Haryana

Fatehabad

CC/238/2019

Sukhbir Kaur - Complainant(s)

Versus

Oriental Insurance - Opp.Party(s)

R.K Tayal

20 Nov 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FATEHABAD.

                                 Sh.Rajbir Singh, President.                                                         Smt.Harisha Mehta and Dr.K.S.Nirania, Members

    

                                                                     Complaint No.238 of 2019.

                                                                     Date of Instt.:   12.06.2019.

                                                                     Date of Decision: 20.11.2023

 

Sukhbir Kaur @ Sukhvir Kaur wife of Gurnam Singh resident of village Ayalki, Tehsil & District   Fatehabad.

                                                                   ……Complainant

                                            Versus

 

1.Oriental Insurance Company Ltd. through its Branch Manager, Branch Office, 17, Industrial Area, Opp. Anaj Mandi, Fatehabad Tehsil & District Fatehabad.

2.Divisional Manager, Oriental Insurance Company Ltd. Divisional Office, Red Square Market, Railway Road, Hisar Tehsil & District Hisar.

 

                                                                   ……Opposite parties.

 

                             Complaint U/s 12 of the Consumer Protection            Act, 1986

 

Argued by:            Sh.R.K.Tayal, counsel for the complainant.

                             Sh.P.K.Jora, counsel for the Ops.                         

 

ORDER:

SH.RAJBIR SINGH, PRESIDENT

 

 

1.                          Brief facts of the present complaint are that the complainant purchased a buffalo from Amit Kumar on 25.07.2018 having Tag No.160019/729915 and she is also owner of another buffalo; that the complainant got insured her buffalos insured vide policy No.265504/47/2019/54 for a sum of Rs.1 lac having validity from 30.07.2018 to 29.07.2019 and the insured buffalos were given tag Nos.160019/729915 & 729926; that one of the above said buffalos having tag No. 160019/729915 died on 30.07.2018; that post mortem of the dead buffalo was also conducted; that the complainant intimated and lodged his claim on account of death of insured buffalo with the Ops but the OPs did not pay any head rather it had repudiated the claim; that  the act and conduct of the Op has not only caused mental agony and harassment to the complainant but also falls within the definition of deficiency in service on its part. Hence, this compliant.   

2.                          On notice OPs appeared and filed its reply wherein several preliminary objections such as cause of action, locus standi, maintainability, estoppal and concealment of material facts from this Commission. It has been further submitted that the on the same day, the complainant had reported the death of one of the insured buffalo, therefore, the claim of the complainant was repudiated because as per terms and conditions of the policy, the claimant was not entitled to get any claim within 15 days of the commencement of the policy after treating it as No Claim.  Other contentions have been controverted and prayer for dismissal of the complaint has been made.

3.                          In evidence, the complainant has tendered affidavit Ex.CW1/A and documents Annexure C1 to Annexure C4 whereas learned counsel for the Ops has tendered affidavit Ex.RW1/A and documents Ex.R1 & Ex.R2.

4.                          We have heard oral final arguments from both sides and have also gone through the case file minutely.

5.                         Learned counsel for the Ops has argued that the insured buffalo died on the same very day i.e. 30.07.2018, therefore, as per Exclusion Clause 8 (13), the claim is not payable and in support of his contentions he drew the attention of this Commission towards the terms and conditions (Annexure R2) wherein it has been mentioned that Death of the animal due to diseases within 15 days from inception of the policy.   The fact regarding death of insured buffalo on 30.07.2018 (on the date of insurance (Annexure C2)   as well as conducing post mortem on the dead buffalo on 30.07.2018 (Annexure C3) is not disputed.  It is not the case of the complainant that the terms and conditions were never supplied to the complainant. Undisputedly, the insurance is a contract and both the parties are bound by the terms and conditions of the contract and no one can be allowed to back out from the same. Therefore, the Exclusion Clause 8 (13) of the terms and conditions of the policy is very much applicable to the case in hand. Though during the course of arguments learned counsel for the complainant has placed on file terms and conditions pertaining to the ICICI Lombard insurance company on the case file to show that the exclusion clause 8 (13) is not applicable to the case. It is worthwhile to mention here that ICICI Lombard Insurance Company is a separate entity and the Ops are separate entities and they all are working independently, therefore, the terms and conditions, so relied upon by learned counsel for the complainant is not applicable to the case in hand and are hereby declined.

6.                          On the basis of above mentioned discussion, we are of the considered opinion that there was no deficiency in service at all or any unfair trade practice, on the part of any of the Ops, as alleged, so as to make any of them liable to any extent in this matter. Hence, the complaint is dismissed in view of the facts and circumstances stated above.  All the parties are left to bear their own costs. A copy of this order be supplied to both the parties free of cost as per rules.  This order be uploaded, forthwith, on the website of this Commission as per rules for the perusal of the parties. File be consigned to record room, as per rules, after due compliance.

Announced in open Commission.                                                           Dated: 20.11.2023.

 

                                                                                                        

(K.S.Nirania)                         (Harisha Mehta)                  (Rajbir Singh)                      Member                                      Member                                  President