Haryana

Kurukshetra

136/2018

Manoj Kumar - Complainant(s)

Versus

OIC - Opp.Party(s)

Vijay Tanwar

10 May 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KURUKSHETRA.

 

                                                                    Complaint No.:    136 of 2018.

                                                                   Date of institution: 18.06.2018.

                                                                   Date of decision:  10.05.2022

 

Manoj Kumar s/o Shri Balwant Singh, r/o VPO Mathana, District Kurukshetra.

 

                                                                                                …Complainant.

                                                     Versus

 

1. The Oriental Insurance Company Limited, Sabharwal Market, Railway Road, Kurukshetra, through its Branch Manager.
2. The Oriental Insurance Company Limited, Registered Office: Oriental House A-25/27, Asaf Ali Road, New Delhi, through its Manager
3.  

 

CORAM:   NEELAM KASHYAP, PRESIDENT.    

                   NEELAM, MEMBER.

                   ISSAM SINGH SAGWAL, MEMBER.           

 

Present:       Shri Vijay Tanwar, Advocate for the complainant.

                   Shri Rohit Jangam, Advocate for the Opposite Parties.

 

ORDER:

 

1.                This is a complaint under Section 12 of the Consumer Protection Act, 1986 (for short “Act”).

2.                By way of complaint in hand, complainant alleged that on the assurances given by the OPs, he purchased a policy of Rs.40,000/- for his one cow from the OPs vide policy No.1073192. The said cow was died on 08.08.2017 and the OPs were informed in this regard by the complainant on the same day. He submitted all the documents and furnished form for claim with the OPs, but the OPs had falsely issued the letter dated 26.12.2017 alleging therein that as per Health Certificate, colour of cow was black, whereas, as per physical inspection report, colour of dead cow was brownish. Before passing the said order, the complainant was not heard. Moreover, as per medical officer’s opinion during weakness due to suffering of illness, the colour may be changed. The complainant was having only one cow, which was died, so there was no dispute of identification of said cow, which was insured with the OPs. The complainant also served legal notice dated 08.02.2018 upon the OPs and the OPs committed false reply dated 28.02.2018. By not paying his genuine claim, the OPs are deficient in services, constraining him to file the present complaint against the OPs, before this Commission.

3.                On receipt of notice of complaint, OPs appeared and filed their written statement, raising preliminary objections regarding maintainability and locus standi. It is submitted that as per documents and claim papers submitted by the complainant, the case was got investigated and during inspection, it was found that “As per Health Certificate, colour of cow was black, whereas, as per physical inspection report, colour of dead cow was brownish, the description of dead cow does not match with the insured cow. Hence, the said cow which allegedly died, was not insured with the OPs and did not tally with the Health Certificate, so OPs was not liable to pay any compensation to the complainant. The complainant was informed that the competent authority repudiated the claim as “No Claim”. There is no deficiency on the part of the OPs and prayed for dismissal the present complaint with costs.

4.                 In order to support his case, complainant tendered affidavit Ex.CW1/A along with document Ex.C-1 and closed the same.

5.                On the other hand, the OPs in order to support their case, tendered affidavits Ex.RW1/A, Ex.RW2/A along with documents Ex.R-1 to Ex.R-9 and closed the same.

6.                However, during the pendency of the complaint, complainant moved an application for summoning the witness Dr. Parveen Kumar, Veterinary Surgeon, GVH Ram Saran Majra, who conducted the postmortem of the cow in question, which was allowed and said witness was examined on 27.10.2021 before this Commission.   

7.                We have heard the learned counsel for the complainant and gone through the case file carefully.

8.                Learned counsel for the complainant argued that the complainant purchased a policy of Rs.40,000/- for his one cow from the OPs vide policy No.1073192. The said cow was died on 08.08.2017 and the OPs were informed in this regard by the complainant on the same day, by submitting all the documents and furnishing form for claim with the OPs, but the OPs had falsely issued the letter dated 26.12.2017 alleging therein that as per Health Certificate, colour of cow was black, whereas, as per physical inspection report, colour of dead cow was brownish. Before passing the said order, the complainant was not heard. Moreover, as per medical officer’s opinion during weakness due to suffering of illness, the colour may be changed. The complainant also served legal notice dated 08.02.2018 upon the OPs and the OPs committed false reply dated 28.02.2018. He lastly argued that by not paying his genuine claim, the OPs are deficient in services.

