BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.

                                                          Consumer Complaint no.100 of 2019                                                                          

                                                          Date of Institution         :    26.02.2019

                                                          Date of Decision   :   20.08.2019.

Jeeto Bai aged about 65 years wife of Shri Sardara Ram, resident of village Rattakhera, Tehsil and District Sirsa.

                                                               ……Complainant.

                                      Versus.

The Oriental Insurance Company Limited, through its Branch Manager, having its office at opposite Janta Bhawan, Sirsa, Tehsil & Distt. Sirsa.

                                                                          ...…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. Surender Kamboj,  Advocate for the complainant.

Sh. A.S. Kalra, Advocate for opposite party.

 ORDER

                   The case of complainant in brief is that complainant was owner of one buffalo of breed Murrah cross aged 6.6 years, colour black with identification mark of both horns curved and tail below hock joint. That complainant got her above said buffalo insured with the op at Sr. No.15 of insurance policy No.261503/47/2015/868 through Deputy Director Live Stock insurance scheme valid w.e.f. 05.3.2015 to 04.03.2016 for a sum of Rs.40,000/- and had paid the premium amount. Before insurance, health cum evaluation certificate was also obtained by op from Veterinary Surgeon GCH Mallekan (Sirsa). A tag bearing No. OIC-133308 was inserted in the ear of buffalo. It is further averred that on 28.12.2015 at 8.00 a.m., the buffalo suddenly died due to sudden heart failure and intimation was immediately sent to the Veterinary Hospital, Madhosinghana and post mortem was conducted on the same day. The post mortem report bearing no.6685 dated 28.12.2015 was prepared by the Veterinary Surgeon in this regard. It is further averred that op was immediately informed about this mis-happening and a live stock claim form cum valuation certificate dated 28.12.2015 was also furnished with the op through the Veterinary Surgeon, GVH Madhosinghana describing the spices, breed, sex, colour, physical identification mark, age and tag details etc. of the deceased buffalo. The spot inspection was also conducted by the Sub Divisional Officer, Animal Husbandry and Dairy Sirsa for verification of tag and a report was furnished to this effect. That op had appointed the Surveyor/ Investigator who visited the house of complainant and collected all the required documents, recorded the statement of complainant and Sarpanch of village Rattakhera. The tag was also handed over to him by the complainant. The Investigator had thoroughly investigated the matter and assured the complainant that she will get the claim amount within one month of submitting his report. That thereafter complainant had visited to the office of op and requested the officials of op for payment of claim, but the officials of op started putting off the matter with one pretext or the other and lastly the op flatly refused to make the payment of claim vide their letter dated 28.8.2016 on the ground that tag was broken, which is wrong, incorrect and against the actual and factual aspects. It is further averred that an application under Section 22 (C) of the Legal Services Authorities Act, 1987 was filed on 24.1.2017 against the op on the same cause of action before PLA for Public Utility Services, Sirsa and on 6.12.2018 the same has been got dismissed as withdrawn by the complainant with permission to file fresh on the same cause of action and thereafter complainant had filed complaint before this Forum, but due to technical defect, the same has been got dismissed as withdrawn on 22.1.2019 with liberty to file fresh complaint on the same cause of action. Hence, this complaint.   

2.                Alongwith the complaint, an application under Section 24-A of Consumer Protection Act for condonation of delay in filing present complaint was also moved. It has been averred in the application that complainant is illiterate lady aged about 65 years residing in village and ignorant regarding the law of limitation for filing the present complaint before the Forum and letter for repudiation of claim has been received by complainant during the pendency of petition before PLA for PUS Sirsa and that delay is not malafide or intentional one. The said application was allowed vide detailed order dated 24.5.2019 and delay was condoned.

3.                On notice, opposite party appeared and filed written statement taking certain preliminary objections. It is submitted that claim lodged by complainant has been decided by Competent Authority/ company in accordance with the terms and conditions of the policy. The complainant is bound by the term and conditions of the policy. Both the parties i.e. insured and insurer are contractually bound by the same and according to the term and condition of the policy, tag should have been intact in all regard and in case tag is not intact in the ear of dead insured buffalo then claim is not payable according to the term and conditions of the policy and case of complainant falls within the parameter of “No Tag No Claim”. It is further submitted that in this case tag was broken and has not been concluded to be intact in all regard and after going through the entire record, PMR, claim form, investigation report placed before competent authority, the claim of complainant has been repudiated. It is further submitted that complaint is barred by the law of limitation. The claim was repudiated vide letter dated 28.8.2016 and present complaint has been filed on 13.2.2019. All other contents of the complaint are also denied and prayer for dismissal of complaint made.    

4.                The parties then led their respective evidence.

5.                We have heard learned counsel for the parties and have perused the case file carefully.

6.                The complainant in order to prove her complaint has furnished her affidavit Ex.CW1/A in which she has reiterated all the averments made in the complaint. The complainant has also produced letter dated 28.8.2016 Ex.C1, copy of post mortem report Ex.C2, copy of policy schedule Ex.C3, copy of health cum evaluation certificate Ex.C4, copy of legal notice Ex.C5 and copy of claim form Ex.C6. On the other hand, op has tendered affidavit of Sh. S.K. Malhotra, Divisional Manager Ex.R1, copy of letter dated 28.8.2016 Ex.R2, copy of claim form Ex.R3, copy of valuation certificate Ex.R4, copy of surveyor report Ex.R5, copy of statement Ex.R6, copy of legal notice Ex.R7, reply to notice Ex.R8, affidavit of Sh. Risal Singh Surveyor/ Investigator Ex.R9 and policy schedule Ex.R10.

7.                Admittedly, the complainant was owner of a buffalo which was insured with the opposite party vide Sr. No.15 of policy No.261503/47/2015/868 for the period 5.3.2015 to 4.3.2016. It is further an admitted fact on record that buffalo of complainant died on 28.12.2015 and post mortem examination was got conducted. Due investigation was got conducted by op after receiving requisite information from the complainant, but however, the claim lodged by complainant was repudiated on the ground “No Tag No Claim”.

8.                The bone of contention between the parties is qua the tag of the buffalo. As per contention of complainant, at the time of getting policy, the officials of the op had put a tag in the ear of the buffalo with number OIC-133308 which was intact at the time of death of buffalo. On the other hand, as per contention of op during the course of investigation, the tag was found to be broken. The perusal of the evidence of complainant reveals that complainant got her buffalo insured with the op with tag No.OIC-133308. The copy of post mortem report also reveals that doctor who conducted post mortem also recorded tag number as 133308 while conducting post mortem on the dead body of buffalo of complainant, but however, in the report of investigator he has reported that cap of the tag was found to be broken. Even if it is presumed that cap of the tag of the buffalo was broken, the op cannot deny claim of complainant in toto. It is settled principle of law that where there is any minor discrepancy, the claim can be settled on non standard basis. It will be in the fitness of things, if the present claim is also ordered to be settled on non standard basis.

9.                In view of above discussion, we allow the present complaint and direct the opposite party to settle and pay the claim of the complainant on non standard basis within a period of 30 days from the date of receipt of copy of this order, 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 further direct the op to 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 after due compliance.      

Announced in open Forum.     Member       Member               President,

Dated:20.08.2019.                                                                   District Consumer Disputes

                                                                                                 Redressal Forum, Sirsa.