Haryana

Yamunanagar

CC/169/2013

Munish Kumar s/o Sh.Satpal, - Complainant(s)

Versus

OIC Ltd. - Opp.Party(s)

JS Nagla

19 Aug 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                Complaint No. 169  of 2013.

                                                                                                Date of institution: 01.03.2013

                                                                                                Date of decision:  19.08.2016

Munish Kumar son of Sh. Sat Pal, resident of Village Silli Kalan, Sub Tehsil Radaur, District Yamuna Nagar.                                                                                                                                                                                                      …Complainant.

                                                Versus                                                

The Oriental Insurance Company Limited, Branch Office: Opp. Hindu Girls College, 1^st Floor, Court Road, Jagadhri, through its Branch Manager.                                                                                                                                                                  

                                                                                                                                                     …Respondent. 

BEFORE:           SH. ASHOK KUMAR GARG, PRESIDENT

                          SH. S.C.SHARMA, MEMBER

           

Present: Sh. J.S.Nagla, Advocate, counsel for complainant.   

              Smt. Aruna Sharma, Advocate, counsel for respondent.  

 

ORDER

 

1.                     Complainant Munish Kumar has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying therein that the respondent (hereinafter referred as OP) be directed to pay Rs. 50,000/- as insured amount on account of death of cow alongwith compensation and litigation expenses.

2.                     Brief facts of the present case as alleged by the complainant, are that  in the month of October, 2011, complainant wanted to open dairy farming to increase his income so he purchased 25 cows at the rate of Rs. 50,000/- per cow after obtaining the loan from State Bank of India, New Grain Market, Ladwa, District Kurukshetra. All the cows were got insured with the OP Insurance Company after due inspection and obtaining health certificate issued by the Animal Husbandry and Dairy Farming Department Haryana. After that, all the cows were inspected by the OP Insurance Company and according to the health certificate, tag No. HLDB-03-025311, 025313 to 025336 were put properly in the ears of all the cows and at that time Development Officer of the OP Insurance Company was present at the spot and in this respect insurance cover notes bearing No. 767513 and 767514 valid from 12.10.2011 to 11.10.2014 were issued. The complainant paid the premium to the Op Insurance Company as per rule. Hence, there exist a relationship of consumer and service provider between the parties. Unfortunately, in the month of June, 2012, one cow having Tag No. 025328 fell ill. The complainant immediately informed the Veterinary Surgeon and the doctor of VLDA Chamrori (Radaur) District Yamuna Nagar visited the spot and provided treatment on dated 05.06.2012, 06.06.2012 and 07.06.2012. Thereafter, the treatment was continued from 08.06.2012 to 18.06.2012 from LLR University of Veterinary and Animal Sciences,  Uchana (Karnal) but no use and ultimately in the morning of 19.06.2012 the said ill cow died. The complainant reported the matter to the Civil Veterinary Hospital, Radaur as well as the OP Insurance Company. On receipt of the information OP Insurance Company deputed investigator who visited the spot and verified the facts. The postmortem of the dead cow was also conducted on 19.06.2012 by the Veterinary Surgeon, Civil Veterinary Hospital, Radaur in the presence of investigator of the insurance company. Thereafter, complainant furnished all the documents relating to the death of said cow alongwith claim form to the Op Insurance Company. Upon which, OP Insurance Company issued a letter dated 22.10.2012 to the complainant in the shape of show cause notice for clarifying some quarries which was duly replied by the complainant. However, Op Insurance Company later on repudiated the claim of the complainant vide its letter dated 28.01.2013. The genuine claim of the complainant has been wrongly repudiated by the OP Insurance Company. Hence, this complaint.

3.                     Upon notice, OP Insurance Company appeared and filed its written statement by taking some preliminary objections such as there is no deficiency in service; no cause of action; complainant has not come to this Forum with clean hands and has concealed the true and material facts. However, it has been admitted that on information of the alleged death of the cow, investigator was appointed to visit the spot and verifying the facts who submitted his report dated 18.08.2012 (Annexure R-4). As per the report of the investigator, the descriptions of the cow did not tally with the particulars given in the health certificate. As per health certificate, the colour of the insured cow should have been black whereas the colour of the deceased cow was black with white belly and white feet and as such, the investigator gave observation that the claim is not genuine and the claim may be filed as “No Claim”. After that, OP Insurance Company issued a letter to the complainant on dated 22.10.2012 (Annexure R-5) to clarify the various points within 10 days but the clarification given by the complainant through reply (Annexure R-6) was not justified, so, the claim of the complainant was repudiated as No Claim vide letter dated  28.01.2013 (Annexure R-7) and on merit controverted the plea taken in the complaint and reiterated the stand taken in the preliminary objections and lastly prayed for dismissal of complaint being there is no deficiency in service or unfair trade practice on the part of OP Insurance Company.

