Haryana

Yamunanagar

CC/37/2013

Ravinder Kumar S/o Darshan Lal - Complainant(s)

Versus

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

Pankaj Kamboj

26 Apr 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                    Complaint No. 37  of 2013.

                                                                                                    Date of institution: 09.01.2013

                                                                                                    Date of decision:  26.04.2016

Ravinder Kumar aged about 32 years son of Shri Darshan Lal, resident of Village Bhukhri, Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                                                                                                                                                                                                                                            …Complainant.

                                                Versus                                                

The Oriental Insurance Company Limited, having its Divisional Office, Opp. Hindu Girls College First  Floor, Court Road, Jagadhri, District Yamuna Nagar, through its Branch Manager.                                                                                                                                                                                                                                                                                 …Respondent. 

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                          SH. S.C.SHARMA, MEMBER

Present: Sh. Pankaj Kamboj, Advocate, counsel for complainant.   

              Sh. Rajiv Gupta, Advocate, counsel for respondent.  

 

ORDER

1.                     Complainant Ravinder Kumar 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 Rs. 1,00,000/- as insured amount on account of death of two cows alongwith compensation and litigation expenses.

2.                     Brief facts of the present case as alleged by the complainant, are that the complainant took a loan from the Haryana Gramin Bank for the purchase of cows and after purchasing 12 cows, the complainant got its cows insured through OP Insurance Company vide its policy bearing No. 261701/47/2012/774 (Annexure R-1) and policy bearing No. 261701/47/2012/775 (Annexure R-5) w.e.f. 29.12.2011 to 28.12.2014. The insurance policies in question were issued by the OP Insurance company after inspecting the dairy farm of the complainant and after taking Health Certificate issued by the Veterinary Surgeon. After inspection and completing all the required formalities, the OP Insurance Company also affixed Tags in the ear of the insured cows and photographs to that effect was also taken alongwith Veterinary Surgeon and two cover note bearing No. 767763 and 767764 to that effect were issued to the complainant by the OP Insurance Company. On 21.7.2012, one cow of the complainant bearing Tag No. 30352 died and on the same day, the complainant gave information to that effect to the Manager of Haryana Gramin Bank as well as OP Insurance Company. Postmortem was also conducted by the Veterinary Surgeon, Buria on the same day and at the time of postmortem Tag bearing No. 30352 was found tagged in the ear of the cow by the Veterinary Surgeon.

3.                     Unfortunately on 1.8.2012, one another cow of the complainant bearing Tag No. 30288 was also died and on the same day complainant again informed the OP Insurance Company Manager of the Haryana Gramin Bank. Postmortem was also conducted by the Veterinary Surgeon, Buria on the same day i.e. on 1.8.2012 and Tag bearing No. 30288 was duly tagged at the time of postmortem in the ear of the said dead cow. The complainant moved separate two applications to the OP Insurance Company on 22.10.2012 requesting the OP Insurance Company to grant the Insurance benefits to the complainant. On 30.11.2012, the OP Insurance Company in utter surprise even after admitting the tag affixed in the ear of the cow declined the claim of the complainant with the false plea that there was no mention of the black flower in the forehead of the cows in the health certificate. Whereas, the insurance policies were issued by the OP Insurance Company after inspecting the cows themselves and after taking relevant photographs and even the Tags were also affixed in the presence of official of the OP Insurance Company, so question of declining the claim of the complainant on the ground of black flower in the forehead of the cows does not arise at all and the OP Insurance Company is legally bound to pay the death claims of two cows. As no claim has been paid by the Op Insurance Company, hence, there is a deficiency in service and unfair trade practice on the part of OP Insurance Company. Hence, this complaint.

4.                     Upon notice, OP Insurance Company appeared and filed its written statement by taking some preliminary objections such as complaint is not maintainable, no deficiency in service or negligence on the part of OP Insurance Company, true facts of the present case are that an intimation dated 21.07.2012 was received by the Op Insurance Company that one cattle owned by the complainant and insured with OP Insurance Company has died. On receipt of the said information, the OP Insurance Company deputed Sh. Anil Sharma, Investigator to visit the residence of the insured and to give his fact finding report. The said investigator visited the house of complainant on the same day i.e. on 21.7.2012 and submitted his report dated 10.9.2012 (Annexure R-7) mentioning therein that the descriptions of the cow which has died is not matching with the insured cow as per health certificate. The cow which died is black and white in colour and its forehead is also white, whereas insured cow was black in colour as per health certificate. Besides this, on receipt of another intimation on dated 1.8.2012 that again one cow owned by the complainant insured with the OP Insurance Company has also died, the OP Insurance Company again deputed Sh. Anil Sharma, Investigator to investigate the matter. The investigator visited the house of the complainant on the same day i.e. on 1.8.2012 and submitted his report dated 10.9.2012 (Annexure R-3) mentioning therein that the descriptions of the cow which has died is not matching with the insured cow as per health certificate. The cow which died is black and its forehead is also black whereas the insured cow’s forehead was white in colour as per health certificate.

 5.                    On receipt of the said investigation reports (Annexure R-3 and R-7), the OP Insurance Company further processed the claim papers and it was found that the insured cows have not died. Therefore,  vide two separate registered letters dated 22.10.2012 (Annexure R-4 and R-8), the complainant was given 10 days’ time to give satisfactory reply and to explain his point of view but the complainant failed to give any satisfactory reply, so, the claim of the complainant has been righty repudiated vide letter dated 30.11.2012 (Annexure L and M) and on merit, reiterated the stand taken in the preliminary objections and lastly prayed for dismissal of complaint.

6.                     To prove the case, counsel for the complainant tendered into evidence photo copy of Health Certificate as Annexure A and B, Photo copy of Cover notes as Annexure C & D, Photograph of dairy as Annexure E, Postmortem report Annexure F & G, Photo copy of letter dated 22.10.2012 as Annexure H & I, Photo copy of application dated 22.10.2012 as Annexure J & K, Photo copy of repudiation letter as Annexure L & M, Photo copy of claim forms as Annexure N & O and closed the evidence on behalf of complainant.

7.                     On the other hand, counsel for the OP Insurance Company tendered into evidence affidavit of Sajeev Madan, Sr. Branch Manager OIC as Annexure RW/A, affidavit of Anil Kumar Sharma, Surveyor & Loss Assessor as Annexure RW/B and documents such as photo copy of Insurance policy as Annexure R-1, Photo copy of intimation letter dated 1.8.2012 as Annexure R-2, Photo copy of Investigation report dated 10.9.2012 as Annexure R-3, Photo copy of letter dated 22.10.2012 as Annexure R-4, Photo copy of policy schedule as Annexure R-5, Photo copy of intimation letter dated 21.7.2012 as Annexure R-6, Photo copy of surveyor report dated 10.9.2012 as Annexure R-7 and photo copy of letter dated 22.10.2012 as Annexure R-8 and closed the evidence on behalf of OP insurance company.

8.                         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 OP insurance company reiterated the averments made in reply and prayed for its dismissal.

9.                     It is admitted fact that the deceased cows of the complainant bearing Tag No. 30288 and 30352 were insured with the OP Insurance Company vide its cover note No. 767763 & 767764 which is evident from Annexure C and D and insurance policy Annexure R-1 & R-5 for a sum of Rs. 40,000/- each w.e.f. 29.12.2011 to 28.12.2014. It is also not disputed that the cows bearing tag No. 30288 and 30352 died on 21.07.2012 & 01.08.2012 which is evident from copy of surveyor report Annexure R-3 and R-7 and claim was lodged with the OP Insurance Company.

10.                   The only plea of the Op Insurance Company is that the cow which died on 21.7.2012 bearing Tag No. 30352 was black and white in colour and its forehead was white whereas the insured cow was black in colour as per health certificate and the cow which died on 1.8.2012 bearing Tag No. 30288 was black and its forehead was also black whereas the insured cow’s forehead was white in colour as per health certificate and these facts have been duly mentioned by the surveyor in his report (Annexure R-3) and (Annexure R-7). Hence, the claim of the complainant has been rightly repudiated by the OP insurance company vide its letters dated 30.11.2012 (Annexure L & M)

11.                   On the other hand, learned counsel for the complainant argued that the genuine claim of the complainant has been wrongly repudiated by the OP Insurance Company which is duly proved from the copy of postmortem report Annexure F and Annexure G and the surveyor reports Annexure R-3 and R-7.

12.                   We have perused the copy of postmortem reports Annexure F and G, wherein the identification of both the dead cows by way of tag number are duly proved, because at the time of conducting the postmortem, the veterinary surgeon found the ear tag duly tagged in the ear of the dead cows. Even, the investigator has also admitted this fact in his report as Annexure R-3 and R-7 under the head of the observation that the dead cows were tagged properly at the time of death. When the surveyor deputed by the OP insurance company himself admitted this fact that both the dead cows were duly and properly tagged with the ear tag at the time of inspection by him and as well as conducting the postmortem then how the OP Insurance Company can raise the objection that the dead cows were not the insured cows. The plea of the insurance company that only one or two features i.e. colour of forehead of both the dead cows were not tallied with the health certificate is no ground to repudiate the claim of the complainant. It is not the case of the OP Insurance Company or the Surveyor/ Investigator that both the tags bearing No. 30352 and 30288 were tagged freshly in the ear of the dead cows. Moreover, no cogent evidence by way of photographs has been placed on file by the OP Insurance Company to prove that the colour of the forehead, as mentioned in the Health Certificate of the dead cows, were not tallied with the insured cows. Even, no affidavit has been filed on behalf of the doctor who prepared the health certificate mentioning such type of colours of the forehead of the insured cows. The learned counsel for the OP Insurance Company has totally failed to convince this Forum that there was any violation of the terms and conditions of the Insurance Policy because as per the terms and conditions of the insurance policy, it is only ground available to the company that no claim will be payable if there is no tag i.e. no tag no claim but in the present case both the dead cows were duly tagged which is evident from the copy of postmortem report as well as investigation report. Hence, we have no option except to partly allow the complaint of complainant.

                        Resultantly, we partly allow the complaint of complainant and direct the OP Insurance Company to pay the insured amount of Rs. 40,000/- for each cow i.e. Rs. 80,000/- for two cows alongwith interest at the rate of 7% per annum from the date of filing of complaint till its actual realization and further to pay a sum of Rs. 3000/- as litigation expenses. Order be complied within 30 days after preparation of copy of this order failing which complainant shall be entitled to invoke the jurisdiction of this Forum 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. 26.04.2016.                                                                                                                                                                                  

                                                                                                (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER