BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SIRSA.
Consumer Complaint no. 125 of 2020
Date of Institution : 17.03.2020.
Date of Decision : 06.05.2024.
Deepak Kumar aged about 25 years son of Shri Raj Kumar, resident of village Sahuwala 2nd District Sirsa.
……Complainant.
Versus.
1. The New India Assurance Company Ltd., Divisional Office – 312700 NH-5/R-2, Badshah Khan Chowk, Faridabad – 121001 through its authorized person.
The New India Assurance Company Ltd. Head Office – 87, MG Road, Fort Mumbai – 400001 through its Authorized Person.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act, 1986.
Before: SH. PADAM SINGH THAKUR …………PRESIDENT
SMT. SUKHDEEP KAUR………………MEMBER.
SH. OM PARKASH TUTEJA…………….MEMBER
Present: Sh. Ashok Kumar, Advocate for complainant.
Sh. Kapil Sharma, Advocate for opposite parties.
ORDER
The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 (after amendment
u/s 35 of the Consumer Protection Act, 2019) against the opposite parties (hereinafter referred as OPs).
2. In brief, the case of the complainant is that on 31.08.2019 complainant had got insured his buffalo from ops vide policy No. 312700471904000000313, tag no. 160002315567, certificate no. 34257 for a sum of Rs.70,000/- and a premium of Rs.1043/- was paid by him to the ops. On 15.09.2019 the buffalo of complainant died natural death on account of illness and information in this regard was supplied to the ops and complainant lodged his claim with the ops under the aforesaid policy and also fulfilled all requisite formalities of ops but ops did not indemnify the claim and ultimately about few days ago they have flatly refused to admit his claim and have repudiated the same. It is further averred that repudiation of claim of complainant on the part of ops is totally unlawful and arbitrary as no cogent reason has been assigned by the ops and is totally in violation of terms and conditions of insurance policy and such act and conduct on the part of ops amounts to deficiency in service and unfair trade practice due to which complainant has suffered unnecessary harassment. Hence, this complaint.
3. On notice, ops appeared and filed written statement submitting therein that the insurance policy is always issued just to all exceptions, terms and conditions as mentioned in the insurance policy. The intimation regarding death of buffalo was received by company and accordingly an investigator was deputed in this case. The buffalo of complainant died on 15.09.2019 whereas it was insured on 2.9.2019. As per terms and conditions of the policy in case of death of animal/ buffalo within 15 days of the inception of the policy, the claim is not payable to the insured and accordingly his claim was repudiated. This condition was also mentioned on the overleaf of the health certificate. Remaining contents of complaint are also denied to be wrong and prayer for dismissal of complaint made.
4. The complainant in evidence has tendered his affidavit Ex. CW1/A and documents Ex.C1 to Ex.C5.
5. On the other hand, ops have tendered affidavit of Sh. R.K. Indora, Senior Divisional Manager as Ex. RW1/A and documents Ex.R1 to Ex.R9.
6. We have heard learned counsel for parties and have gone through the case file.
7. The insurance of the buffalo in question of complainant is not disputed but the date of insurance is disputed because complainant has averred that ops insured the buffalo of complainant from 31.08.2019 for a period of one year whereas ops have alleged that the period of insurance was effective from 02.09.2019 to 01.09.2020. Admittedly the buffalo of complainant died on 15.09.2019 i.e. during the period of policy in question. The ops have repudiated the claim of complainant on the ground that death of buffalo is within 15 days from the date of start of risk which started on 02.09.2019 and according to ops the risk was to be started after expiry of 15 days waiting period. According to certificate of insurance placed on file by complainant himself as Ex.C4 and even as per policy placed on file by ops as Ex.R2, the period of insurance is 02.09.2019 to 01.09.2020 whereas complainant claims that as the premium was received from him on 31.08.2019 the risk has been started from 31.08.2019 and not from 02.09.2019. In this regard, Hon’ble Supreme Court of India in recent judgment in case titled as Reliance Life Insurance Company Ltd. & anr. Versus Jaya Wadhwani, CA No. 35 of 2024 decided on 03.01.2024 has held that “date of issuance of the policy would be the relevant date for all the purposes and not the date of proposal or the date of issuance of the receipt”. As such the law laid down by Hon’ble Supreme Court in that case will prevail.
8. The buffalo of the complainant died on 15.09.2019 i.e. within 15 days of issuance of policy in question which was issued on 02.09.2019. In post mortem report Ex.C2, the Veterinary Surgeon has opinion that animal may have died due to Trypanosomiasis Surra i.e. disease. The ops have also relied terms and conditions of the policy whereby policy does not cover death directly or indirectly due to arising out of or resulting from Disease contracted prior to commencement of risk and any disease within 15 days from the date of commencement of risk as per clause 2 of the policy meaning thereby that death of animal should not be within 15 days from the date of commencement of risk due to any disease. But in the present case, as per post mortem report the buffalo of complainant died within 15 days of issuance of policy due to disease and as such as per terms and conditions of the policy, the complainant is not entitled to any compensation from ops.
9. In view of our above discussion, we do not find any merit in the present complaint and same is hereby dismissed but with no order as to costs. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced: Member Member President,
Dated: 06.05.2024. District Consumer Disputes
Redressal Commission, Sirsa.