4.                     To prove the case,  counsel for the complainant tendered into evidence affidavit of complainant as Annexure CX and photo copies of documents such as postmortem report as Annexure C-1, copy of treatment chart as Annexure C-2, claim form as Annexure C-3, Health Certificate as Annexure C-4, Letter dated 22.10.2012 form OP as Annexure C-5, Reply of clarification as Annexure C-6, Repudiation letter as Annexure C-7, Valuation certificate as Annexure C-8 and closed the evidence on behalf of complainant.

5.                     On the other hand, counsel for the OP Insurance Company tendered into evidence affidavit of Sh. Sanjeev Madan, Senior Branch Manager OIC as Annexure RW/A and affidavit of Anil Kumar Sharma, Investigator as Annexure RW/B and photo copies of documents such as insurance policy as Annexure R-1, Copy of Health Certificate as Annexure R-2, Copy of Postmortem report as Annexure R-3, Copy of Investigator report as Annexure R-4, Copy of clarification letter as Annexure R-5, Copy of the reply of the clarification letter as Annexure R-6, copy of repudiation letter dated 28.01.2013 as Annexure R-7 and closed the evidence on behalf of OP 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.                     It is not disputed that vide insurance policy Annexure R-1, one cow bearing tag No. 025328 was insured with the OP Insurance Company for a sum of Rs. 50,000/- vide insurance policy bearing No. 261701/47/2012/476 valid from 12.10.2011 to 11.10.2014 issued by OP Insurance Company.

8.                     The only plea of the Op Insurance Company is that as per investigator report (Annexure R-4), description of the deceased cow did not tally with the insured cow. As per health certificate the colour of the insured cow should have been black whereas the colour of deceased cow was black with white belly and white feet. So, the claim of the complainant has been repudiated as “No Claim”, but this plea of the OP Insurance Company is not tenable as from the perusal of the copy of postmortem report, it is duly evident that veterinary surgeon has specifically mentioned the identification of the deceased cow as HLDB03/025328 in the left ear. Further, we have also perused the investigator report (Annexure R-4) in which also it has been so recorded by the investigator at serial No.2 under head of observation at the last page of his report that “the cow was tagged properly at the time of death as Tag No. 25328”.  Even, the investigator has also disclosed in his report under the head details of investigations that he inspected the farm of the insured and it was observed that the remaining cows were tagged. The investigator has nowhere mentioned in his report that the alleged tag was tagged freshly by the complainant and in the absence of any cogent evidence just mere 1 or 2 particulars did not tally with the health certificate is no valid ground to repudiate the claim of the complainant. As per terms and conditions of the insurance policy for the identification of the deceased cow only tag is a mandatory condition and this condition is duly fulfilled in the present case. The deceased cow was tagged at the time of conducting the postmortem by the Veterinary Surgeon as well as at the time of inspection by the Investigator deputed by the OP Insurance Company. So, we are of the considered view that the deceased cow was the insured cow and the claim of the complainant has been wrongly repudiated by the OP Insurance Company. Hence, the complainant is entitled for relief.  

9.                     In the circumstances noted above, we are of the considered view that the claim of the complainant has been wrongly repudiated by the Op Insurance Company. Hence there is a deficiency in service on the part of OP Insurance Company. As such, we have no option except to partly allow the complaint of complainant. 

10.                   Resultantly, we partly allow the complaint of complainant and direct the OP Insurance Company to pay a sum of Rs. 50,000/- as insured amount on account of deceased cow bearing tag No. 025328 to the complainant within a period of 30 days failing which complainant shall be entitled to recover the interest at the rate of 7% per annum for the defaulting period. The OP Insurance Company is also directed to pay Rs. 2000/- as litigation expenses to the complainant. 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: 19.08.2016.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER