Haryana

Yamunanagar

CC/1221/2012

Harbans S/o Mahinder Kumar - Complainant(s)

Versus

Oriental Insurance Company Ltd. - Opp.Party(s)

Yadvinder Singh

28 Jul 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                           Complaint No. 1221  of 2012.

                                                                                                           Date of institution: 23.11.2012

                                                                                                           Date of decision:  28.07.2015

Harbans son of Sh. Mahinder Kumar resident of Village Gobindpura, Tehsil Jagadhri, District Yamuna Nagar.    

                                                                                                                                   …Complainant.

                                                Versus

1. The Oriental Insurance Company Limited, Court Road, Jagadhri, Distt. Yamuna Nagar through its Branch Manager.                                                                                            
2. The Oriental Insurance Company Limited, Regional Office, LIC Building, 2^nd Floor, Jagadhri Road, Ambala Cantt-133001 through its Regional Manager.                                                                                                                                                                                                                                                                                                  …Opposite parties.

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                          SH. S.C.SHARMA, MEMBER

 

Present: Sh. Yajvander Singh, Advocate, counsel for complainant.   

              Smt. Aruna Sharma, Advocate, counsel for Opposite parties.  

 

ORDER

1.                     Complainant has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying that OPs be directed to pay Rs. 50,000/- alongwith interest at the rate of 18% per annum on account of death of his insured cow and further to pay Rs. 40,000/- as compensation for mental agony, harassment and economic loss etc. and further to pay Rs. 5000/- as cost of proceedings.

2.                     Brief facts of the present case as alleged are that complainant had purchased five cows and got insured the same from the respondents (hereinafter referred as OPs) vide policy No. 261701/47/2013/251 valid from 25.7.2012 to 24.7.2015 issued by OP No.1 and paid a sum of Rs. 12,000/- as premium for his five cows i.e. Rs. 2400/- for each to the OPs. Hence, there exist relationship of consumer and service provider between the parties and further stated that each cow of the complainant was covered the risk to the tune of Rs. 50,000/- each. It has been further stated that out of the aforesaid five cows one cow having tag No. 51874 died and after the death of the said cow, the complainant immediately informed the OPs. On intimation, OPs deputed Sh. Anil Kumar Sharma as investigator, who visited the spot at the farm of the insured at village Khajuri on the same day i.e. 28.8.2012 and conducted survey and got the signatures of the complainant on certain documents and blank papers. The said surveyor had also taken the Tag No. 51874 of the died cow. It has been further stated that necessary formalities were completed by the complainant and requested to the OPs to settle and disburse his genuine claim as soon as possible. However, instead of getting claim, the complainant received a letter dated 2.11.2012 issued by the OP No.1 wherein, the OP No.1 raised certain objections in respect of the deceased cow and sought clarifications on those objections and called the complainant to clear his objections within 10 days. It has been further alleged that on receipt of the said letter dated 2.11.2012, the complainant approached to OP No.1 and cleared all the objections raised by OP No.1.  The OP No.1 again assured the complainant that he will soon get the claim in respect of his dead cow.  The complainant many times requested the OPs to settle his claim positively but the OPs failed to concede the request of the complainant and ultimately OPs orally repudiated the claim of the complainant. Hence, from the act and conduct of the OPs, it is clear that there is a deficiency in service on the part of OPs. Hence this complaint. 

3.                     Upon notice, opposite parties appeared and filed written statement taking some preliminary objections such as cause of action, concealing and twisting the true facts, no deficiency in service and on merit, it has been stated by the OPs that immediately on receiving the information of the alleged death of the cow, the OPs company appointed the investigator who visited the spot on the very day and made a report.  As per the report of the Investigator, the description of the deceased cow did not tally with the particulars given in the health certificate. As per the health certificate, the switch of tail of the insured cow was white, whereas, the switch of tail of the deceased cow at the time of inspection by the investigator was black. Further, the insured cow was fully black in colour whereas, the deceased cow was having white spots at the belly.  As such, the investigator gave observation that the claim is not genuine and the claim file may be closed as “No Claim”. Lastly, learned counsel for OPs prayed that there is no deficiency in service on the part of the OPs, hence, the complaint deserves dismissal.  

4.                     To prove the case, counsel for the complainant has tendered into evidence, affidavit of complainant as Annexure CX and documents such as Annexure C- 1 and Annexure C-2 Photo copies of Health Certificates regarding Tag No. 51874, 51867,51868, 51960 & 51857 respectively, Annexure C-3 Photo copy of  Postmortem report, Annexure C-4 claim form, Annexure C-5 Photo copy of letter dated 2.11.2012, Annexure C-6 Photo copy of Clarification letter dated 12.11.2012, Annexure C-7 Photograph of deceased buffalo and closed the evidence on behalf of complainant..

