Company tendered into evidence affidavit of Parveen Arora, Administrative Officer, NIC, as Annexure RW1/A and documents such as Photo copy of claim repudiation letter dated 31.12.2012 as Annexure R1, Photo copy of Insurance Policy as Annexure R2, Photo copy of letter dated 27.08.2012 as Annexure R-3, Photo copy of letter dated 26.03.2012 as Annexure R-4, Photo copy of letter dated 12.10.2012 as Annexure R-5 and closed the evidence on behalf of OPs Insurance Company.

6.                         We have heard learned counsel for both the parties and have gone through the pleadings as well as documents carefully and minutely placed on the file. Counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for opposite parties reiterated the averments made in reply and prayed for its dismissal.

7.                     Learned counsel for the complainant argued at length that genuine claim of the complainant has been repudiated by the OPs Insurance Company on the flimsy ground that the complainant failed to comply with the letters of the OPs Insurance Company and failed to handed over the ear tag whereas the Veterinary surgeon has clearly mentioned the ear tag No. NIC-51193 in the Postmortem Report (Annexure C-7) and other particulars of the dead cow mentioned in the PMR Annexure C-7 were tallied with the particulars mentioned in the Health Certificate Annexure C-2. Learned counsel for the complainant further argued that a certificate (Annexure C-1) has also been issued by the Gram Panchayat Ganauli in which it has been clearly mentioned that the insured buffalo bearing tag No. NIC 51193 of Anwar Hussain had died. Learned counsel for the complainant further argued that OPs Insurance Company cannot repudiate the claim of the complainant on the mere ground that the ear tag of the dead buffalo had not been handed over to the OPs Insurance Company and referred the case law titled as National Insurance Company Limited and another Versus Roop Dass and Another, 2004(1) CPC page 573 State Commission Punjab wherein it has been held that three buffalos were insured with opposite party for Rs. 38,250/- one of them died- Claim 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. Further referred the case law titled as New India Assurance Co. Ltd. Versus Gaindi Devi, 2004(1) CLT page 347 Uttaranchal State Commission, Dehradoon wherein it has been held that Insurance Claim- Buffalo died- Claim refused on the ground that there was no tag in the ear of the buffalo- The survey was after 5 months- Held that the recording of evidence by the surveyor after 5 months does not remain reliable- Order of the District Forum allowing the complaint on the basis of evidence on record upheld.

8.                     On the other hand, counsel for the OPs Insurance Company hotly argued at length that the claim of the complainant has been rightly repudiated vide its letter dated 31.12.2012 (Annexure R-1) as there was violation of terms and conditions of the Insurance Policy on the part of the complainant. Learned counsel for the OPs Insurance Company argued that as per condition of the policy Tag should be surrendered at the time of claim otherwise it will be treated as no claim whereas the complainant had failed to surrender the ear tag after issuance of letter dated 27.08.2012, 26.09.2012 and lastly letter dated 12.10.2012 and draw our attention towards the insurance policy/cover note Annexure R-2/C-9. Learned counsel for the OPs further argued that the claim of the complainant has been rightly repudiated vide its letter dated 31.12.2012 (Annexure R1). Hence, there is no deficiency in service or unfair trade practice on the part of Op Insurance Company and referred the case law titled as United India Insurance Company Ltd. Versus Banbari 2003(1) CLT Page 621 State Commission, Lucknow.

9.                     After hearing the parties at length, we are of the considered view that there is deficiency in service on the part of OPs Insurance Company and the claim of the complainant has been wrongly repudiated by the OPs Insurance Company. The law cited by the counsel for the OPs is not disputed but not helpful in the present case whereas the law cited by the counsel for the complainant is fully applicable in the present case.  In the present case Postmortem of the dead buffalo was conducted by the Veterinary Surgeon and who has specifically mentioned the tag No. NIC-51193 in the postmortem report Annexure C-7 and in this regard he has also issued a certificate (Annexure C-6) in which the tag number has also been mentioned. The version of the Veterinary Surgeon has also been supported by the Gram Panchayat Ganauli vide certificate Annexure C-1 in which it has also been clearly mentioned that the insured buffalo bearing tag No. NIC-51193 died on 07.06.2012. Furthermore, from the perusal of health certificate and postmortem report it is evident that the description of the animal in the health certificate and postmortem report are same. Even, the OPs Insurance Company neither tender any investigation report nor tender any affidavit of any surveyor who conducted the investigation of the said buffalo.  Thus the repudiation letter dated 31.12.2012 (Annexure R-1) is liable to be set aside and the act of the OPs Insurance Company in repudiating the claim of the complainant amounts to deficiency in service and the complaint of complainant deserve acceptance.

10.                   Resultantly, we partly allow the complaint of complainant and direct the OPs Insurance Company to pay a sum of Rs. 50,000/- as insured amount on account of deceased buffalo bearing tag No. NIC/51193 to the complainant within a period of 30 days after preparation of copy of this order failing which OPs will be liable to pay interest at the rate of 7% per annum for the defaulting period. Order be complied within a period of 30 days after preparation of copy of this order failing which complainant shall be entitled to invoke the jurisdiction of this Forum as per law. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court. 17.03.2017.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

                                                                                           DCDRF, YAMUNANAGAR.

 

 

                                                                                           (S.C.SHARMA)

                                                                                            MEMBER