BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no.287 of 2016
Date of Institution : 25.10.2016
Date of Decision : 20.12.2017.
Gurditt aged about 65 years son of Shri Thana Singh, resident of village Pakka Shahidan, Tehsil and District Sirsa.
……Complainant.
Versus.
- The Oriental Insurance Company Ltd., through its Manager, having its office at Opp. Janta Bhawan, Sirsa, Distt. Sirsa.
- The Oriental Insurance Company Ltd., through its Managing Director, having its Regd. Office at Oriental House, A-25/27, Asaf Ali Road, New Delhi0 110002.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L. AHUJA …………..PRESIDENT.
SH. MOHINDER PAUL RATHEE ……MEMBER.
Present: Sh. N.,K. Daroliya, Advocate for the complainant.
Sh. A.S. Kalra, Advocate for opposite parties.
ORDER
The case of complainant in brief is that complainant was owner of one buffalo of black colour of the age six years. That the complainant got his above said buffalo insured with opposite party no.1 at Sr. No.16 of insurance policy No.261503/47/2015/574 through Deputy Director Live Stock Insurance Scheme valid w.e.f. 31.1.2015 to 30.1.2016 for a sum of Rs.50,000/- and had paid the premium amount of Rs.1250/- plus taxes. A health cum evaluation certificate was also issued for this buffalo by the ops. On 15.10.2015 at about 3.20 p.m, the buffalo of the complainant died due to heart attack. However, the complainant tried his best to get her treated but the buffalo had already died due to heart failure. The information was immediately sent to the veterinary hospital and post mortem was conducted upon the body of the buffalo on the same day. Post mortem report bearing No.7/15 dated 19.10.2015 was prepared by the veterinary doctor in this regard. It is further averred that information regarding death of the buffalo was immediately supplied to the opos and he lodged the claim bearing No.47/16/000120 alongwith all the necessary and requisite documents and a live stock claim form cum valuation certificate was also furnished with the ops through the veterinary surgeon, Government Veterinary Hospital describing the species, breed, sex, colour, physical identification mark and age etc. of the deceased buffalo. A live stock claim form was also furnished with the ops by the complainant himself. It is further averred that the insurance company after receipt of the information regarding claim had appointed the surveyor/investigator to investigate the matter and to give the report about the same. The investigator had visited the house of the complainant and had collected all the required documents. He was also handed over both the tags bearing No.OIC123448. The investigator had properly checked and identified the deceased buffalo and had compared the same with the details of the insured buffalo and found that the died buffalo is the same which was insured with the ops. The investigator had thoroughly investigated the matter and had assured the complainant that he shall get the claim amount within 10-12 days of submitting his report. It is further averred that complainant had visited the office of the ops on 8.2.2016, 2.3.2016 and on various dates and also wrote letters requesting the ops to pass the compensation/ insurance claim to him but at all the eventualities the officials of the op kept on lingering on the matter with one pretext or the other and it was on 21.3.2016 that the officials of the ops vide letter dated 21.3.2016 informed the complainant that they have repudiated his claim for the reason of breakage of tag and he will not get the insured amount from them. It is further submitted that complainant was the owner of two buffaloes only. Both the buffaloes could be easily identified with the description mentioned in the health cum evaluation certificate. The complainant was having no other buffalo with the same identification breed etc. to that of the deceased. That the ops are legally liable to pay the claim of the deceased buffalo to the complainant but they have arbitrarily refused the claim of the complainant. Hence, this complaint.
2. On notice, opposite parties appeared and filed written statement taking certain preliminary objections. It is submitted that after receipt of report of investigator and after going through the record, the competent authority has decided the claim to be No claim as per terms and conditions of the policy as according to the policy, its terms and conditions tag should have been intact in all regard but same has not been intact in all regard i.e. backside of tag was not present at the time of investigation. Decision of repudiation is according to the terms and conditions of the policy. If tag is broken, then it is the duty of insured to get the same changed immediately and there is no such efforts on the part of complainant. Remaining contents of the complaint are also denied.
3. The complainant produced his affidavit Ex.C1 and copies of documents Ex.C2 to Ex.C8. On the other hand, ops produced affidavit of Sh. Sushil Kumar, Divisional Manager Ex.R1, affidavit of Sh. Madan Goyal, Advocate as Ex.R2 and copies of documents Ex.R3 to Ex.R5.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. Learned counsel for the complainant has contended that ops have arbitrarily and illegally repudiated the claim of the complainant on the ground that back side of the tag was not present at the time of investigation despite the fact that case of complainant is duly proved on file. The ops have not denied the issuance of the policy by which the deceased buffalo of the complainant was insured by putting the tag bearing No. OIC123448 and the ops have not led any evidence that the deceased buffalo was not having the tag No. OIC123448.
6. On the other hand, learned counsel for ops has contended that no doubt the ops have repudiated the claim of the complainant on the basis of ‘No Tag No Claim’ as back side of the tag was not present at the time of investigation, but however, the ops can consider the claim of the complainant on non standard basis if complainant makes so offer to get his claim settled on non standard basis due to reason that back side of the tag was not there at the time of investigation.
7. Learned counsel for the complainant has stated at bar that he has no objection if the present complaint is allowed and the ops are directed to make payment of claim of the complainant on non standard basis.
8. In view of the above, we allow the present complaint and direct the opposite parties to settle and pay the claim of the complainant i.e. insured value of the deceased insured buffalo of the complainant on non standard basis as per terms and conditions of the policy within a period of 30 days from the date of receipt of copy of this order. We also direct the ops to pay a sum of Rs.2000/- as composite compensation and litigation expenses to the complainant. A copy of this order be supplied to the parties free of costs. File be consigned to the record room after due compliance.
Announced in open Forum. Member President,
Dated:20.12.2017. District Consumer Disputes
Redressal Forum, Sirsa.
