Haryana

Ambala

CC/437/2016

Smt Sangeeta Sharma - Complainant(s)

Versus

OIC - Opp.Party(s)

Harpreet Singh Baidwan

20 Mar 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM:

                                                AMBALA

 

                                                Complaint Case No.      :         437 of 2016.

                                                Date of Institution                   :         13.12.2016.

                                                Date of Decision            :         20.03.2018.

 

Smt.Sangeeta Sharma w/o Sh.Anil Sharma resident of village Chattan Tehsil Naraingarh District Ambala.

………….Complainant.

Versus

The Oriental Insurance Company, LIC Building Ambala City through its Branch Manager.

…………Opposite Party.

          Complaint Under Section 12 of the Consumer Protection Act.

CORAM:             SH. DINA NATH ARORA, PRESIDENT

                             MS. PUSHPENDER KUMAR, MEMBER

MS. ANAMIKA GUPTA, MEMBER

 

Present: -              Sh. H.S.Baidwan, Adv, counsel for complainant.

                             Sh. Dev Batra, counsel for the OP.  

ORDER

 

                             Brief facts of the present complaint are that as per scheme of Government of Haryana he had established a diary after taking a loan of Rs.12,50,000/- from SBP, Sehzadpur Branch. As per scheme of government 13 cows were insured vide cover note No.965119 on 21.02.2014 for a sum of Rs.6,50,000/- by paying a sum of Rs.14,625/- as premium. Thereafter 12 cows were insured vide cover note dated 987561 on 23.02.2015 by paying a sum of Rs.25650/- as premium and thereafter third renewal for 10 cows was obtained vide cover note No.1051850 dated 23.02.2016  and a sum of Rs.22500/- were taken as premium from the complainant. As per terms of the loan second installment of loan was advanced after 6 months of first purchased accordingly insurance of 12 cows were taken as cover note dated 986778 dated 15.09.2014 and thereafter Rs.13500/- were taken as premium by the for a sum insured of Rs.6,00,000/- and for second renewal for 10 cows as per cover note No.987993 dated 14.09.2015 a sum of Rs.11250/- for a sum assured of Rs.5,00,000/- was taken as premium from the complainant.  The cows of the complainant were duly insured by OP and were duly tagged by veterinary surgeon GVH,Sehzadpur. On 13.01.2016 one cow bearing tag No.62033 died at 7.30 A.M.  The tags of some cows were replaced with new one due to dropping of tag and misplaced. The complainant lodged the claim on account of death of cow during the insurance policy but it declined the same on flimsy grounds that tag No.62033 does not tally with the records of OP. The complainant had also informed the Veterinary Surgeon GVH, Sahzadur on 26.05.2015 regarding misplacing of tag and putting of new tag to the cow.  The OP wrongly and illegally declined the claim therefore, complainant got served a legal notice but to no avail.  The act and conduct of the OP clearly amounts to deficiency in service and unfair trade practice on its part. In evidence, the complainant has tendered affidavit Annexure CA and documents Annexure C1 to Annexure C8.

2.                          Upon notice, OP appeared and filed reply to the complaint wherein it has been submitted that in the event of loss of ear tag/s it is the responsibility of the insured to give immediate tag loss intimation to the concerned insurance company and get the animal/s re-tagged and submit the ragging certificate to the insurance company. It appears that the complainant has got some documents prepared in collusion with the staff of G.V.Hospital. The policy No.473 having validity from 24.02.2015 to 23.02.2016 was specifically issued for 12 cows having tags No.19739, 63703, 62030, 63705, 19741, 62029, 19744, 62026, 62027, 63712, 63713 and 62028.  The claim lodged by the complainant qua death of cow having tag No.62033 expired on 13.01.2016. Surveyor was appointed and he in his report dated 20.01.2017 has opined that the cow with tag No.62033 was not covered as per policy No.473; therefore, there is no liability upon the OP to pay the claim. All of a sudden it is only after registration of the claim in hand it is being alleged by the complainant that old tag number 19744 has been got replaced with new tag number 62033 and that too on the basis of fabricated documents.
The complainant is in the habit of lodging false claims because he has filed two other claims. There is no deficiency and unfair trade practice on the part OP as the alleged claim was not payable as per terms and conditions of the policy because the complainant has never intimated regarding alleged change/re-issue the new tag. Other pleas made in the complaint have been controverted and prayer for dismissal of the complaint has been made. In evidence, the OP has tendered affidavits Annexure RA, Annexure RB and documents Annexure R1 to Annexure R3.

