Haryana

Yamunanagar

CC/300/2013

Adityaveer singh S/o . Karanveer - Complainant(s)

Versus

OIC.ltd - Opp.Party(s)

J.S.Nagla

21 Apr 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                    Complaint No. 300  of 2013.

                                                                                                    Date of institution: 22.04.2013

                                                                                                    Date of decision:  21.04.2016

Adityaveer Singh aged about 40 years son of Sh. Karanveer, resident of Village Unehri, P.O. Jathlana Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                                                                                               …Complainant.

                                                Versus                                                

The Oriental Insurance Company Limited, Branch Office: Opp. Hindu Girds 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.   

              Sh. Parmod Gupta, Advocate, counsel for respondent.  

 

ORDER

1.                     Complainant Adityaveer Singh 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 his 25 cows bearing Tag No. HLDB-03-025351 to 025271 and 76127, 76128, 76149 and 79529 were insured with the OP Insurance Company vide over note No.  767958 w.e.f. 06.02.2012 to 05.02.2015 for a sum of Rs. 50,000/- each and paid premium of Rs. 60,000/- as per insurance policy Annexure C-5/R-1. On 15.10.2012, one cow having Tag No. 025252 fell ill and ultimately at about 12.30 P.M. on 17.10.2012 the said cow died. Immediately, the complainant reported to the Civil Veterinary Hospital, Jathlana as well as OP Insurance Company. The OP Insurance Company deputed investigator immediately for spot verification who inspected/ verified the spot and the postmortem of the dead body of the said cow was also conducted on the same day i.e. on 17.10.2012 by the Veterinary Surgeon, Veterinary Hospital, Jathlana in the presence of Investigator of the OP Insurance Company. It has been further stated that at the time of death, the said cow was having the same tag number in her ear. Thereafter, the complainant lodged his claim and all the relevant documents were sent to the OP insurance company but the OP Insurance company, vide its letter dated 21.03.2013, has wrongly repudiated the genuine claim of the complainant due to the reason best known to them. The complainant made so many requests but all in vain. Hence, this complaint.

3.                     Upon notice, OP appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable, no locus standi, no cause of action, bad for mis joinder and non joinder of necessary parties and complainant running a commercial dairy, hence not covered under the definition of Consumer. On merit, it has been admitted that the OP Insurance Company has insured the 25 cows of the complainant vide cover note No. 767958 (Annexure C-5) and policy bearing No. 261701/47/2012/956 w.e.f. 06.02.2012 to 05.02.2015 (Annexure R-1 & R-2). It has been further admitted that upon information, Sh. Sumit Goyal was appointed as surveyor who after visiting the spot submitted his report (Annexure R-5) mentioning therein that physical features of the deceased cow were different from the features of cow having tag No. 025252 as mentioned in the health certificate. It has been further admitted that complainant submitted claim form as well as postmortem report with the OP insurance company, however OP insurance company obtained expert opinion from Dr. M.P. Mehla (Retired Veterinary Surgeon), who reported that the case is not genuine on the basis of change of animal. Therefore, the OP Insurance Company has correctly and rightly repudiated the claim vide its letter dated 21.03.2013 (Annexure R-7). Lastly prayed for dismissal of complaint.

4.                     To prove the case, counsel for the complainant tendered into evidence affidavit of complainant as Annexure CX and documents such as photo copy of postmortem report as Annexure C-1, Photo copy of Health Certificate as Annexure C-2, Photo copy of claim form as Annexure C-3 & C-4, Photo copy of letter dated 06.02.2012 received from OP Insurance Company as Annexure C-5 and closed the evidence on behalf of complainant.

5.                     On the other hand, counsel for the OP Insurance Company tendered into evidence affidavit of Ashish Bhatnagar, Sr. Branch Manager as Annexure RW/A and documents such as photo copy of insurance policy as Annexure R-1 and R-2, Photo copy of claim form as Annexure R-3 & R-4, Photo copy of investigation report of Er. Sumit Goyal dated 06.11.2012 as Annexure R-5 & R-6, Photo copy of supplementary Investigation report dated 12.3.2013 of Sh.Sumit Goyal as Annexure R-7, Photo copy of repudiation letter as Annexure R-8 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 admitted fact that the deceased cow of the complainant bearing Tag No. 25252 was insured with the OP Insurance Company vide its cover note No. 767958 which is evident from Annexure C-5 and insurance policy Annexure R-1 for a sum of Rs. 50,000/- w.e.f. 06.02.2012 to 05.02.2015. It is also not disputed that the cow bearing tag No. 025252 died on 17.10.2012 which is evident from copy of postmortem report Annexure C-1 and claim was lodged with the OP Insurance Company  which is evident from claim form Annexure C-3 & C-4.

8.                     The only plea of the Op Insurance Company is that the physical features of the deceased cow were not matching as per report/ expert opinion of Dr. M.P.Mehla (Retired Veterinary Surgeon) who reported that case is not genuine on the basis of the change of animal whereas the plea of the OP Insurance Company is not tenable as no such report of Dr. M.P. Mehla has been placed on file. Moreover, the supplementary report of Sh. Sumit Goyal Investigator/Surveyor dated 12.03.2012 (Annexure R-7) has been obtained after a period of near about 5 months from the death of the cow. He had submitted his earlier report on 6.11.2012 but this supplementary report has been submitted on 12.03.2013 i.e. after a period of more than 4 months. Meaning thereby that the supplementary report has been procured just to repudiate the claim of complainant.

9.                     We have minutely perused the earlier report submitted by the investigator on dated 6.11.2012 (Annexure R-5) wherein the said investigator has specifically mentioned under the head of conclusion and opinion as mentioned below:

“ On the basis of my visit to and inspection of carcass produced for inspection it was confirmed that one cow belonging to insured had died and the dead animal as shown was wearing an ear tag which was intact at the time of spot survey. However, on comparing the physical features of dead cow and that mentioned in health certificate few differences were noted it physical identification marks. The ear tag found intact and not freshly fitted in one of the ear. Keeping the physical features in consideration the claim of insured does not stand but the ear tag was found intact, the underwriters may decide as per terms and conditions of policy.”

10.                   After going through the above noted facts, it is clear that the deceased cow was wearing tag No. 25252 which was not freshly tagged as per this report of the investigator. Further it is also evident from the perusal of copy of postmortem conducted by the veterinary surgeon (Annexure C-1) that the deceased cow was wearing the same tag No. 025252 and almost other features i.e. age, breed and colour of whole body matched with the health certificate as well as postmortem report.

11.                   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.

12.                   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. 025252 to the complainant alongwith interest at the rate of 7% per annum from the date of filing of complaint till its realization and also to pay Rs. 2000/- as litigation expenses within 30 days failing which the complainant is at liberty to initiate the legal proceedings against the OP Insurance Company 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: 21.04.2016.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER