Haryana

Yamunanagar

CC/103/2014

Jasbir Singh S/o Phool Chand - Complainant(s)

Versus

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

Devinder Mehla

18 May 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                    Complaint No. 103  of 2014.

                                                                                                    Date of institution: 12.02.2014

                                                                                                    Date of decision:  18.05.2016

Jasbir Singh aged about 42 years son of Sh. Phool Chand, resident of Village Balouli, Tehsil Chhachhrauli, District Yamuna Nagar.                                                                                                                                                                          …Complainant.

                                                Versus                                                

Oriental Insurance Company Limited, Opp. Hindu Girls College, Jagadhri, District Yamuna Nagar through its Branch Manager.                                                                                                                                                                                                                                                                                                                                                                                                     …Respondent. 

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                          SH. S.C.SHARMA, MEMBER

Present: Sh. Devender Kumar, Advocate, counsel for complainant.   

              Sh. Parmod Gupta, Advocate, counsel for respondent.  

 

ORDER

1.                     Complainant Jasbir Singh has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying therein that the respondent (hereinafter referred as OP) be directed to pay claim amount of Rs. 50,000/- alongwith interest on account of death of cow and also to pay compensation and litigation expenses.

2.                     Brief facts of the present complaint, as alleged by the complainant, are that complainant purchased a cow after taking loan from State Bank of Patiala and got the same insured with the Op Insurance Company vide its cover note No. 886325 dated 18.02.2013 for a sum insured of Rs. 50,000/-. For identification of the cow in question, a tag bearing No. OIC 90247 was also affixed in the ear of the cow. The cow of the complainant fell ill and got treatment from Veterinary Doctor and ultimately the cow in question died on 22.11.2013. The OP Insurance Company was duly informed and surveyor was appointed who inspected the dead cow and submitted his report with the OP Insurance Company. The postmortem of the cow was also conducted by the Veterinary Surgeon. The complainant lodged his claim with the Op Insurance Company and submitted all the relevant documents. However, the OP Insurance Company repudiated the claim of the complainant vide its letter dated 23.12.2013 on flimsy ground. Hence this complaint.

3.                     Upon notice, OP Insurance Company appeared and filed its written statement by taking some preliminary objections such as complicated questions of law and facts are involved in the present complaint; complainant has violated the terms and conditions of the policy as there was no Tag on the deceased animal and therefore, the identity of the deceased animal could not be ascertained and it is clearly mentioned on the policy “ No Tag No Claim” and as such the claim of the complainant has been rightly repudiated vide letter dated 23.12.2013. On merit, it has been admitted that one cow was insured with the OP Insurance Company for a sum of Rs. 50,000/- and a tag Bearing No. OIC 90247 was inserted in the ear of the said cow. It has been further submitted that on receiving the intimation, the Op Insurance Company deputed a Surveyor and Loss Assessor to investigate the matter and on investigation it was found that deceased cow was not having ear tag bearing No. OIC 90247, which was inserted at the time of insurance and the identity of the dead cow was disputed, as such, the claim of the complainant has been rightly repudiated on 23.12.2013. Lastly, prayed for dismissal of complaint being no deficiency in service or unfair trade practice on the part of OP Insurance Company.  

4.                     To prove the case, complainant tendered into evidence his affidavit as Annexure CW/A and documents such as Photo copy of Health Certificate as Annexure C-1, Photo copy of Insurance Cover Note as Annexure C-2, Photo copy of postmortem report as Annexure C-3, Photo copy of intimation letter to the State Bank of Patiala dated 23.11.2013 as Annexure C-4, Photo copy of repudiation letter dated 23.12.2013 as Annexure C-5 and closed his evidence.

5.                     On the other hand, counsel for the OP Insurance Company tendered into evidence affidavit of Abhas Toppa official of OIC as Annexure RW/A and affidavit of Surveyor & Investigator Rakesh Kumar as Annexure RW/B and documents such as photo copy of intimation letter Annexure R-1, Photo copy of Cover Note as Annexure R-2, Photo copy of Health Certificate as Annexure R-3, Photo copy of Postmortem report as Annexure R-4, Photo copy of surveyor/investigator report dated 24.11.2013 as Annexure R-5, Photo copy of intimation letter to the OP dated 23.11.2013 as Annexure R-6, Photo copy of repudiation letter as Annexure R-7 and closed the evidence on behalf of OP Insurance Company.