3.                          Learned counsel for the complainant has argued that the complainant had insured the dead cow alongwith the other cattle with OP by paying necessary premium and value of the each cattle was assessed at Rs.50,000/- and  several tags were fixed on the insured cows. The dead cow was having old tag No.19744 and as per Annexure C3 the old tag was changed to new tag bearing No.62033 but when the claim qua dead cow was lodged with the Op it had repudiated the same on the false and flimsy ground that the dead cow was not covered under the policy purchased by the complainant as she was having different.

                             Per contra, it has been argued by learned counsel for the Op that the complainant in collusion with the staff of GV, Hospital got false and fabricated documents to take wrongful benefit because no intimation regarding changing/ affixing of new tag has been given to it and the dead cow was not insured with the insurance company for which the claim has been lodged.

                             It is established on the case file that a cow has died and she was having tag No.19744 (old) which was insured with the OP with other cattle (Annexure C1). As per Annexure C2 the complainant had moved an application to the Veterinary Surgeon, GV, Hospital Shazadpur for affixing of Tag. Perusal of the Annexure C3 reveals that old tag No. 19744 was changed to new tag No.62033. As per Post Mortem Annexure C5 the dead cow was having tag No.62033. When the complainant had moved an application Annexure C2 to the GV Hospital regarding affixing of Tag then it cannot be said that she was having further duty to intimate the OP because that letter has duly been received by the concerned officer vide dispatch dated 29.05.2015 and copy of the dispatch register has been placed on file at the time of arguments.

                             After going through the material such as insurance policy, post mortem report and the certificate Annexure C3 dated 29.05.2015 regarding re-tagging the new tag bearing No.62033 prior to the death of cow issued by Veterinary Surgeon it is clear that there is no difference in tag number and the dead cow was duly insured with the OP. The plea of the OP that the complainant got issued some documents in connivance with the staff members of VS, GVH, Sahzadpur is not tenable because there is nothing on the file to show that the officials of VS GVH,Sahzadpur was partial and the documents have been prepared in order to give benefit to the complainant. Another strange factor which this Forum has noticed that the Op has not placed on the case file the health certificate on the case to show that there was difference in between the dead cow and the cow allegedly insured by it. Health certificate was the essential document to match makes the identification of the cow which was to be issued by the Veterinary Surgeon before getting the cow insured. Though the investigator was appointed by the OP after lodging the claim but it appears that the investigator has even not taken any steps to enquire about the changing/replacing of the tag from old to new and even not recorded the statement of veterinary doctor and under what circumstances the new tag was affixed on the insured cow. The Op has wrongly and illegally declined the genuine claim of the complainant after ignoring the other fact that the dead cow was insured with it. The complainant has been able to prove her case by leading cogent and reliable evidence, therefore, present complaint deserves acceptance. Accordingly, we allow the present complaint with cost which is assessed at Rs.3,000/-. The OPs are also directed to pay Rs.50,000/- being sum assured of the buffalo alongwith interest @ 9% per annum  to the complainant from the date of filing of the complaint till its realization. However, it is made clear that the complainant would be entitled for the said amount on depositing of no objection certificate from the bank from which she had obtained the loan. Copies of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance. 

Announced on: 20.03.2018    

                                                                                                                   

 

(Pushpender Kumar)    (Anamika Gupta)                      (D.N.Arora)

Member                         Member                             President

                                                                   District Consumer Disputes                                                                                 Redressal Forum, Ambala.