Haryana

Yamunanagar

CC/903/2011

Maya Devi W/o Gurnam Singh - Complainant(s)

Versus

NIC Ltd. - Opp.Party(s)

M.S.Bodhla

10 Sep 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                           Complaint No. 903 of 2011.

                                                                                                           Date of institution: 25.8.2011

                                                                                                           Date of decision:  10.9.2015.

Maya Devi wife of Sh. Gurnam Singh resident of Village Safeelpur, Tehsil Jagadhri, District Yamuna Nagar.

                                                                                                                                                          …Complainant.

                                                Versus

1. The National Insurance Company Ltd. Branch Office at Yamuna Nagar, District Yamuna Nagar through its Branch Manager.                                                                                            
2. Haryana Gramin Bank, Branch Machhrauli, District Yamuna Nagar, through its Branch Manager.                                                                                                                                                                                                                                                                                                                                       …Opposite parties.

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                          SH. S.C.SHARMA, MEMBER

 

Present: Sh. M.S.Bodhla, Advocate, counsel for complainant.   

              Sh. V.K.Sharma, Advocate, counsel for OP No.1.

              Sh. D.S.Kamboj, Advocate, counsel for OP No.2.   

 

ORDER

1.                     Complainant Maya Devi has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying that respondents (hereinafter referred as OPs) be directed to pay Rs. 15,000/- as insured amount alongwith interest at the rate of 18% per annum from the date of claim till the payment in respect of death of buffalo of the complainant and further to pay Rs. 50,000/- as compensation and Rs. 5000/- as litigation expenses.

2.                     Brief facts of the present case, as alleged by the complainant, are that complainant being a member of Krishna Self Help Group having 10 members purchased one buffalo each from the loan advanced by the OP No.2 and all the ten buffalos were got insured with the OP No.1 for a sum of Rs. 15,000/- each vide policy No. 420402/47/09/9400001165 valid from 7.2.2010 to 6.2.2011. The OP No.1 had affixed tag No. NIC 6275 on the buffalo of complainant when the same was insured by the OP No.1 for the period stated above. The complainant had even paid premium amount with respect to the insurance of her buffalo. As such the complainant is a consumer of the OPs.

3.                     It has been alleged that on 22.11.2010 buffalo of the complainant bearing tag No. NIC6275 died and the complainant had informed the OPs as well as the veterinary surgen about the death of her buffalo. Accordingly the OP No.1 company appointed its surveyor who took the photographs of the dead buffalo and collected all the relevant papers including insurance cover note, certificate regarding death of buffalo, issued by Barkha Ram, Sarpacnh, Gram Panchayat, Report of veterinary surgeon, death verification report by the Manager of the OP No.2  i.e. bank. After that complainant received a letter dated 13.1.2011 from the OP No1. Alleging therein that died buffalo was not the same which was insured with OP No.1. The complainant  showed the certificate issued by the Sarpanch Gram Panchayat Safeelpur and verification report of the Manager of the Op No.2 and also certificate issued by veterinary surgeon but the OP No.1 did not concede the request of the complainant to release the claimed amount despite repeated requests and ultimately the OP No.1 wrongly repudiated the claim of the complainant. In this way, the OP No.1 is guilty of deficient and negligent services to the complainant. Hence, this complaint.

4.                     Upon notice, opposite parties appeared and filed their written statement separately. OP No.1 filed written statement by taking some preliminary objections such as complaint not maintainable, no deficiency in service or cause of action against the OP No.1 and on merit it has been stated that Op No.1 has rightly repudiated the claim of the complainant vide repudiation letter dated 13.1.2011 Annexure R-2 as there was violation of the terms and conditions of the insurance policy. It has been further stated that as per inspection report of the Independent Surveyor who visited the place of complainant and inspected the dead animal, the identification of died buffalo does not match with the insured buffalo. Further the age of the died buffalo was 6-7 years and the same was having second lactation but as per the health certificate, the insured buffalo was 10 ½ years of the age and the same was under third lactation at the time of first insurance in the year 2007. Further the shape of the horns also differs. The dead animal was not bearing ear tag at the time of alleged death and the tag was planted one and one side head of the tag was found broken by the surveyor. It has been further stated that the above noted facts have been duly admitted by the complainant in her statement given to the surveyor, copy of which is Annexure R-3 to R-5. Lastly stated that the claim of the complainant has been rightly repudiated. Hence, there is no deficiency in service on the part of Op No.1 and requested for dismissal of complaint.

5.                     OP No.2 filed written statement separately and stated that OP No.2 have no concerned whatsoever with the matter because Op No.2 has only financed the alleged dead buffalo. Hence, he has filed his formal reply.

6.                     The complainant as well as OP No.2 failed to file any evidence despite availing several opportunities and ultimately their evidence was closed by court order on 13.11.2014. However, at the time of filing of complaint, some documents such as photo copy of intimation letter to OP No.2 as Annexure A1, Photo copy of Insurance Cover Note as Annexure A2 Photo copy of Live Stock claim form as Annexure A3, Photo copy of Verification letter of bank OP No.2 as Annexure A4, Photo copy of Bank advance certificate as Annexure A5, Photo copy of Form issued by District Rural Development, Authority as Annexure A6, Photo copy of Certificate issued by Gram Panchayat as Annexure A7, Photo copy of Live Stock claim form issued by veterinary doctor dated 25.11.2010 as Annexure A8, Photo copy of Valuation certificate issued by veterinary surgeon on dated 25.11.2010 as Annexure A9, Repudiation letter as Annexure A-10.