5.                      On the other hand, counsel for OPs has tendered into evidence affidavit of Sh. Anil Kumar Sharma, Investigator as Annexure RX, Affidavit of Sh. Sanjeev Madan, Sr. Branch Manager  Oriental Insurance Company, as Annexure RY  and documents such as Annexure R-1 Photo copy of Insurance Cover Note, R-2 Investigation report, R-3 Photo copy of letter dated 2.11.2012, Annexure R-4 Health Certificate regarding Tag No. 51860 & Tag No. 51857, Annexure R-5 Photo copy of postmortem report and closed the evidence on behalf of OPs.

6.                            We have heard learned counsel for both the parties and have gone through the pleadings as well as documents carefully and minutely placed on the file. Counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for opposite parties reiterated the averments made in reply and prayed for its dismissal.

7.                     it is admitted fact that the complainant got insured his five cows with the OPs for Rs. 50,000/- each after paying premium of Rs. 2400/- for each cow vide policy bearing No. 261701/47/2013/251 valid from 25.7.2012 to 24.7.2015 and one cow bearing tag No. 51874 died during the substance of the policy in question. It is also admitted fact that claim was lodged by the complainant with OPs which was orally repudiated by the OPs. The onus to prove this fact that whether the claim was rightly repudiated is on the OPs and to subsistence his contention, the learned counsel for the OPs argued that feature of the dead cow were not the same to that of the descriptions of the insured cow and in support of his contention he has placed reliance upon the report of Surveyor Annexure R-3. Per Contra, complainant counsel argued that at the time of death and inspection by investigator, the cow was duly tagged and the dead cow was the insured cow.

8.                     We have considered the contention of the parties. Annexure C-1 is the live stock health certificate and annexure C-3/R-5 is the postmortem report. In the postmortem report and in the health certificate, the veterinary surgeon has mentioned description of dead cow such as Tag No. OIC/ 51874, colours black and age 5 ½ years and all these descriptions tally with each other in both these documents i.e. Post Mortem Report and Health Certiificate.  The Surveyor Sh. Anil Kumar Sharma, has specifically mentioned in his report that the dead cow was properly tagged at the time of inspection and other description of the dead cow were also tally with the insured cow. The report of the surveyor is reproduced for perusal is as under:

                        “ On receiving instructions over the telephone I visited the spot at the farm of insured at village Khajuri on 28.8.2012. On visiting there it was observed that one female cow, colour black was laying there dead. The cow was properly tagged. I took few photographs of the dead cow and got the tag No. 51874 removed from the ear. On enquiry from the insured, he stated that today i.e. 28.8.2012 at about 4.00A.M. one of his cows died due to illness. He stated that he took loan from PNB Jagadhri for running Hi tech dairy and the same are insured with OIC, Jagadhri. He stated that the said cow with Tag No. 51874 died all of a sudden due to illness and was not treated by the doctor. I inspected the dairy of insured and found that all other insured cows were properly tagged.”

9.                     After going through the contents of this para of the investigation report it is clear that dead cow was duly tagged at the time of inspection and surveyor has not given any opinion or remarks that the tag was tagged freshly or otherwise. On the other hand, he has specifically mentioned that tag was duly tagged and other cows were also duly tagged. However, Investigator Anil Kumar Sharma, in the last para of his investigation report under the head of observation has mentioned that at serial No.4, “that description of the dead cow is not matching with the health certificate”. The switch of tail as per health certificate was white whereas the ST of dead cow was black. Also there are white spots at the belly of the dead cow whereas the insured cow was fully black in colour.  The report of the surveyor on this point is contradictory and is highly doubtful because at the time of inspection the surveyor was not having any health certificate with him which was lying with the company at that time. Moreover, the health certificate was not prepared in the presence of that surveyor. The colour of the cow was black as he has admitted in his report himself as mentioned above. We have gone through the contents of health certificate as well as postmortem report of the dead cow and noted that the features i.e. age, number of lactation, sex of calf at foot are the same. Moreover, the dead cow was duly tagged with the tag No. OIC/51874 at the time of inspection of the investigator and the same tag number has been mentioned in the PMR by veterinary surgeon. Hence, the contention of OPs that dead cow was not insured cow and the complaint of the complainant is not genuine is not tenable to our mind. OPs have failed to prove that the claim of complainant has been rightly repudiated.

10.                   Hence, we are of the considered view that there is a deficiency in service on the part of OPs as the genuine claim of the complainant has been illegally with-held by the OPs, hence we have no option except to allow the present complaint and therefore, we partly allow the present complaint and direct the OPs No.1 & 2 Oriental Insurance Company to pay sum of Rs. 50,000/-as insured amount to the complainant alongwith interest at the rate of 7% per annum from the date of filing of complaint till its realization and also to pay Rs. 2000/- as compensation and cost  of litigation expenses within 30 days failing which the complainant is at liberty to initiate the legal proceedings against the opposite party Insurance Company as per law. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court: 28.7.2015

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER