Haryana

Bhiwani

CC/825/2019

Kulbir - Complainant(s)

Versus

NIA - Opp.Party(s)

Harish verma

11 Jan 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSED COMMISSION, BHIWANI.

 

                                                     Consumer Complaint No. : 825 of 2019                                                        Date of Institution             :  11.11.2019

                                                     Date of Decision               :  11.01.2024

 

Kulbir son of Sh. Ranbir R/o village Baliyali, Tehsil Bawani Khera, District Bhiwani.

                                                                                  ….Complainant

 

                                              Versus

 

1. The New India Assurance Company Limited, Regd. Office: 3 12700, NH-5/R-2, Badsha Khan Chowk NIT Faridabad through its Branch Office at Bhiwani.
2. Managing Director, Haryana Livestock Development Board, Pashudhan Bhawan, Sector-2, Panchkula.
3. Director and Principal Officer, Hindustan Insurance Brokers Ltd., New Delhi.                                                                                     …..Opposite Parties

 

COMPLAINT UNDER SECTION 12 OF THE

CONSUMER PROTECTION ACT, 1986.

 

BEFORE:        Mrs. Saroj Bala Bohra, Presiding Member.

Ms. Shashi Kiran Panwar, Member.

 

Present:           Sh. Harish Verma, Advocate for complainant.         

          Sh. Rajbir Singh, Advocate for OP No.1.

          Sh. Vikram, VLDA on behalf of OP No.2.

          OP No.3 exparte.

ORDER

 

SAROJ BALA BOHRA, PRESIDING MEMBER

                     

1.                     Briefly, facts of this case are that complainant was having a buffalo of Murrah breed, age about 6 years which was insured with OP No.1 vide policy No.31270047180400000207 valid from 06.03.2019 to 05.03.2020 by paying a sum of Rs.1311/- as premium and insured value of the buffalo was Rs.88,000/-, through agent OP No.3 as per scheme of Haryana Govt. The OP issued a Tag bearing No.160036888863 which was affixed on left ear of the buffalo. It has submitted that before insurance, the buffalo health certificate was issued by veterinary surgeon concerned.  It has averred that on 08.03.2019, the buffalo died. Postmortem was conducted by Veterinary Surgeon vide PMR NO.01/2019 dated 08.03.2019 and also issued declaration certificate. Complainant informed the OP about the incidence, surveyor visited the spot, took photographs of dead buffalo as well as the tag which was found intact and collected all necessary documents including certificate of Gram Panchayat, Baliyali. Complainant lodge claim of the buffalo which was closed by OP company as No Claim. Complainant has submitted that the buffalo at the time of death was giving 18 litres milk and thus complainant has suffered monetary loss. Hence, the present complaint has been preferred by complainant alleging deficiency in service on the part of OP insurance company resulting into mental and physical harassment to him besides monetary loss.  As such, the complainant has submitted that the OPs may kindly be directed to pay Rs.88,000/- alongwith interest @ 18% per annum on account of death of  the buffalo of complainant. Further, to pay Rs.30,000/- for harassment and cost of litigation. Any other relief to which this Commission deems fit may also be awarded.  

2.                     Upon notice, OPs No.1 & 2 appeared whereas OP No.3 did not bother to appear despite notice, as such, it was proceeded against exparte vide order dated 16.01.2019.

3.                     OP No.1 appeared through counsel and tendered reply raising preliminary objections qua maintainability, cause of action, locus standi and that concealment of material facts. On merits, it is submitted that on receiving intimation qua death of complainant’s buffalo, Sh. Rakesh Vashistha was appointed as investigator, who submitted his report dated 20.03.2019 and found that buffalo died within 15 days of from commencement of the policy.  As per insurance policy, in case of death of animal takes place within the waiting period of 15 days from the date of issuance of the policy, insurance company is not liable to pay any claim.  As such, the claim of complainant was rightly closed under due intimation to the complainant. As such, there is no deficiency in service on the part of answering OP and  prayed for dismissal of the complaint with costs.

4.                     OP No.2 in his written statement taken preliminary objections qua maintainability, locus standi cause of action and concealment of material facts.  On merits, it is submitted that the vehicle was insured as per details in the complaint and tag was affixed on the left ear of complainant’s buffalo and health certificate was issued by veterinary surgeon before insurance of the buffalo. The answering OP has submitted that as per terms and conditions of policy, risk cover will be covered after 15 days from the day of the policy and if any death due to illness or snake bite of the insured animal, the insurance company will not be liable to pay the insured amount.  In the end, prayer has been made for dismissal of the complaint with costs.

5.                     In the evidence of complainant, his affidavit Ex. PW1/A alongwith  documents Annexure C-1 to Annexure C-9 have been filed and closed the evidence.

6.                     On behalf of OP No.1 affidavit Ex.RW1/A of Sh. Lalit Singh, Regional Manager filed alongwith documents Ex. R-1 to Ex. R-4 and closed the evidence.

7.                     No evidence tendered on behalf of OP No.2 rather made a statement their written statement may be read into evidence.

8.                     We have heard learned counsel for the contesting parties and gone through the record minutely.

9.                     Learned counsel for the complainant has argued that buffalo of complainant died during the insurance cover but the OP insurance company denied that the claim which amounts to deficiency in service and caused mental & physical harassment to the complainant besides huge monetary loss. The counsel has argued that at the time of insurance, the buffalo was healthy and  certificate by concerned veterinary surgeon was given qua health of the buffalo.  To strengthen his case, learned counsel for complainant has placed reliance on case law delivered by Hon’ble State Consumer Disputes Redressal Commission, Punjab in First Appeal No.966 of 2010 in case titled United India Insurance Company & Anr. Vs. Surinder Singh, decided on 03.06.2010.

10.                   On the other hand, learned counsel for OP No.1 has argued that the buffalo died within 15 days of commencement of the policy, in such a situation, as per terms and conditions of policy Ex.R-3 and Ex. R-4, the OP insurance company is not liable to pay any amount to the beneficiary.  In support of his case, the counsel has placed reliance on case law delivered by Hon’ble State Consumer Disputes Redressal Commission, U.T. Chandigarh in First Appeal No.06 of 2015 in case titled M/s Valecha Agri-Venture Vs. The New India Assurance Company Ltd., decided on 09.01.2015.

10.                   The main ground for denying the claim to the complainant by OP insurance company, as per repudiation letter (Ex. R-2) is that the animal/buffalo in question died during 15 days of commencement of the policy and in such eventuality, the OP insurance company, as per insurance policy Ex.R-3 & Ex. R-4, is not liable to pay any compensation. Otherwise, there is no dispute between the parties qua date of death of the buffalo, insured value, intact of tag, cause of death and owner of the buffalo.  The proviso attached to the insurance policy Ex. R-3 says that “………. Provided always that this policy does not cover (unless expressly agreed to by the Company in writing) death directly or indirectly due to or arising out of or resulting from: 2) Disease contracted prior to commencement of risk and any disease within 15 days from the date of commencement of risk”.

11.                   The veterinary surgeon vide his certificate (Annexure P-5) has stated that at the time of insurance the buffalo was healthy. Perusal of PMR report of the buffalo (Annexure P-4) reveals that the buffalo died due to acute tympany.  There is no mention in the PMR that the buffalo was having any pre-existing disease. It is also pleading of OP No.2 that before insurance of the cattle, certificate qua health fitness was issued by concerned veterinary surgeon. Certificate issued by Sarpanch of village Baliyali (Annexure P-6) corroborates the version of complainant. 

12.                   From the above discussion, we are of the view that the cattle was not having and pre-existing disease and the death of the buffalo was sudden and natural.  It cannot be said from any angle that the buffalo died due to any pre-existing disease or after the insurance policy.  Accordingly, it is observed that the OP insurance company has wrongly and illegally repudiated the claim of complainant.  As such, the OP No.1 is deficiency and negligent in providing proper services to the complaint for which he has to suffer monetary and as well as mental pain and physical harassment.  As per insurance policy Ex. R-4, the insured value of the buffalo was Rs.88,000/- and complainant is owner of the vehicle.  Accordingly, the complaint is allowed and OP No.1 insurance company is directed to comply with the following direction within 40 days from the date of passing of this order:-

(i)        To pay a sum of Rs.88,000/- (Rs.Eighty eight thousand) to the complainant alongwith simple interest @ 9% per annum from the date of filing of this complaint till actual realization.

(ii)       To pay a sum of Rs.10,000/- (Rs. Ten thousand) as compensation on account of mental and physical harassment.

(iii)      Also to pay a sum of Rs.55,00/- (Rs.Five thousand five hundred) as litigation expenses.

                        In case of default, the OPs shall liable to pay simple interest @ 12% per annum on all the aforesaid awarded amounts for the period of default.                              If this order is not complied with, then the complainant shall be entitled to the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite party may also be liable for prosecution under Section 72 of the said Act which envisages punishment of imprisonment, which may extend to three years or fine upto rupees one lac or with both. Certified copies of this order be sent to parties concerned, free of costs, as per rules. File be consigned to the record room, after due compliance.

Announced.

Dated:11.01.2024

 

                                    (Shashi Kiran Panwar)                    (Saroj Bala Bohra)

                                                       Member                           Presiding Member

District Consumer

Disputes Redressal

Commission,Bhiwani.