9.                Contrary to it, learned counsel for the OPs argued that as per documents and claim papers submitted by the complainant, the case was got investigated and during inspection, it was found that “As per Health Certificate, colour of cow was black, whereas, as per physical inspection report, colour of dead cow was brownish, the description of dead cow does not match with the insured cow. Hence, the said cow which allegedly died, was not insured with the OPs and did not tally with the Health Certificate, so OPs was not liable to pay any compensation to the complainant and in this regard, he was informed that the competent authority repudiated the claim as “No Claim”. There is no deficiency on the part of the OPs and prayed for dismissal the present complaint with costs.

10.               There is no dispute that the complainant got insured his cow with the OPs insurance company w.e.f. 22.12.2016 to 21.12.2019, for a sum assured of Rs.40,000/- vide Policy/Cover Note No.1073192 and in this regard, the OPs insurance company issued an Ear Tag No.055015 to the said cow. There is also no dispute that the said cow died on 08.08.2017 and the complainant intimated to the OPs in this regard and lodged his claim with the OPs insurance company as Ex.R1, Ex.R-4 and Ex.R-5 respectively. Postmortem of dead cow was conducted by the Animal Husbandry & Dairying Department, Haryana as Ex.R-6. Shri R.N. Sharma got investigated the matter and submitted his report in this regard as Ex.R3. The OPs repudiated the claim of the complainant as ‘No Claim’, vide letter dated 26.12.2017 Mark-A, on the ground that as per Health Certificate colour of cow was black whereas, as per physical inspection report colour of dead cow was brownish.

11.              Since the OPs repudiated the claim of the complainant, therefore, the onus to prove the grounds, on which the claim of complainant was repudiated by them, was upon the OPs. To prove the same, the OPs mainly relied on the photographs Ex.R-7 to Ex.R-9 respectively and contended that in these photographs, the colour of dead cow was brownish, but in this regard, the complainant alleged that as per medical officer’s opinion, during weakness due to suffering of illness, the colour may be changed. It is pertinent to mention here that the buffalo is of black and brown colour only and the cow is of white and brown color only. In the case in hand, the cow in question was not of white coloured, therefore, quite obvious, it was of brown coloured, but from the photographs Ex.R-1, it seems that head of said cow was blackish and that’s why in the documents i.e. Surveyor report Ex.R-3 and postmortem report of Animal Husbandry & Dairying Department, Haryana Ex.R-6, colour of said cow might be mentioned as “black” instead of “brown”. Moreover, the colour of body of dead cow gave resemblance quite black and brownish in the photographs Ex.R-7 to Ex.R-9. Hence, the objection raised by the OPs in this regard, is not tenable, hence rejected. Moreover, from the perusal of documents Ex.R-1, Ex.R4, Ex.R5, Surveyor report Ex.R-3 and postmortem report of Animal Husbandry & Dairying Department, Haryana Ex.R-6, it is evident that the description and other particulars, mentioned in these document regarding the dead cow, such as, Tag number and date of dead of buffalo etc. are tallied with each other. Moreover, Dr. Parveen Kumar, Veterinary Surgeon, GVH Ram Saran Majra, who was called for examination, also admitted in his cross-examination that the tag of insurance was available at the time of postmortem of the cow.

12.              Keeping in view the above facts and circumstances of the case, we are of the considered opinion that the OPs insurance company has not been able to prove the allegations, on the basis of which, they had refused to pay the genuine claim of the complainant. Thus, the repudiation of the claim as ‘No Claim’, done by the OPs, is held to be unjustified and amounts to deficiency in services on their part. Since as per insurance policy, the insured value of cow was Rs.40,000/-, therefore, the OPs are liable to pay the said amount to the complainant along with compensation and litigation expenses, being deficient one.

13.              In view of our above discussion, we accept the present complaint against the OPs and direct the OPs severally and jointly, pay the claim amount of Rs.40,000/-, to the complainant, alongwith interest @6% (simple) per annum, from the date of filing the present complaint, by the complainant i.e. 18.06.2018, till its actual realization. The OPs are further directed to pay Rs.10,000/- to the complainant, as compensation for mental agony and physical harassment, caused to the complainant, due to an act of deficiency in service, on the part of the OPs, along with Rs.5,000/-, as litigation expenses. The OPs is further directed to make the compliance of this order within a period of 45 days from the date of preparation of certified copy of this order, failing which, the complainant shall be at liberty to initiate proceedings under Section 25/27 of the Act, against the OP. Certified copy of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the record-room, after due compliance.

Dated: 10.05.2022.

    

                                                                                        (Neelam Kashyap)               

(Neelam)                    (Issam Singh Sagwal)                   President,

Member.                    (Member).                                     DCDRC, Kurukshetra.           
 

 

 

 

 

Typed by: Sham Kalra, Stenographer.