Haryana

Ambala

CC/314/2020

Sarabjeet Singh - Complainant(s)

Versus

New India Assurance Co Ltd - Opp.Party(s)

Ankush Gupta

12 Oct 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, AMBALA.

Complaint case no.	:	314 of 2020
Date of Institution	:	10.12.2020
Date of decision	:	12.10.2023

 

Sarabjeet Singh S/o Sh. Baldev Singh R/o village Santokhi Sub Tehsil Shahzadpur, Tehsil Naraingarh, Distt Ambala.

          ……. Complainant.

                                                Versus

1. New India Assurance Company Ltd. Divisional office-312700, NH-5/R-2, Badshah Khan Chowk Faridabad-12001 Haryana, through its branch manager.
2. New India Assurance company Ltd. Head office 87 MG Road, fort, Mumbai-400001 Maharastra.
3. Veterinary Surgeon GVH., Santokhi Ambala.

….…. Opposite Parties

 Before:       Smt. Neena Sandhu, President.

          Shri Vinod Kumar Sharma, Member.           

 

Present:       Shri Ankush Gupta, Advocate, counsel for the complainant

                     Shri Mohinder Bindal, Advocate, counsel for the OPs No.1 and 2

                   None for OP No.3.        

Order:        Smt. Neena Sandhu, President.

1.                Complainant has filed this complaint under Section 35 of the Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) praying for issuance of following directions to them:-

1. To pay a sum of Rs.70,000/- as claim amount to the complainant along with interest @ 18% p.a.
2. To pay a sum of Rs.1,00,000/- as general and special damages for mental pain and sufferings and cost of traveling etc.
3. To pay cost of litigation of Rs.11,000/-

 

2.             Brief facts of this case are that the complainant had two Buffalos for domestic milk purpose. In the month November 2019 OP No. 3 visited the house of the complainant and explained about the government policy with regard to the insurance. As such, on the assurance of OP No.3, the complainant got insured his two buffalos for Rs.70,000/- each with OP No.1 through OP No.3 vide Policy No. 106149 valid for the period from 22.11.2019 to 21.11.2021. Two separate tag bearing no.160040812262 and 160040812268 were also given to identify the buffalos. On 23.12.2019, one buffalo of the complainant bearing tag no. 160040812268 fell ill for which her treatment was taken from OP No.3. During the treatment, the said buffalo died on 10.01.2019. Intimation in this regard was given to OP No.3, who conducted postmortem on 10.01.2020. However, after certifying the claim from OP No.3, the complainant submitted claim with OPs No.1 and 2, yet, they   in the first instance lingered on the matter and thereafter, ultimately refused to pay the claim without any reason thereby causing mental agony, harassment and financial loss to the complainant.   Hence, the present complaint.
3.           Upon notice, OPs No.1 and 2 appeared and filed written version and raised preliminary objections to the effect that  the complaint is not maintainable; the complainant has not approached the Commission with clean hands and has suppressed the material facts;  this Commission has got no territorial jurisdiction to entertain and try the present complaint;  the present complaint is ex-facie misconceived, vexatious, untenable and devoid of any merit; the present complaint is also not maintainable since the same has been filed without any cause of action etc. On merits, it has been stated that the complainant had never provided the treatment record of the cattle in question and even provided a vague post mortem report (PMR) which is suspicious as well, since on the said PMR, the doctor has prescribed certain medicines for the animal in question which has been declared and shown dead by him. Although the buffalo of the complainant was insured vide tag no. 160040812266 instead of 160040812268 for the period from 22.11.2019 to 21.11.2021 but at the same time it was required that in case of any causality, he was supposed to provide all the requisite papers with regard to the ailment, treatment and cause of death of the insured animal but the complainant failed to provide all these papers and rather submitted a vague postmortem report and wrong tag number etc. and even failed to explain, therefore, he is not entitled to any compensation.  The policy was issued subject to certain terms and conditions and the insured or the beneficiary out of the same was legally bound to follow them without any failure. Under a cattle policy, tag number is very important for the identification of the insured animal thus all the claims preferred without a proper tag and number is not payable as per law. The complainant himself has not acted as per the terms and conditions and has not followed the specified procedure.  Rest of the averments of the complainant were denied by the OP No.1 and 2 and prayed for dismissal of the present complaint with costs.
4.           Upon notice, OP No.3 in his short written version stated that he has just Joined GVH Santokhi on 15.6.2021. The documents of this complaint were handed over to him by VS Sherpur to give relevant reply to the case pertaining to Dr Sonu Kumar, Vety. The then Surgeon in service on contract basis at GVH Santokhi. It was further stated that the treatment of buffalo was done from 23.12.2019 to 31.12.2019 and the buffalo died on 10.1.2020 at 7:00 am. Post mortem was conducted at 2.30 pm at Hadda rori Santokhi on 10.1.2020. Dr Sonu Kumar had sent the documents to SDO Naraingarh on 13.1.2020 including Animal tag, Animal photo, claim form, Post mortem Report PAN Card, Bank Copy and Adhaar card as required by the insurance company through Dispatch no .6 dated 13.1.2020. After that this case was sent vide letter no. 522 dated 31.1.2020 to SDO Animal husbandry and Dairying Naraingarh and then to Deputy Director ICDP Ambala. Then whole case was sent to the insurance company for claim settlement. In the nut shell this case doesn't pertains to OP No.3 and he has only compiled the events that had taken place. If required, Dr Sonu Kumar may be called up to know the exact details of the case. The company may be directed to settle the claim of owner at the earliest please.
5.           Learned counsel for the complainant tendered affidavit of the complainant as Annexure C-A alongwith documents as Annexure C-1 to C-10 and closed the evidence on behalf of the complainant. Learned counsel for OP No.1 and 2 tendered affidavit of K.K. Sachdeva, Senior Divisional Manager and Authorized Signatory of the OPs No.1 and 2 company –New India Assurance Co. Ltd., Divisional Office, Ambala as Annexure R-X  alongwith documents  as Annexure R-1 to R-4 and closed evidence on behalf of the OPs No.1 and 2.  However, it is pertinent to mention here that the OP No.3 failed to lead any evidence despite availing various opportunities, therefore, evidence of the OP No.3  has been closed by the order of this Commission on 01.06.2023.
6.           None put in appearance on behalf of OP No.3 on the date of arguments and therefore, we have heard the learned counsel for the complainant and learned counsel for the OPs No.1 & 2 and have also carefully gone through the case file.
7.           Learned counsel for the complainant submitted that in the post mortem report the doctor concerned against the Column “History of Illness and Treatment” has mentioned the entire History of Illness and treatment given to the insured buffalo before her death. In the post Mortem report it has been categorically stated that the insured buffalo died on 10.01.2020 and by not making payment of genuine claim of the complainant, despite the fact that the insured buffalo died during currency of the policy in question, OPs No.1 and 2 are deficient in providing service.
8.           On the contrary, the learned counsel for the OP No.1 and 2 while reiterating the objections taken in the written version submitted that the complainant had never provided the treatment record of the cattle in question and even provided a vague post mortem report which is suspicious as well, since on the said PMR, the doctor has prescribed certain medicines for the animal in question which has been declared and shown dead by him. He further submitted that it was required of the complainant to provide all the requisite papers with regard to the ailment, treatment and cause of death of the insured animal but the complainant failed to provide all these papers and rather submitted a vague postmortem report and wrong tag number etc.  He further submitted that under a cattle policy, tag number is very important for the identification of the insured animal thus all the claims preferred without a proper tag and number is not payable as per law. He further submitted that as such, OPs No.1 and 2 cannot be held negligent or deficient in providing service to the complainant, if his claim was not considered by them. 
9.           The first question that falls for consideration is as to whether this Commission has territorial jurisdiction to entertain and decide this complaint? It may be stated here that since the complainant is a resident of Ambala, which falls under the territorial jurisdiction of this Commission as such, in this view of the matter, this Commission has territorial jurisdiction to decide this complaint in view of Section 34 (2) (d) of CPA 2019 and therefore, objection taken by the OPs in this regard is rejected.
10.           Coming to the merits of this case, it may be stated here that to prove his case that his buffalo died on 10.01.2021 due to severe pyometra leads septicemia lead to septic shock, the complainant has placed on record postmortem report dated 10.01.2020,  Annexure C-1 having been issued by the Veterinary Surgeon, Department of Animal Husbandry and Dairying Department, Government of Haryana, wherein the said surgeon has clearly opined that the Buffalo with tag no.160040812266, Black, died on 10.01.2020 at 7 A.M. and the  cause of death is severe pyometra leads septicemia leads to septic shock.  The plea of the OPs No.1 and 2 is that the said post mortem report is vague because it evident therefrom that the doctor has prescribed certain medicines for the insured buffalo, whereas, on the other hand, the insured buffalo has been shown to be dead.  It may be stated here that it appears that OPs No.1 and 2 have wrongly interpreted the said postmortem report.  Bare perusal of the postmortem report, reveals that the doctor concerned against the Column “History of Illness and Treatment” has mentioned the entire History of Illness and treatment given to the insured buffalo before her death. On perusal of medical record of the insured buffalo Annexure C-3 to C-7, it is found that the medicines mentioned in the coloum, ‘history of Illness and treatment’ in the postmortem report do match with the medical record of the insured buffalo. This fact was also intimated by the Doctor concerned to OPs No.1 and 2 vide letter dated 27.05.2020, Annexure C-8.  Thus, in our considered opinion, when the opinion/postmortem report of the expert/surgeon is read as a whole, it leaves no doubt to hold that the buffalo of the complainant with tag No.160040812266 has died on 10.01.2021 at 7 AM due to severe pyometra leads septicemia lead to septic shock.
11.            As far as plea taken by OPs No.1 and 2 that complete  record of the claim was not provided to them, it may be stated here that there is nothing on record to prove that OPs No.1 and 2 demanded any document(s) from the complainant. Perusal of letter dated 20.02.2020, Annexure R-3, reveals that  no documents were demanded by the OPs No.1 and 2 from the complainant, except doubting the contents of Post Mortem Report, which stands clarified by this Commission in this order.  Under these circumstances, bald plea taken in this regard is not sustainable and accordingly rejected.
12.           Thus, it is held that on account of death of the insured buffalo,  the complainant is certainly entitled to get the insured amount of Rs.70,000/-, as is evident from the certificate issued by the New India Assurance Company Limited, Annexure C-9,  yet, OPs No.1 and 2 by not considering his case on flimsy grounds are deficient in providing service. Under these circumstances, OP No.1 and 2 are liable to make good the loss suffered by the complainant to the tune of Rs.70,000/-.
13.           Since no deficiency in service has been proved on behalf of OP No.3 therefore, the complaint filed by the complainant against him is liable to be dismissed.
14.           In view of the aforesaid discussion, we hereby dismiss the present complaint against OP No.3 and allow the same against OPs No.1 and 2 and direct them, in the following manner:-
    1. To pay the amount of Rs.70,000/-, to the complainant alongwith interest @6% p.a. from the date of filing of this complaint onwards. 
    2. To pay 3,000/- as compensation for the mental agony and physical harassment suffered by the complainant.
    3. To pay Rs.2,000/-, as litigation expenses.

The OPs No.1 and 2 are further directed to comply with the aforesaid directions within the period of 45 days, from the date of receipt of the certified copy of the order, failing which the OPs No.1 and 2 shall pay interest @ 8% per annum on the awarded amount, from the date of default, till realization. Certified copy of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

 Announced:- 12.10.2023

(Vinod Kumar Sharma)		(Neena Sandhu)
Member		President