BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.

                                                          Consumer Complaint no.01 of 2018                                                                  

                                                           Date of Institution         :    01.01.2018

                                                          Date of Decision   :   28.11.2018.

Sanjay Sharma, aged 33 years son of Shri Tulsi Ram, resident of vill. Chattergarh Patti, Tehsil and District Sirsa.

                                                               ……Complainant.

                                      Versus.

The Oriental Insurance Company Limited, Divisional Office at Opp. Janta Bhawan, Sirsa- 125055 through its Divisional Manager.

                                                                             ...…Opposite party.

Complaint under Section 12 of the Consumer Protection Act,1986.

Before:        SH. R.L. AHUJA …………..PRESIDENT.

          SH. ISSAM SINGH SAGWAL ……MEMBER.

Present:       Sh. Inderjit Singh,  Advocate for the complainant.

Sh. K.L. Gagneja, Advocate for opposite party.

 ORDER

                   The case of complainant in brief is that complainant is consumer of the opposite party. That as a matter of fact the complainant being the eligible person for the loan has applied for the Bank loan with State Bank of Patiala, Sirsa for getting the loan for the purchase of cow and the fact remains that after obtaining the loan facility, the complainant purchased the cow Breed Sahiwal brown colour having identification as with horns, straight black colour tail. It is further averred that after the purchase of the said cow, the complainant got the said horned cow insured from the op-company vide insurance policy No.261503/47/2016/1939 valid w.e.f. 16.1.2016 to 15.1.2019 for the sum assured of Rs.30,000/- on payment of the insurance premium amount. That at the time of insurance, the female cow brown colour was aged six years six months mulching cow and was having tag No.OIC/189147 for its identity and a health cum evaluation certificate for the purpose was issued by Veterinary Surgeon, Govt. Veterinary Hospital. It is further averred that above mentioned live stock died due to illness and post mortem was conducted by the Veterinary Surgeon who has opined that in his opinion, animal has died due to acute tympani. Intimation in this regard was sent by the complainant to the op/ insurance company immediately after the death and the surveyor of the company immediately visited the spot and verified the death of the live stock/ cow and he took the snaps of the dead cow and also got conducted the post mortem of the dead animal from the Doctor V.L.D. concerned. It is further averred that every fact regarding the dead cow was enquired by the surveyor from the complainant and other neighboring villagers and it was quite confirmed that the insured cow bearing tag No.OIC-189147 has died due to illness and within the insurance period and after being satisfied, the surveyor of op/ company also assured the complainant that within a short days, the sum assured of Rs.30000/- would be paid to the complainant. It is further averred that thereafter the op failed to disburse the claim of dead insured cow of complainant. However, the complainant took the rounds of the insurance company time and again, but every time the op assured the complainant that the proceedings of claim is under process and very soon the same would be disbursed to the complainant, but now vide letter dated 14.11.2017, the op repudiated the claim of the complainant simply on the flimsy ground that as per claim form and veterinary surgeon certificate, the died animal was horned in the policy as per the said H/C (dehorned) since the identification does not match, so no claim file closed as No claim. It is further averred that in fact and in reality, the op/ company is not interested to disburse the genuine claim of the complainant and that is why the op only on the basis of false and frivolous stand has repudiated the claim of the complainant while the fact remains that tag number so fixed by the insurance company was found tagged as same/tact with the insured dead cow and there is no dispute of the tag or any kind of tampering with the tag nor there is any such reporting. The company in collusion with its Surveyor just by manipulating the photograph has repudiated the genuine and legal claim of the complainant. It is also submitted that the op/ company being the clever body shown status of the cow bearing tag no.251458 shown in the case of dead cow bearing tag no.189147 and this intermingling has been done by the company just to repudiate the claim of complainant. It is further averred that at the time of death, the cow was hale and hearty and was producing out approximately 10-12 liters milk daily. That immediately after receipt of above mentioned letter, the complainant contacted to the op with a request to reconsider his claim and showing his willingness to give an affidavit/ surety in this regard but the op was hell bent not to pay any heed to the genuine request of complainant and lastly after lingering the matter on one pretext orf the other for a long time ultimately few days back made clear denial to the complainant for the same. It is further averred that complainant is a very poor person and he was having the income for his livelihood from the deceased cow and he is not in position to purchase other cow of his own. The opposite party has caused unnecessary harassment, humiliation and mental tension to the complainant. Because of the death of this cow and delay in disbursement of claim by op, the complainant was required to purchase milk from the market at the enhanced price for fulfilling the needs. Hence, this complaint.

2.                On notice, opposite party appeared and filed written statement asserting therein that contents of para no.3 of the complaint are admitted to the extent that the cow of the complainant was insured with the op by a composite insurance policy alongwith other nine heads of cattle vide policy no.261503/47/2016/1939 dated 16.1.2016, but all the heads of cattle were insured subject to the terms and conditions as specified in the Livestock (cattle) insurance policy. It is further submitted that it is admitted that the insured cow of the complainant died on 19.10.2016 and the post mortem of the dead cow was conducted by the Veterinary Surgeon Farwain Kalan, explaining the cause of death in the post mortem report. As per PMR, the cow died due to acute tympani. On receiving the intimation of death of the insured cow, a surveyor was appointed by the op to ascertain the cause of death of the cow. It is further submitted that after going through the complete claim file by the officials of op, it was observed that claim form and valuation certificate show that the dead cow has horns whereas in the health-cum evaluation certificate, the insured cow was dehorned (without horns). The photographs taken by the surveyor also show that the dead cow was horned. As the identification of the dead cow was not matching, the claim was repudiated. It is further submitted that it is wrong to suggest that op has repudiated the claim of complainant on the basis of false and frivolous grounds. The tag was fixed by the veterinary surgeon and not by the op. It is also wrong to suggest that op has manipulated the photographs in collusion with the surveyor and that op has inter mingled the tags of different cattle. The op had sent by registered post a letter to the complainant on 29.8.2017 to clarify and arrange the correction in claim form and valuation certificate within seven days of the receipt of the letter, which was received back by the op undelivered, resulting into repudiation of the claim. It is further submitted that the complainant has described the color of the dead cow as black whereas in the claim form-cum-valuation certificate, the veterinary surgeon, GVH, Farwain Kalan has written the color of the dead cow as brown which also does not match with the description of the dead cow. Remaining contents of the complaint have also been denied and prayer for dismissal of complaint has been made. 

3.                The parties then led their respective evidence by way of affidavits and documents.

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

5.                The perusal of the record reveals that complainant in order to prove his complaint has furnished his affidavit Ex.CW1/A in which he has reiterated all the averments made in his complaint. He has also furnished letter dated 14.11.2017 Ex.C1, copy of policy schedule Ex.C2, copy of post mortem report Ex.C3, copy of livestock claim form Ex.C4, copy of document regarding description of animal Ex.C5, copy of health cum evaluation certificate Ex.C6. On the other hand, op has furnished affidavit of Sh. Sanjay Aggarwal, Branch Manager Ex.R1 in which he has deposed on the lines of pleas taken in the written statement. The op has also furnished copy of post mortem report Ex.R2, copy f claim form Ex.R3, copy of description Ex.R4, copy of health cum evaluation certificate Ex.R5, copy of letter dated 29.8.2017 Ex.R6, copy of letter dated 25.10.2017 Ex.R7, copy of letter dated 14.11.2017 Ex.R8, copy of photograph Ex.R9 and copy of policy schedule Ex.R10.

6.                Sh. Sanjay Aggarwal, Branch Manager in his affidavit Ex.R1 has specifically deposed that after going through the complete claim file by the officials of the respondent, it was observed that claim form and veterinary surgeon certificate show that the dead cow has horns whereas in the health certificate, the insured cow was dehorned (without horns). The photographs taken by the surveyor also show that the dead cow was horned. As the identification of the dead cow was not matching and the claim of the complainant was repudiated.

7.                During the course of arguments, though learned counsel for complainant has strongly contended that the dead cow was having the same tag which was affixed at the time of issuance of insurance coverage and there may be some mistake in the evaluation cum health certificate in which it has been mentioned as dehorned but the perusal of the health cum evaluation certificate Ex.R5 reveals that cow which was tagged with OIC- 189147 was dehorned. So there remains no doubt about the fact that cow which was insured with op was having dehorned but the copy of photograph taken by the surveyor reflects that cow which died was having horned, which is not possible. So, it appears from the evidence of opposite party that op has rightly repudiated the claim of complainant.

8.                In view of the above, we do not find any merit in the present complaint and same is hereby dismissed but with no order as to costs. 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                      President,

Dated:28.11.2018.                                                                   District Consumer Disputes

                                                                                       Redressal Forum, Sirsa.