Haryana

Karnal

434/13

Baljit Kaur - Complainant(s)

Versus

Oriental Insurance Company - Opp.Party(s)

Sh. Rajesh Kashyap

14 Oct 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                              Complaint No. 434 of 2013

                                                             Date of instt. 23.10.2013

                                                               Date of decision:14.10.2016

 

Baljit Kaur wife of Shri Amandeep Singh son of Sarvjeet Singh resident of village Buddanur Bangar P.O. Butan Kheri Tehsil Indri District Karnal.

 

                                                                         ……..Complainant.

                                                Versus

Oriental Insurance Company Limited, Divisional Office at G.T. Road, Karnal through its Divisional Manager.

                                                                                 …………Opposite Party.

 

                     Complaint u/s 12  of the Consumer Protection Act.

 

Before                   Sh.K.C.Sharma……….President.

                   Sh.Anil Sharma…….Member.

 

Present:-      Shri Rajesh Kashyap Advocate for complainant.

                    Shri Parveen Daryal Advocate for opposite party.

                                     

 ORDER:

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer protection Act, 1986, on the averments that she got insured her cow with the opposite party, vide insurance policy no.CH-959773, valid from 07.09.2013 to 06.09.2014. The insured value of the cow was Rs.40,000/-. The opposite party issued tag no.76980 for the said cow. Unfortunately, on 11.09.2013 at about 11.00 p.m. the cow died. Post Mortem was conducted by Veterinary Surgeon, village Indri. Claim was lodged with the opposite party on 12.09.2013 and all formalities were completed. Opposite party postponed the matter regarding settlement of the claim on one pretext or the other, but about one week ago refused to pay the claim without disclosing any sufficient cause or reason. Such act and conduct on the part of the opposite party amounted to deficiency in service, due to which she suffered mental pain, agony and harassment apart from financial loss.

2.                Notice of the complaint was given to the opposite party, who put into appearance and filed written statement disputing the claim of the complainant. Objections have been raised that the complainant has no locus standi and cause of action to file the complaint; that the complaint is not maintainable in the present form; that the complainant is estopped from filing the complaint by her own acts and conduct; that the complaint has been filed with malafide intention and is misuse of process of law and that the complainant has not approached this forum with clean hands.

                   On merits, it has been admitted that the cow of the complainant was insured for the period of  07.09.2013 to 06.09.2014. It has been submitted that the opposite party wrote a registered letter dated 30.09.2013 informing the complainant that the cow died within five days from the commencement of the policy which falls within 15 days waiting clause of the policy. She was asked to submit reply to the said letter within two weeks, but she failed to submit reply. The claim of the complainant was repudiated, vide letter dated 1.11.2013 as per terms and conditions of the policy and intimation was sent to her. Therefore, there was no deficiency in service on the part of the opposite party. The other allegations made in the complaint have been denied.

3.                In evidence of the complainant, her affidavit Ex. CW1/A and documents Ex.C1 to Ex.C6 have been tendered.

4.                On the other hand, in evidence of the opposite party, affidavit of R.S.Behlan Ex.O/1 and documents Ex.O2 to Ex.O8 have been tendered.

5.                We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.                Admittedly, the cow of the complaint was insured by opposite party for the period of 7.9.2013 to 6.9.2014 by assessing the insured value as Rs.40,000/-. The said cow had died on 11.09.2013. Complainant lodged the claim on 12.09.2013, but the same was repudiated by the opposite party.

7.                The copy of repudiation letter is Ex.O6, wherein there is reference of the letter of the opposite party dated 30.09.2013.  A perusal of the copy of the letter dated 30.09.2013 Ex.O5 shows that the complainant was informed that the animal died within five days of the policy, which was within the 15 days waiting clause. She was afforded an opportunity to explain within two weeks, failing which her claim would be closed. The main plank of the opposite party is the cattle insurance scheme, the copy of which is Ex.O8. According to this document Market Agreement on cattle insurance is effective from 1.10.1997. Clause 7 is regarding the scope of cover/insurance coverage. Certain exclusions have been given under the said clause. As per sub clause (m) death of animal due to disease within 15 days from the inception of the policy falls in the exclusion clause. The insurance policy for the cow of the complainant was effective from 7.9.2013. The cow died on 11.9.2013 i.e. within five days of the policy becoming effective. As per the aforesaid sub clause (m) no claim was payable if death of the animal due to disease takes place within 15 days from the inception of the policy. The complainant even did not furnish any explanation to the opposite party in response to the letter dated 13.09.2013. Learned counsel for the complainant could not point out any law rule or instruction according to which the insurance company was liable to pay for death of any animal within 15 days of the inception of the policy. Looking into all such facts and circumstances, we have no hesitation in concluding that there was no illegality in the order of repudiation of her claim by the opposite party and as such there was deficiency in service.

8.                As a sequel to the foregoing reasons, we do not find any merit in the present complaint. Therefore, the same is hereby dismissed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 14.10.2016

                                                                                      (K.C.Sharma)

                                                                                         President,

                                                                             District Consumer Disputes

                                                                             Redressal Forum, Karnal.

                             (Anil Sharma)

                               Member