BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 187 of 2019
Date of Institution : 19.04.2019
Date of Decision : 07.11.2019.
Jaspal aged about 75 years son of Shri Harbhaj Ram, resident of village Panjuana Dhani, Tehsil and District Sirsa.
……Complainant.
Versus.
The Oriental Insurance Company Limited, Branch Office, Opposite Janta Bhawan, Post Box-11, Sirsa, District Sirsa, through its Branch Manager.
...…Opposite party.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L.AHUJA…………………………PRESIDENT
SH. ISSAM SINGH SAGWAL………….MEMBER
SMT. SUKHDEEP KAUR………… …… MEMBER.
Present: Sh. H.S. Bishnoi, Advocate for the complainant.
Sh. Ravinder Goyal, Advocate for opposite party.
ORDER
The case of the complainant in brief is that complainant was owner of one female buffalo (Murrah) who was healthy having age of about 10 years and used to give milk of 20 kgs. for two times. The above said buffalo was insured by the opposite party vide insurance policy no.261503/47/16/2943 for the period w.e.f. 3.3.2016 to 2.3.2019 for the value of Rs.50,000/- as shown at Sr. No.5 in the policy as per tag No.153620. It is further averred that complainant is an agriculturist and he used to sell milk of above said buffalo. The buffalo of complainant fell ill and died on 24.8.2016 at 2.00 p.m. midnight. The post mortem of buffalo was conducted by the Veterinary Surgeon, Govt. Veterinary Hospital, Panjuana vide PMR No.33645 dated 25.8.2018 and according to the opinion of the doctor, the animal might have died due to tympany. It is further averred that immediately after the death of said buffalo, the complainant informed the op about the same. The Surveyor of the op visited the spot and took photographs of the buffalo and he also received copy of PMR from the complainant. The claim case of complainant was prepared by the op vide claim No.47/19/000073 but till date the complainant has not been given any claim with regards to the death of above said buffalo of the complainant. It is further averred that costs of Murrah buffalo of complainant is more than Rs.2,00,000/-. The complainant is legally entitled to get the above said amount from the op in all respect. That the complainant approached and requested the op on many occasions but all the times the op has postponed the matter and has caused deficiency in service and unfair trade practice towards the complainant due to which he is suffering recurring financial losses till today and also suffering serious harassment and mental tension. That complainant served a legal notice upon the op on 16.3.2019 but to no effect. Hence, this complaint.
2. On notice, opposite party appeared and filed written statement taking certain preliminary objections. It is submitted that on receipt of information about the death of insured buffalo, the op deputed Shri Madan Goyal, Advocate (Investigator) to investigate the cause of death of the insured buffalo and other aspects. The Investigator visited the spot and prepared his report dated 17.9.2018 and submitted the same to the op. The investigator also took photographs of the said buffalo. From the perusal of the photographs of the dead buffalo, it was found that the tag was affixed in its right ear, whereas, as per health certificate of the said buffalo issued at the time of insurance policy, the tag was in the left ear of the buffalo. On coming to know of this aspect of the case, the complainant was required vide letter dated 11.3.2019 to clarify on the point that “ the position of ear tag is different in health certificate and paper submitted by you. Kindly clarify otherwise we shall close the file”. However, the complainant did not give any reply to the said letter and did not clarify the above aspect of the case. Therefore, the op vide its letter dated 17.3.2019 in a legal and lawful manner closed the claim file of complainant due to non furnishing of any clarification to letter dated 11.3.2019. It is further submitted that complainant had got insured the buffalo for a sum of Rs.50,000/- with the op. So, it is wrong that the value of the buffalo was Rs.2,00,000/-. Moreover, the dead animal is different from the insured animal, as fully detailed above. Remaining contents of the complaint are also denied and prayer for dismissal of complaint made.
3. The parties then led their respective evidence.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. The complainant in order to prove his complaint has tendered his affidavit Ex.CW1/A in which he has deposed and reiterated all the averments made in the complaint. He has also furnished copy of post mortem report Ex.C1, copy of legal notice Ex.C2, postal receipt Ex.C3, copy of policy schedule Ex.C4, letter dated 11.3.2019 as Ex.C5 and copy of adhar card Ex.C6. On the other hand, op has furnished affidavit of Sh. S.K. Malhotra, Senior Divisional Manager as Ex.RW1/A, copy of letter dated 11.3.2019 Ex.R1, copy of letter dated 15.1.2019 Ex.R2, copy of claim form Ex.R3, copy of health cum evaluation certificate Ex.R4, copy of post mortem report Ex.R5, copies of photographs Ex.R6 to Ex.R14 and copy of policy schedule Ex.R15.
6. It is undisputed fact between the parties that complainant was owner of a female buffalo (Murrah) which was insured with opposite party for the period 3.3.2016 to 2.3.2019 for insured value of Rs.50,000/- as per tag number 153620. Further, it is admitted fact that said buffalo died on 24.8.2018 at 2.00 p.m. and post mortem was got conducted by op on the dead body of buffalo. Due intimation was given to op and claim was lodged, but however, claim file was closed by op on the ground that complainant was called upon to explain the query that position of ear tag is different in the health certificate and papers submitted by complainant.
7. The perusal of the health certificate Ex..R4 reveals that before issuance of insurance policy, the tag bearing No.153620 was affixed in the left ear of the buffalo but as per photographs, the tag is reflected in the right ear of the buffalo. Though in the post mortem report, only tag number 153620 is mentioned but side of the ear is not mentioned by the doctor who conducted post mortem examination. The doctor has never given opinion that dead buffalo is not same which was insured by op, but however, there may be some inadvertent and clerical mistake in the health certificate of buffalo. So, claim of complainant cannot be denied in toto. It is settled principle of law that once it is proved on record that complainant is entitled to claim, but however, there is some technical ground, claim of complainant can be settled on non standard basis. In this regard, reliance can also be placed on the judgment of the Hon’ble Supreme Court in case titled as National Insurance Co. Ltd. Vs. Nitin Khandelwal reported in IV(2008) CPJ page 1 (SC).
8. In view of our above discussion, we allow the present complaint and direct the opposite party to re-open the claim file of the complainant and thereafter to settle and pay the claim of the complainant on non standard basis within a period of 45 days from today, failing which the complainant will be entitled to interest @7% per annum on the payable amount from the date of order till actual payment. We also direct the opposite party to further pay a sum of Rs.5000/- 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.
Announced in open Forum. President,
Dated: 07.11.2019. Member Member District Consumer Disputes
Redressal Forum, Sirsa.
