BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 134 of 2016 Date of Institution : 23.5.2016
Date of decision : 08.02.2017
Subhash Chander aged about 42 years son of Shri Jai Lal, resident of village Bansudhar, Tehsil and District Sirsa.
……Complainant.
Versus.
The Oriental Insurance Company Limited, Sirsa, Tehsil and District Sirsa, through its Branch Manager/ Divisional Manager.
...…Opposite party.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI S.B.LOHIA……………………….PRESIDENT
SHRI RANBIR SINGH PANGHAL ……MEMBER.
Present: Sh. K.S. Chahal, Advocate for the complainant.
Sh. A.S. Kalra, Advocate for opposite party.
ORDER
In brief, complainant’s case is that he is a poor person. He was owner in possession of one buffalo of murrah breed, about six years of age, black colour who was giving 14 Ks. Milk per day. Its horns were fully curved with white tip at tail and value of the buffalo was Rs.50,000/-. It was insured with the opposite party vide insurance policy No.261503/47/2015/475 for the period w.e.f. 14.1.2015 to 13.1.2016 for sum assured of Rs.50,000/- under cattle insurance policy. Tag No. OCI-14151 was allotted to the buffalo by op-company which was tagged with the ear of the buffalo. It is further averred that complainant used to sell buffalo milk and was earning Rs.10,000/- per month and besides it he has no source of income. The buffalo of complainant became ill on 11.11.2015 and he got its treatment from Veterinary Surgeon of Khairekan from 11.11.2015 till death as per prescription slip/ treatment chart. But on 19.11.2015 at evening time the buffalo suddenly started breathing very fast and ultimately left breathing. The Veterinary surgeon was called who after examination declared it dead. The post mortem of buffalo was conducted on 20.11.2015 and in the opinion of doctor animal died due to surra. The information in this regard was also given to op. The complainant moved application for getting insured amount of buffalo from op as buffalo died during the period of insurance. The complainant made several rounds to the op on many occasions but all in vain and vide memo dated 21.3.2016 the claim of complainant was repudiated by op without any cogent and convincing reason with the remarks that one side of tag was broken at the time of investigation. The aforesaid findings of the op-company are wrong, incorrect and against law and facts because at the time of investigation, the tag was attached in the ear of dead buffalo. But the op-company is not ready to listen the complainant and is not ready to pay any sum to the complainant without any rhyme or reason. Hence, this complaint.
2. On notice, opposite party appeared and filed written statement. It has been submitted that after receipt of report of Investigator and after going through the record, the competent authority has decided the claim to be No claim as per terms and conditions of the policy as according to the policy, its terms and conditions tag should have been intact in all regard but same has not been found to be intact in all regard. Decision of repudiation is according to the terms and conditions of the policy. Remaining contents of complaint have also been denied.
3. The complainant has tendered his affidavit Ex.PW1/A, repudiation letter dated 21.3.2016 Ex.C1, letter dated 27.4.2016 Ex.C2, copy of claim security sheet Ex.C3, photocopy of tag, copy of investigation report Ex.C5, photocopy of photo of dead buffalo Ex.C6, copies of statements Ex.C7 to Ex.C10, copy of post mortem report Ex.C11, copy of certificate Ex.C12, copy of treatment chart Ex.C13, copy of health cum evaluation certificate Ex.C14, copy of claim form Ex.C15, copy of document regarding description of animal Ex.C16. On the other hand, opposite party tendered affidavit of Sh. Sushil Kumar, Divisional Manager Ex.R1, copy of repudiation letter Ex.R2, copy of investigation report Ex.R3 and copy of policy schedule Ex.R4.
4. We have heard learned counsel for the parties and have gone through the case file carefully.
5. There is no dispute that the above said buffalo of the complainant was insured with the opposite party w.e.f. 14.1.2015 to 13.1.2016 for sum assured of Rs.50,000/- under cattle insurance policy. It has also come on record that above said insured buffalo of the complainant died on 19.11.2015 i.e. within insurance period due to some illness. Post mortem examination on the buffalo of complainant was conducted on 20.11.2015 and copy of post mortem report has been placed on file as Ex.C11. The claim submitted by complainant has been repudiated by the opposite party vide letter dated 21.3.2016 Ex.C1 on the ground that one side of tag was broken at the time of investigation. The Investigator appointed by the opposite party in his report Ex.C5 has mentioned that at the time of his spot inspection, broken tag from one side was found inserted in the right ear of the dead buffalo but number side (OIC 14141) was intact. According to the opposite party, as per terms and conditions of policy, tag should have been intact in all regard but same has not been found to be intact in all regard. The opposite party has not placed on file any such terms and conditions of the policy. But keeping in view the fact the report of Investigator that although tag was found intact but it was broken from one side, therefore, we are of the considered opinion that opposite party is liable to pay 75% of the claim/ insured amount on non standard basis.
6. Thus, keeping in view the facts and circumstances of the present case, we allow the present complaint and direct the opposite party to pay 75% of Rs.50,000/- i.e. claim/ insured amount of the buffalo to the complainant within a period of one month from the date of receipt of copy of this order, failing which the complainant will be entitled to interest @9% per annum from the date of order till actual payment. 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. President,
Dated:08.02.2017. Member. District Consumer Disputes
Redressal Forum, Sirsa.