7.                      On the other hand, counsel for OP No.1 filed affidavit of Sh. Parveen Arora, Administrative Officer as Annexure RX, affidavit of surveyor Sumit Goyal as Annexure RY and documents such photo copy of insurance policy as Annexure R-1, Photo copy of repudiation letter as Annexure R-2, Photo copy of investigation report as Annexure R-3, Photo copy of valuation certificate as Annexure R-4, Photo copy of intimation letter as Annexure R-5, Photo copy of intimation letter issued by Op No.2  to the Company dated 27.11.2010 as Annexure R-6 and closed the evidence on behalf of OP No.1.  

8                             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. Arguments advanced by the learned counsel for the parties have also been taken care of. If we go through the repudiation letter dated 13.1.2011 Annexure A-10/R-2, it would be revealed that the claim of the complainant was repudiated by the OP company because there was no ear tag in the ear of the dead buffalo and as such as per the terms and conditions of the insurance policy the claim of the complainant was repudiated as “No Tag No Claim”. If we examine the insurance policy Ex. R-1 it would be clear that it has been mentioned in the policy that no claim would be paid in the absence of the tag of the buffalo.

9.                     Learned counsel for the complainant vehemently argued that died buffalo was having ear tag but the surveyor has wrongly indicated in his report that died buffalo was not having any ear tag and learned counsel for the complainant further argued that all the other features match with health certificate which was issued at the time of insurance. It has also been  argued that surveyor obtained thumb impression of the complainant being illiterate on some blank papers and misused later on as per his choice and lastly prayed that claim of the complainant is genuine one and Ops be directed to pay the insured amount.

10.                   On the other hand, counsel for OP No.1 vehemently argued that died buffalo was not having any ear tag at the time of inspection of the surveyor. Learned counsel for the OP No.1 further argued that as per statement of the complainant Annexure R-5, the age of the died buffalo was near about 7 years and the same was having second lactation but as per health certificate/ valuation certificate prepared on 25.11.2011 by the Doctor Annexure A-9/R-4, the insured buffalo was 10 ½ years of age which was under 5^th lactation at the time of alleged death and further argued that the shape of the horns was also differ and lastly prayed that claim of the complainant is totally false and manipulated, hence deserves dismissal.  

11.                   We have examined the documents, affidavit produced by the parties, the complainant has claimed compensation with respect to her buffalo bearing tag No. NIC-6275 which died on 22.11.2010 due to sudden illness. In order to determine the matter in controversy between the parties we shall have to find out whether the terms and  conditions of the insurance policy have been complied with by the complainant. Annexure R-1 is the copy of insurance policy which reveals identification of the insured buffalo and as per terms and conditions, tag must be intact at the time of physical inspection by the surveyor otherwise “ No Tag No Claim”. Insured complainant was even supposed to inform the OP No.1 company immediately with regard to the death or illness of the insured buffalo. The letter of the complainant Annexure R-5 reveals that complainant informed the OP No.1 company that her buffalo died all of sudden due to illness and she requested the insurance company that the dead buffalo be physically examined and claim amount be paid to her. The OP No.1 company appointed its surveyor Sh. Sumit Goyal who visited the spot on the same day i.e. on 22.11.2010 and found that carcass of the dead animal lying near to the complainant’s residence. Various physical identification marks present on the dead animal were noted and few photographs of the dead animal were taken. It also revealed that buffalo when died was not wearing any tag at the time of death which was inserted in the ear after the death of buffalo. During the process of refixing the tag in the ear, it got reshaped and one head of the tag was broken. It has been further mentioned by the surveyor that the age of the dead animal appeared to be around 6-7 years whereas as per health certificate (Annexure A9/R-4) the insured buffalo was 10 ½ years of age and the same was having 5^th lactation.  The shape of the horns also differs but the matter did not end here.  Complainant Maya Devi also made a statement as per Annexure R-5, alongwith other persons of the village before the surveyor Sh. Sumit Goyal wherein she had clearly stated that there was no tag in the ear of dead buffalo at that time. This statement of the complainant clearly proves that the dead buffalo was not having any tag when examined by the surveyor. Further, the complainant has also admitted in her statement Ex. R-5 that the died buffalo was of the age of near about 7 years and was under the second lactation. Sh. Parveen Arora, Administrative Officer, NIC, Yamuna Nagar and Sh. Sumit Goyal, Surveyor and Loss Assessor of OP No.1 company has sworn in their affidavit Ex. RX & RY all the facts as contained in the written statement. The complainant is bound by the terms and conditions of the insurance policy which is a contract between the parties. Learned counsel for the complainant could not match the dead buffalo with the insured buffalo of the complainant and thus it seems that the dead buffalo was not the insured buffalo of the complainant which was insured with the insurance company. Even the complainant failed to produce postmortem report of the alleged dead buffalo. The identification of the dead buffalo has not at all been proved in this case. All these facts clearly create a doubt regarding genuineness of the case of complainant and when the identification of the dead buffalo has not been established how the complainant is entitled to claim for her dead buffalo, even as per insurance policy “ No Tag No Claim”.

12.                   Taking into consideration all the aforesaid facts and circumstances of the case, we find no deficiency in service on the part of OP No.1 because the complainant has miserably failed to establish that her alleged dead buffalo was the same which had been insured with the OP No.1 company. In the absence of physical evidence and ear tag, the identity of the dead buffalo also could not be established. Hence, the OP No.1 insurance company is not bound to pay the claim amount to the complainant. The complaint of the complainant thus deserves dismissal.

13.                   For the reason and finding recorded above, we find no merit in the present complaint and the same is hereby dismissed. In the facts and circumstances of the case, we leave the parties to bear their own costs. 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: 10.9.2015

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER