BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.
Complaint No.: 289 of 2015.
Date of Institution: 12.10.2015.
Date of Decision: 06.03.2019.
Naresh son of Shri Partap, resident of village Nimri, post office Baund Kalan, Tehsil and District Bhiwani.
….Complainant.
Versus
The Oriental Insurance Company Ltd., near Bus Stand, Loharu Road, Charkhi Dadri through its Branch Manager.
…...Opposite Party.
COMPLAINT UNDER SECTIONS 12 AND 13 OF
THE CONSUMER PROTECTION ACT, 1986.
Before: - Hon’ble Mr. Manjit Singh Naryal, President.
Hon’ble Mr. Parmod Kumar, Member.
Hon’ble Mrs. Saroj Bala Bohra, Member.
Present: Shri Amarjit Baniwal, Advocate for the complainant.
Shri M. L. Sardana, Advocate for the OPs.
ORDER:-
PER MANJIT SINGH NARYAL, PRESIDENT
The case of the complainants in brief, is that he was owner of a Murrah Buffalo which was insured from OP for a sum of Rs.60,000/- vide policy No. 261204/47/2015/347 for the period w.e.f. 1.11.2014 to 31.10.2015, having Tag No.087725 and paid the premium. It is alleged that the Buffalo of complainant died on 15.07.2015 due to illeness and Post Mortem of buffalo was conducted on the same day by Veterinary Surgeon, Veterinary Hospital, Baund Kalan. It is further alleged that surveyor of the insurance company also examine the buffalo and noted the Tag No.087725 of the buffalo. It is further alleged that photographs were also taken. It is further alleged that the post mortem report and surveyor report were submitted to the OP company vide claim No.261204/47/2016/000010, but the claim of the complainant was rejected by the OP vide letters dated 18.9.2015 and 1.10.2015 on the ground that the age of insured buffalo not matched with the buffalo died. It is further alleged the complainant is a poor person and use to sell the milk to meet his daily expenses. It is further alleged that the complainant has requested many times to the OP company to pay the claim of his insured buffalo, but to no effect. Hence, repudiation of claim by the OP amounts to deficiency in service and as such, the complainant has suffered the mental tension, physical harassment and financial losses. Hence, the present complaint.
2. On appearance, the OP filed the contested written statement and took preliminary objections qua maintainability; estoppel; locus standi; cause of action & concealment of material facts. On merits, it is alleged that after receiving information regarding the death of Buffalo the OP company deputed Shri Virender Shekhawat, Advocate Bhiwani for investigation and as per the report of above Advocate dated 30.8.2015, several suspicious circumstances arises from the statement of the complainant and from the health certificate, as neither the lacation nor the age of the buffalo matched with each other and in other words these differ with each other. It is further alleged that after considering the report of the investigation, the file of the complainant was closed as “No Claim” by the competent authority and he was informed accordingly vide letter dated 18.9.2015. It is further alleged that the complainant has made request for reconsideration and vide letter dated 1.10.2015 he was again informed that his claim has been closed as “No Claim” for the reason that the particulars of the dead buffalo did not match with the buffalo insured. So, there is no deficiency in service on the part of OP and complaint of the complainant is liable to be dismissed with costs.
3. Ld. Counsel for the complainant has placed on record the documents Annexure C1 to C16 in evidence and closed the evidence.
4. Ld. Counsel for the OP has placed on the record documents annexure R1 to R9 and closed the evidence.
5. We have heard both the parties at length and have gone through the case file carefully.
6. The only plea taken by the OP company is that as per the investigation report the description of the insured Buffalo does not tally with died Buffalo. Moreover, as per the statement of the complainant made before the investigator and from the health certificate, neither the lacation nor the age of the died buffalo matched with the insured buffalo. Ld. counsel for the complainant has argued that the complainant has only two buffaloes and both were insured with the OP at the same time, but he failed to prove on record that both the buffaloes were insured at the same time by placing on record the copy of the policy of the second buffalo and he has also failed to prove on record that the complainant has only two buffaloes. It is pertinent to mention here that the arguments advanced by ld. counsel for the complainant are not part of the pleadings. Furthermore, the complainant has also failed to prove his version by any other supporting affidavits and any cogent and convincing evidence. Moreover, the plea taken by the OP has substance, because from perusal of Annexure R3 statement of complainant recorded by investigator, in which it has been categorically found mentioned that the age of died Buffalo was about 7 years and the died buffalo had 3rd lacation, whereas as per the health certificate of buffalo i.e. Annexure C2 the age of the insured Buffalo was 8 years and the buffalo had 5th lacation. The report of the investigator is also placed on the file by the OP as Annexure R4. So, from the statement of the complainant Annexure R3 and the health certificate of insured buffalo Annexure C2, it has been clearly established on record that the specification of the insured Buffalo and the died buffalo not matched. Learned counsel for the complainant has failed to explain the above difference in died buffalo and insured buffalo. So, this fact itself creates suspicious on the case of the complainant and this fact create doubts that the died Buffalo was not same which was got insured by the complainant from the OP. Therefore, statement of the complainant does not inspire any confidence that the died Buffalo was the same which was got insured from the OP, because the description of the died Buffalo did not tally with the Health Certificate. Therefore, presumption must be drawn against the complainant and in favour of the OP. Hence, the genuineness of the above claim has not been established.
7. Therefore, in view of the facts and circumstances mentioned above the OP has rightly and legally repudiated the claim of the complainant. Hence, the complaint of the complainant is hereby dismissed with no order as to costs. Certified copies of the order be sent to the parties free of costs. File be consigned to the record room, after due compliance.
Announced in open Forum.
Dated: - 06.03.2019.
(Saroj Bala Bohra) (Parmod Kumar) (Manjit Singh Naryal)
Member. Member. President,
District Consumer Disputes
Redressal Forum, Bhiwani.