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.                     Learned counsel for the complainant argued at length that genuine claim of the complainant has been repudiated by the OP Insurance Company on the flimsy ground that the dead cow was not wearing any tag in the ear at the time of death i.e  No Tag No Claim, whereas other particulars of the dead cow mentioned in the PMR Annexure C-3 were tallied with the particulars mentioned in the Health Certificate Annexure C-1. Learned counsel for the complainant further argued that OP Insurance Company cannot repudiate the claim on the mere ground that there was no Tag in the ear of the dead cow and referred the case law titled as Oriental Insurance Company Limited vs. Harish Giri Goswami and Others, Appeal No. 463/2004 decided on 31.01.2006 State Commission, Uttaranchal and referred the another case law titled as Sunita Sen Versus Incharge Officer, TATA AIG General Insurance Co. Ltd. Appeal No. FA 12/2012 decided on 12.06.2013 State Commission, Pandri Raipur Chhatisgarh.

8.                     On the other hand, counsel for the Op Insurance Company hotly argued at length that the claim of the complainant has been rightly repudiated vide its letter dated 23.12.2013 (Annexure C-5/R-7) as there was violation of terms and conditions of the Insurance Policy on the part of the complainant. The dead cow was not wearing any tag in the ear at the time of spot survey done by the Investigator Sh. Rakesh Kumar, which is evident from Investigator Report (Annexure R-5) and further it is also evident from the copy of Intimation letter written by the complainant himself on dated 23.11.2013 (Annexure R-6) in which the complainant himself admitted that at that time no tag was tagged in the ear of the dead cow. Learned counsel for the OP further argued that as per terms and conditions of the insurance policy no claim is payable if the dead cow does not wear the tag as the specific condition has been mentioned in the policy that “No Tag No Claim” and draw our attention towards the insurance policy/cover note Annexure R-2/C-2. Learned counsel for the OP further argued that the claim of the complainant has been rightly repudiated vide its letter dated 23.12.2013 (Annexure R-7). Hence, there is no deficiency in service or unfair trade practice on the part of Op Insurance Company and referred the case law titled as United India Insurance Company Ltd. Versus Banbari 2003(1) CLT Page 621 State Commission, Lucknow.

9.                     After hearing the parties at length, we are of the considered view that there is no deficiency in service on the part of OP Insurance Company and the claim of the complainant has been rightly repudiated by the Op Insurance Company. The law cited by the counsel for the complainant is not disputed but not helpful in the present case as in that case titled as Oriental Insurance Company Limited Versus Harish Giri Goswami and others (supra) no investigator/surveyor was deputed by the insurance company to ascertain the identity of the dead cow and the claim of the complainant was decided only on the papers submitted by the complainant. In the present case, Sh. Rakesh Kumar Surveyor and Loss Assessor was deputed by the Insurance Company who submitted his report dated 24.11.2013 (Annexure R-5) in which, it has specifically been mentioned in his report that there was no tag in the ear of the dead cow. We have also perused the intimation letter given to the OP Insurance Company on dated 23.11.2013 (Annexure R-6), in which the complainant himself admitted that the ear tag of the dead cow had fallen 2 days ago and at this time no tag is tagged in the ear of the dead cow. The arguments advanced by the counsel for the complainant that veterinary surgeon has disclosed all the identification marks in the postmortem report which were tallied with the health certificate and tag bearing No. OIC 90247 is also mentioned in the postmortem report is not tenable. As and when the complainant himself is admitting that the ear tag had fallen 2 days ago from the death then how the veterinary surgeon can mention the ear tag number in his postmortem report. So, the credibility of the postmortem report is also doubtful being contradictory with the statement of complainant himself. Further no documentary evidence has been filed by the complainant to prove that the alleged cow was under treatment from the last 15 days and when the cow was under treatment of the veterinary surgeon from the last 15 days then why the complainant did not get the tag re-fixed (retagged) from the veterinary surgeon prior to the death of the dead cow. Even, if the tag had fallen 2 days prior to the death of the alleged dead cow then why no intimation was given to the Op Insurance Company and made request for re-fixing the tag. The facts of the case referred by the counsel for the OP Insurance Company titled as United India Insurance Co. Ltd. Versus Banbari (supra) are fully applicable to the facts of the present case. No doubt other particulars of the dead cow are matched with the particulars mentioned in the health certificate but it does not mean that the identity of the dead cow was duly established. In such like circumstances, it cannot be said at own that the cow which was insured had died. As per the terms and conditions of the insurance policy, the claim of animal can only be disbursed to the claimant in case it is found that in fact the animal insured has died and to identify the animal a tag is always inserted to the animal in question and in case no tag is found, No claim can be given on the basis of “ No Tag No Clam”

10.                   In these circumstances noted above, we are of the considered view that the claim of the complainant has been rightly repudiated by the Op Insurance Company vide its letter dated 23.12.2013 (Annexure C-5/R-7).

11.                   Resultantly, we find no merit in the present complaint and the same is hereby dismissed with no order as to costs. 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. 18.05.2016.

 

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER