Haryana

Karnal

162/14

Sh. Jagdish - Complainant(s)

Versus

Oriental Insurance Company - Opp.Party(s)

Sh. Surinder Kumar

16 Jun 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                                Complaint No.162 of 2014

                                                               Date of instt. 12.06.2014

                                                               Date of decision: 16.06.2016

 

Jagdish son of Shri Mukand Lal resident of village and post office Nadana Tehsil Nilokheri District Karnal.

                  

                                                                             ………….Complainant.       

 

                                                         Versus

 

1. The Oriental Insurance Company Limited, Divisional office at Sabharwal Market, Railway Road, Kurukshetra through its Divisional Manager.

2. The Oriental Insurance Company Limited, divisional office at Karnal through its Divisional Officer.

.                                           

                                                                            ………..Opposite Parties.

 

 

                   Complaint u/s 12 of the Consumer Protection Act.

                  

 

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

                   Sh. Anil Sharma……….Member.

                  

 

 Present       Sh. Surender Kumar Advocate for the Complainant.

                   Sh. A.K. Vohra Advocate for opposite parties.

 

ORDER:                    

 

                   This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986, on the averments that he got insured his two buffalos from opposite party no.1, vide policy no.47/2014/814. Unfortunately, on 15.12.2013 one buffalo died during subsistence of the insurance policy. Post mortem was conducted by Veterinary Surgeon village Sultanpur in presence of official of the opposite parties. Thereafter, he lodged claim with the opposite parties, vide claim no.47/2014/000132 and completed all the formalities. On 27.1.2014 opposite parties sent letter alleging that particulars of the dead buffalo did not tally with the health certificate of the insured buffalo and he was asked to clear the position. On receipt of the aforesaid letter he visited the office of opposite party no.1 and clarified that the buffalo, which had died, was insured with the opposite parties after due examination. The opposite parties were satisfied with the reply and assured that the amount would be given to him. However, his claim was repudiated, vide letter dated 5.3.2014. The repudiation of the claim amounted to deficiency in service on the part of the opposite parties which caused him mental pain, agony and harassment apart from financial loss.

2.                Notice of the complaint was given to the opposite parties, who put into appearance and filed written statement disputing the claim of the complainant. Objections have been raised that the complaint is not legally maintainable; that the complainant has no locus standi and cause of action; that the complainant has not approached this forum with clean hands; that there was no deficiency in service on the part of the opposite parties and that the complaint is grossly misconceived, false and frivolous and has been filed just to harass the opposite parties.

                   On merits, it has been submitted that the claim of the complainant was processed and independent investigator was appointed, who submitted report according to which the description of the dead buffalo did not tally with the health certificate of insured buffalo. As per the spot inspection there was white flower on the forehead of the dead buffalo, whereas no such identification mark was mentioned in the health certificate. The complainant was also given opportunity to explain regarding the difference in the description of the buffalo. On the basis of the documents and investigation report the claim was rightly repudiated. The other allegations made in the complaint have been denied.

4.                In evidence of the complainant, his affidavit EX.C1 and documents Ex.C2 to C5 have been tendered.

5.                On the other hand, in evidence of the opposite parties, affidavit of R.S.Behlan, Senior Divisional Manager Ex.OP1/A, affidavit of R.N. Sharma Surveyor Ex.OP2/A and documents Ex.O1 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, buffalo of the complainant was insured by the opposite parties, vide policy no. 47/2014/814. As per the case of the complainant, the buffalo was insured for Rs.50,000/-. The said buffalo died on 15.12.2013. Post mortem was conducted by Veterinary Surgeon of village Sultanpur.  Claim lodged with the opposite parties, but the same was repudiated on the ground that the dead buffalo was having white flower on the forehead, whereas no such identification mark was mentioned in the health certificate.

7.                The report of the investigator Ex.O3 is a material document, which shows that the insured buffalo was having ear tag no.OIC/75851. For identification of the insured animal, ear tag is affixed. The copy of post mortem report Ex.O7 makes it quite clear that the Veterinary Surgeon conducted post mortem on the dead body of the buffalo having tag no.OIC/75851. Even the surveyor in his conclusion reported that the dead buffalo was seen and the ear tag no.OIC/75851 was found intact in ear of the dead buffalo. Neither there is any allegation nor evidence of the opposite parties that the ear tag was tampered with in any manner. The opposite parties have alleged that on the forehead of the dead buffalo, there was white flower mark, whereas no such mark was mentioned in the health certificate. In the health certificate prepared at the time of insurance of the animal all identification marks are required to be mentioned, but if the concerned person who prepared the health certificate, did not make mention of the white flower on the forehead of the buffalo, the complainant cannot be made to suffer on that account. The insured buffalo could very well be identified on the basis of the ear tag affixed by the opposite parties. The claim of the complainant could not be repudiated merely on the ground that white flower mark found on the forehead of the dead buffalo was not mentioned in the health certificate. Under such circumstances, repudiation of the claim of the complainant by the opposite parties was neither legal nor justified and the same amounted to deficiency in service.

8.                As a sequel to the foregoing discussion, we accept the present complaint and direct the opposite parties to pay Rs.50,000/- as insured amount to the complainant alongwith interest @ 9% per annum from the date of filing the complaint till its realization. We further direct the opposite parties to  pay Rs.5500/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expenses. This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 16.06.2016

                                                                                      (K.C.Sharma)

                                                                                         President,

                                                                             District Consumer Disputes

                                                                             Redressal Forum, Karnal.

                             (Anil Sharma)

                               Member