BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SIRSA.
Consumer Complaint no. 496 of 2019
Date of Institution : 26.08.2019.
Date of Decision : 02.09.2022.
Dharamvir, aged about 26 years son of Shri Raju @ Rajiv, resident of village Kheowali (Dhani), Tehsil and District Sirsa.
……Complainant.
Versus.
Oriental Insurance Company Limited, Opposite Janta Bhawan, Sirsa, District Sirsa, through its Branch Manager/ Divisional Manager.
...…Opposite party.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. PADAM SINGH THAKUR …………PRESIDENT
MRS.SUKHDEEP KAUR………………MEMBER.
SH. SUNIL MOHAN TRIKHA………… MEMBER
Present: Sh. K.S. Gill, Advocate for complainant.
Sh. A.S. Kalra, Advocate for opposite party.
ORDER
The present complaint has been filed by complainant against the opposite parties (hereinafter referred as OP) for the indemnification of claim amount of Rs.50,000/- on account of death of buffalo of complainant.
2. In brief, the case of the complainant is that he had five buffaloes of Murrah breed which were got insured by him through op vide insurance policy No. 261503/45/2016/2408 with effect from 10.2.2016 to 9.2.2019 and the buffaloes were tagged with tag numbers. That one buffalo bearing Tag No. 189975 fell down on 13.09.2016 and sustained spinal injuries and the Veterinary Doctor who had checked the buffalo told that there is no treatment of spinal injury but inspite of it the doctor provided required treatment and ultimately the buffalo died on 21.09.2016. The complainant submitted his claim to the op vide claim no. 47/17/)W154 alongwith required documents i.e. post mortem report etc. for indemnification of the loss caused to him but same was rejected by the op. Being aggrieved and dissatisfied with the rejection of the claim, complainant has filed present complaint.
3. On notice, op appeared and filed written statement and has taken preliminary objections qua limitation, no tag no claim and that no proper treatment had been given to the buffalo by the complainant. Complainant has violated terms and conditions of the insurance policy. The claim of complainant was rejected on 22.5.2017. Complainant was informed in this regard on 21.06.2017. On merits, the op again taken same objections that no treatment has been provided to the animal and claim is not filed within limitation period of two year. The claim of complainant has been repudiated on the ground of No Tag No Claim. It is submitted that complainant during the inquiry got conducted by insurance company has stated that second part of tag was broken and complainant failed to reaffix the tag and violated terms and conditions of insurance policy and as such claim has been rightly rejected as No Tag No Claim. Complainant was duly intimated vide letter dated 21.06.2017 through registered post. It is denied that claim was repudiated on 29.07.2019. It is submitted that this letter dated 29.07.2019 was in response to letter dated 29.07.2019 written by complainant and prayed for dismissal of complaint being barred by limitation. The claim has been rightly rejected by op.
4. In order to prove his complaint, the complainant has tendered his affidavit Ex.CW1/A and copies of documents Ex.C1 to Ex.C5.
5. On the other hand, op has tendered affidavit of Sh. S.K. Malhotra, Divisional Manager as Ex.RW1/A and copies of documents Ex.R1 to Ex.R8.
6. We have heard learned counsel for the parties and have perused the case file carefully.
7. Learned counsel for complainant has contended that claim has been wrongly rejected by the insurance company on the basis of No Tag No Claim whereas tag number has been mentioned in the application of complainant and it is also mentioned by doctor who has conducted post mortem examination and main part of tag bearing No. 189975 of the animal was intact although back part of the tag was broken. It is also mentioned by complainant in his application dated 21.09.2016 and nothing was kept concealed by complainant from op. Ld. counsel for complainant prayed that op be directed to indemnify the loss of Rs.50,000/- as buffalo was insured for an amount of Rs.50,000/- and apart from it op be also directed to pay Rs.50,000/- as compensation for harassment and Rs.11,000/- as costs of litigation.
8. On the other hand, learned counsel for op Sh. A.S. Kalra, Advocate has contended that insurance company has rightly repudiated the claim of complainant on the basis of No Tag No Claim and secondly complainant was informed vide letter dated 21.6.2017 Ex.R3 which was sent through registered post. He has further contended that animal has not been given proper treatment by the complainant and ultimately the animal had died due to negligence of complainant which is violation of terms and conditions of insurance policy and complaint is also time barred and prayed for dismissal of the complaint.
9. We have considered the rival contentions of the parties. The complainant in order to prove his complaint has tendered his affidavit Ex.CW1/A in which he has reiterated the contents of his complaint. He has also placed on file copy of insurance policy as Ex.C1 in which buffalo bearing tag No. 189975 insured for the amount of Rs.50,000/- has been shown at Sr. No.9. Ex.C3 is having description of the insured buffalo and Ex.C3 is the assessment of the value of Rs.50,000/- of the buffalo. Ex.C4 is post mortem report of the buffalo bearing tag No. 189975 which has been mentioned by the Doctor and sustained injury on 13.09.2016 and died on 21.09.2016. The doctor had given his opinion that animal died due to spine injury leading to recumbent position.
10. In order to rebut the evidence of complainant, insurance company op has furnished affidavit of Sh. S.K. Malhotra, Divisional Manager as Ex.RW1/A in which he has reiterated their version of written statement. Op has also placed on file copy of application given by complainant to the Branch Manager of op on 21.09.2016 regarding information of death of his buffalo in which he has also mentioned tag number and it is also mentioned in the application that back part of the tag was in broken condition which has not been informed by him earlier. Ex. R2 is copy of post mortem report, Ex.R3 is copy of repudiation letter dated 21.06.2017 vide which claim of complainant was rejected on the ground of No Tag No Claim. Ex.R4 is copy of application dated 27.06.2019 written by complainant to the Branch Manager, Oriental Insurance Company Limited, Sirsa and Ex.R5 is reply given by insurance company. Ex.R6 is investigation report conducted by Sh. Naresh Jayant, Advocate Insurance Investigator. Ex.R7 is copy of insurance policy and Ex.R8 is statement of complainant recorded by the Investigator.
11. Though complainant has relied upon repudiation letter dated 29.07.2019 Ex.C5 but op in order to prove that claim of complainant was repudiated on 21.06.2017 has placed on file copy of repudiation letter dated 21.6.2017 Ex.R3 vide which claim has been rejected on the basis of No Tag No Claim and same was sent to the complainant through registered letter but no acknowledgment or any receipt of this letter has been placed on record by op. If it is presumed that insurance company has informed the complainant by way of registered letter, its receipt and acknowledgment might be definitely in the custody of op which has not been placed on record by op and for concealing of the record by the op, an adverse inference is to be drawn against the insurance company op. The complainant had filed an application before insurance company after long wait on 27.06.2019 though it was very hurriedly and quickly replied by op vide letter dated 29.07.2019 and feeling aggrieved and dissatisfied from the reply and rejection of his claim by op, complainant preferred present complaint on 26.08.2019 and cause of action accrued when finally on 29.07.2019 complainant received above said letter that his claim was rejected on the ground of broken tag and insurance company has wrongly repudiated the claim of complainant as it is proved on record that complainant has himself informed this fact in his application dated 21.09.2016 and tag number was duly mentioned by the Veterinary Surgeon at the time of post mortem of the buffalo. Therefore, complainant is entitled for the indemnification of loss caused to him to the tune of Rs.50,000/- since his Murrah buffalo bearing tag No. 189975 was insured vide insurance policy with effect from 10.2.2016 to 9.2.2019 and animal sustained spine injury for which doctor had advised that there is no treatment for such injury with them and it is mentioned in the affidavit by complainant as well as in the complaint that despite no treatment, the doctor had given treatment of spine injury but the animal could not survive and ultimately died on 21.09.2016.
12. In view of our above discussion, we allow the present complaint and direct the opposite party to pay claim amount of Rs.50,000/- to the complainant within a period of 45 days from the date of receipt of copy of this order, failing which complainant will be entitled to interest on the above said amount at the rate of 7% per annum from the date of this order till actual payment. We also direct the op to further pay a sum of Rs.10,000/- as composite compensation for harassment and litigation expenses to the complainant within above said stipulated period. 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:02.09.2022. District Consumer Disputes
Redressal Commission, Sirsa.
JK
