DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

PATIALA.

                                      Consumer Complaint No. 495 of 23.12.2016

                                      Decided on:   8.2.2019

Jasveer Singh age 35 yrs. Son of Sh.Jeet Singh, resident of village Matoi, Tehsil Malerkotla, District Sangrur.

                                                                   …………...Complainant

                                      Versus

1.       The Oriental Insurance Co. Ltd., Regd. & Head Office: Oriental House, A25/27, Asaf Ali Road, New Delhi through its Managing Director.

2.       The Oriental Insurance Co. Ltd., Branch Office: 126, Chhoti Baradari, Patiala through  its Branch Manager.

                                                                   …………Opposite Parties

                                      Complaint under Section 12 of the

                                      Consumer Protection Act, 1986.

QUORUM

                                      Sh. M.P.Singh Pahwa, President

                                      Smt. Inderjeet Kaur, Member

                                      Sh.B.S.Dhaliwal, Member

ARGUED BY

                                       Sh.Inderpal Singh, counsel for complainant.

                                      Sh.B.L.Bhardwaj, counsel for Opposite Parties. 

 ORDER

                                     M.P.SINGH PAHWA,PRESIDENT                

1. This is the complaint filed by Jasveer Singh (hereinafter referred to as the complainant) against Oriental Insurance Co. Ltd. and another (hereinafter referred to as the OPs).
2. Briefly the case of the complainant is that he is doing the work of milk for earning his livelihood. He got insured his six cows with the OPs. The OPs after conducting medical examination from the veterinary officer and after examining all the aspects, insured the cows vide cover note dated 14.3.2016 for the period from 14.3.2016 to 13.3.2017. Complainant paid Rs.16488/- as premium for insurance. OPs issued insurance policy No.233503/47/2016/1180 to the complainant. The six cows were insured by the OPs vide micro/chip Nos.990000000374951 to 9900000003749561. The sum of the insured cow was Rs.60,000/-each.
3. It is pleaded that on 8.4.2016, one of the insured cows bearing chip No.990000000374956 fell ill and lateron died on 14.4.2016. Intimation of the same was immediately given to the OPs vide letter dated 15.4.2016. Veterinary officer of the Civil Hospital, Malerkotla also conducted postmortem of the cow on 15.4.2016. He opined that cow died because of severe infection of respiratory system, which is sufficient to cause death. Statement of the complainant was also recorded. Photographs of the dead cow were also clicked. Complainant applied and filled forms with the OPs for payment of insured amount but the OPs vide letter dated 11.7.2016 repudiated the claim with the observation that microchip of dead cow was broken and was not readable, whereas the cow was properly identified. Complainant is entitled to receive the amount of sum insured.
4. On this background of the facts, the complainant has pleaded that the OPs are indulging for harassing and humiliating him and he had suffered huge loss. For these sufferings, the complainant has claimed compensation to the tune of Rs.20,000/-, in addition to Rs.60,000/-, the sum insured of the cow and litigation expenses of Rs.7500/-.Hence this complaint.
5. Upon notice, OPs appeared through counsel and contested the complaint by filing the written reply. In reply the OPs raised preliminary objections that the complaint is not maintainable on the ground of jurisdiction. The residence of the complainant and alleged cause of action has taken place in the jurisdiction of District Sangrur as per admission of the complainant; that the complainant has no cause of reason to file the complaint; he has not come to the Court with clean hands and has concealed material facts from this Forum.
6. On merits, it is not denied that the complainant got insured six cows and he was issued the policy as pleaded by the complainant but these facts are stated to be matter of record. It is admitted that the OPs insured six cows vide insurance policy No.233503/47/2016/1180 for the period 14.3.2016 to 13.3.2017 @ Rs.60,000/- per cow as per tags put on each cow as stated in the insurance policy. If there is no tag, as mentioned in the policy, then any claim case in respect of dead cow is not payable by the insurance company as per terms and conditions of the policy. On receipt of intimation from the complainant/insured as regard to the death of one cow, the OPs detailed Sh.Ankur Jindal, Investigator to carry out the spot verification. During investigation/verification, it was found that the microchip is broken and is not readable.
7. It is denied that cow was having micro chip No.990000000374956.The complainant could not produce the requisite tag with dead cow to the Investigator at the time of verification. The micro chip which was showed to the Investigation was broken one. It was not readable. As per statement of the insured as well of the insurance company only six cows were insured with the OPs whereas as per spot verification of the investigator, complainant was found having seven cows. One cow dead. It is evident that insured cow with the microchip No. 990000000374956 was not died.Since requisite tag number during verification on the dead cow was found broken, during verification by the investigator. The complainant has got six cows insured, whereas he was found having more than six cows. Accordingly claim case for dead cow of the complainant was repudiated by the insurance company vide letter dated 11.7.2016.Complainant was given seven days time to file written reply. But the complainant has not filed any reply to the repudiation letter. Instead of filing reply, he has filed the present complaint which is devoid of any truth. It is liable to be dismissed. All other averments of the complainant are also denied. In the end, the OPs prayed for the dismissal of the complaint.
8. Parties were afforded opportunity to produce their evidence.
9. In support of the complaint, the complainant tendered into evidence his affidavit, Ex.CA, copy of cover note, Ex.C1, policy schedule, Ex.C2, copy of application, Ex.C3, copy of postmortem report, Ex.C4, copy of statement, Ex.C5, photographs, Exs.C7 to C12, copy of claim form, Ex.C13, copy of repudiation letter, Ex.C14. Complainant failed to close evidence despite giving opportunity. As such evidence of the complainant was closed vide order dated 4.10.2017.
10. The OPs tendered into evidence affidavit of Mukesh Malhotra, Ex.OPA,affidavit of Ankur Jindal, Ex.OPB, copy of letter dated11.7.2016,Ex.OP1,copy of letter, Ex.OP2 and copy of report,Ex.OP3 of the Investigator. The ld. counsel for the OPs has also submitted written arguments.
11. The ld. counsel for the complainant has reiterated his stand as taken in the complaint. It is further submitted by the ld. counsel for the complainant that it is not disputed that the complainant got his six cows insured with the OPs with the value of Rs.60,000/- per cow.
12. The version of the complainant is that one, of the six insured cows, died on 14.4.2016.Intimation in this regard was given to the OPs on the very next day and OPs got investigated the matter from their investigator. The OPs have repudiated the claim vide letter dated 11.7.2016,ExC14. The reason for repudiation is stated that, the microchip of the dead cow was found broken and was not readable.
13. The death of the cow  is not disputed. Insurance  of the cow is not disputed. Therefore, the OPs were not to repudiate the claim. The chip was provided by the OPs. Therefore, if the chip has broken or is not readable, the complainant is not to be blamed. Claim is repudiated  on the basis of report of the investigator, copy of which is Ex.OP3. In his report also, the investigator has no where expressed any doubt regarding genuineness of the claim. Rather it is mentioned that the company can take decision as per terms and conditions of the issued policy. The OPs have not produced on record copy of insurance policy. Complainant has produced copy of insurance policy,Ex.C1.It proves that six cows were covered as per health certificate attached. The OPs have got prepared health certificate. The other features of the insured cows were also recorded. The OPs were  having opportunity to examine the dead cow with the  health certificate but no such step has been taken. Adverse inference can be drawn for this reason also.
14. On the other hand, the ld. counsel for the OPs has submitted that  on receipt of the claim the investigator was appointed. He has concluded that microchip was found broken from the dead cow and it was not readable. Therefore, the identity of the insured cow was not established.
15. The claim case of the complainant was found doubtful for another reason also. Only six cows were got insured ,whereas the complainant was having seven cows after death of the cow in question i.e. total eight cows. In these circumstances the claim of the complainant was considered to be not payable. Hence repudiated.
16. We have given careful consideration to the rival submissions.
17. The admitted facts are that the complainant got his six cows insured vide insurance policy, Ex.C1.As per this document, the cows were insured as per health certificate attached with. From this fact, it can be safely  inferred that health certificate of the different six cows were prepared which must be  having some identification features also. One of the cows died within covered period. OPs got investigated the matter. Report of the investigator is Ex.OP3. Of course as per this report, the investigator found that microchip was broken from the dead cow and it was not readable but no doubt regarding genuineness of the microchip is expressed by the investigator. It is not in the report of the investigator that there was any tampering in the microchip to make it un readable. Even otherwise the OPs were having health certificate of the insured cow which must have containing salient distinguishable features of cows. The OPs were having opportunity to compare the features reported in the health certificate with the dead cow. No such step has been taken by the OPs in this direction. The investigator has also not expressed any doubt regarding the death. He has rather stated that the company can take decision as per terms and conditions of the issued policy. OPs have not produced the terms and conditions of the policy to justify the repudiation.

For the reason recorded above, the conclusion is that the repudiation of the claim is not sustainable.

18. As a result of above discussion, the complaint is partly accepted with Rs.5000/-as costs of the litigation. The OPs are further directed to pay Rs.60,000/-(value of the dead cow) to the complainant. The repudiation was unjustified. Therefore, the complainant is held entitled to interest @12% per annum, on this amount, on account of compensation, from the date of repudiation i.e. 11.7.2016 till its realization. Compliance of the order be made by the OPs within a period of 45 days from the date of the receipt of  certified copy of this order.
19.  Certified copies of this order be sent to the parties free of cost under the Rules. Thereafter, file be indexed and consigned to the Record Room.

ANNOUNCED

DATED: 8.2.2019        

 B.S.Dhaliwal                         Inderjeet Kaur              M. P. Singh Pahwa

       Member                                 Member                                      President