DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
CC.No.358 of 25-07-2011
Decided on 10-02-2012
Mukhtiar Singh, aged about 47 years, son of Lal Singh son of Pala Singh, Resident of V. Krarwala, Tehsil Phul,
Distt. Bathinda. .......Complainant
Versus
The Reliance General Insurance Co. Ltd., Reliance Office, Prime Time, SCO 5, Ahta Pritam Singh Sidhu, Amrik
Singh Road, Bathinda, through its Branch Manager/Incharge. (Deleted)
The Reliance General Insurance Co. Ltd., Regional Office: SCO 212, 213, 214, Ist Floor, Sector 34,
Chandigarh, through its Regional Manager.
Deputy Director, Animal Husbandry, Bhagu Road, Bathinda.
......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986
QUORUM
Smt. Vikramjit Kaur Soni, President
Sh. Amarjeet Paul, Member
Smt. Sukhwinder Kaur, Member
Present:-
For the Complainant: Sh.Varun Gupta/Sh.Pritam Singh, counsels for the complainant
For Opposite parties: Sh. Sunder Gupta, counsel for opposite party No.2
Sh. Dhan Singh, A.R. of opposite party No.3
Opposite party No.1 deleted
ORDER
Vikramjit Kaur Soni, President:-
1. The present complaint has been filed by the complainant under Section 12 of the Consumer Protection Act, 1986 as amended up-to-date (Here-in-after referred to as an 'Act'). The brief facts of the complaint are that the Murrah Breed buffalo of the complainant was insured with the opposite party Nos.1&2 vide Insurance Certificate No.102965 for the period from 09.10.2009 to 08.10.2010 for IDV Rs.30,000/-. The complainant has alleged that no terms and conditions of the policy were supplied to him by the opposite party Nos.1&2 till date. The said buffalo of the complainant was insured with the opposite party Nos.1&2 after getting Health-cum-Evaluation Certificate from Dr. Ashish Bahia, Civil Veterinary Hospital, Krarwala. The doctor after examining the said buffalo, declared that the said buffalo is free from any disease and is in good health and recommended for Cattle Insurance. The said buffalo was allotted a Tag No.R-102965 which had been attached in the ear of the said buffalo. The above said buffalo of the complainant had died in the month of November, 2009 and the Post Mortem of the said buffalo was conducted by the Rural Veterinary Officer, Civil Veterinary Hospital, Krarwala. Thereafter, due intimation was sent to the opposite party Nos.1&2 for the payment of the claim through the office of Deputy Director, Animal Husbandry, Bathinda and all the documents with claim Form were also submitted by the complainant. The Deputy Director, Animal Husbandry, Bathinda i.e. opposite party No.3 lodged the claim of the complainant with the opposite party Nos.1&2 along with all documents but the claim of the complainant has been repudiated by the opposite party Nos.1&2. The opposite party Nos.1&2 have never given any intimation with regard to the repudiation of the claim of the complainant. The opposite party No.3 also wrote a letter No.1281 dated 06.08.2010 to the opposite party Nos.1&2. Hence, the complainant has filed the present complaint for seeking directions of this Forum to pay the IDV of Rs.30,000/- along with interest, cost and compensation.
2. Notice was issued to the opposite parties. The opposite parties after appearing before this Forum, have file their separate written statements. The opposite party No.2 has pleaded that there is no branch office of the opposite party No.2 within the territorial jurisdiction of this Forum. Merely by impleading Deputy Director, Animal Husbandry and Dairy, Bathinda do not give rise to the complainant to file the present complaint as no relief has been sought against the Deputy Director and has been impleaded as party, just to create jurisdiction before this Forum. The claim of the complainant has been repudiated as per exclusion clause of the policy printed on the backside of the Insurance Cover Note in which it has been stated that the Insurance Company is not liable in case of death of animal due to disease contracted within 15 days from the date of commencement of the policy. As per documents supplied by the complainant, the Insured buffalo fell ill and was suffering from disease since 21.10.2009 and the said Insurance Policy/Cover Note was obtained on 09.10.2009 and the animal died on 03.11.2010. Since the animal has suffered from disease within 15 days of issuance of the above said policy as such the claim of the complainant is not payable as per the above said exclusion clause. The opposite party No.2 has further pleaded that the terms and conditions of the cattle insurance are printed on the backside of every cover note and the complainant has not intentionally produced the same before this Forum. Further, as per terms and conditions of the policy, the intimation regarding the death of the insured has to be given within 24 hours but the complainant has failed to give intimation of the dead animal within stipulated time. The opposite party No.2 has further pleaded that if this Forum comes to the conclusion that the Insurance Company is liable to pay any compensation, the liability of the Insurance Company is limited to Rs.30,000/- only being sum assured as per Insurance Certificate. The opposite party No.2 has further pleaded that the buffalo of the complainant was suffering from pre-existing disease and as per treatment certificate issued by Civil Veterinary Hospital, Krarwala, the insured cattle was suffering from disease since atleast from 01.10.2009 i.e. within 15 days of the issuance of the policy and the insured animal had died on 03.11.2009 as such the animal has suffered from disease within 15 days of the issuance of the policy as such the claim of the complainant is not payable The opposite party No.2 has further pleaded that 134 death claims of the insured animals were received, out of which 94 lawful claims have been paid and only 27 have been rejected as per terms and conditions of the policy.
3. The opposite party No.3 has pleaded that the buffalo of Sh. Mukhtiar Singh was insured with Reliance General Insurance Co. Ltd. for IDV of Rs.30,000/- for the period from 09.10.2009 to 08.10.2010. The Insured buffalo died on 03.11.2009 and the post mortem was conducted by Rural Veterinary Officer, Civil Veterinary Hospital, Krarwala and all the documents i.e. Post Mortem Report, Death Certificate, Treatment Chart, Tag and Photograph were deposited by the concerned Rural Veterinary Officer in the office of the opposite party No.3 and the opposite party No.3 had sent all the original documents to the Reliance General Insurance Co. Ltd. through agent Sh. Sanjay vide letter No.3584 dated 12.11.2009. The Reliance General Insurance Co. Ltd. sent a list of 134 claims on 12.07.2010 in which 94 were settled, 27 were rejected and 13 were outstanding. The Deputy Director came to know about regarding that the case of the buffalo of Mukhtiar Singh has been rejected. The opposite party No.3 has further pleaded that the no investigation or enquiry of the death of said buffalo was conducted by the Company or any investigation official and the case of the complainant was rejected without any reason and no response was given by Reliance General Insurance Co. Ltd. by the opposite party No.3.
4. The opposite party No.1 is deleted vide application order dated 27.09.2011.
5. Parties have led their evidence in support of their respective pleadings.
6. Arguments heard. Record along with written submissions submitted by the parties perused.
7. The undisputed facts between the parties are that the complainant had purchased the Insurance Policy/Cover Note bearing No.102965 from Reliance General Insurance Company Limited for his buffalo of Murrah breed after paying the requisite premium. The said buffalo was insured for the IDV of Rs.30,000/- and a Tag No.R-102965 was issued which was attached in the ear of the said buffalo. The policy was valid from 09.10.2009 to 08.10.2010. The Insured buffalo had died on 03.11.2009.
8. The disputed facts between the parties are that the complainant has specifically submitted that no terms and conditions of the policy have been supplied to him. He got Health-cum-Evaluation Certificate from Rural Veterinary Officer, Civil Veterinary Hospital, Krarwala to the effect that the animal is free from any disease and is in good health and recommended for Cattle Insurance. The Insured buffalo had died on 03.11.2009 and the Post Mortem examination of the said buffalo was conducted by Veterinary Officer, Civil Veterinary Hospital, Krarwala and the due intimation with regard to the claim of the said buffalo was sent by the complainant to the opposite party No.3 along with claim Form and other requisite documents. The opposite party No.3 lodged the claim of the complainant with the Insurance Company i.e. the opposite party Nos.1&2 but they have repudiated the claim of the complainant.
9. The opposite party No.2 has submitted that the claim of the complainant has rightly repudiated as per exclusion clause of the policy printed at the back side of the Insurance Policy/Cover Note in which it has been stated that the complainant is not entitled to get the death claim of the said animal as the insured buffalo fell ill and was suffering from disease since 21.10.2009 and the policy was obtained on 09.10.2009 and the animal died on 03.11.2009 as such the claim of the complainant is not payable. The opposite party No.2 has further submitted that the intimation regarding the death of the Insured Animal has to be given within 24 hours but the complainant has failed to give intimation regarding the death of animal within stipulated period as prescribed in the terms and conditions of the policy and has further submitted that if this Forum concludes that the Insurance Company is liable to pay any compensation, then the liability of the Insurance Company is limited to Rs.30,000/- only according to the Health cum Evaluation Certificate.
10. The opposite party No.3 has submitted that no investigation of the said buffalo was done either by the Insurance Company or by any investigation official and the case of the complainant was rejected without any reason.
11. The Insurance Policy/Cover Note bearing No.102965 was valid from 09.10.2009 to 08.10.2010 and the buffalo had died on 03.11.2009. The opposite parties have taken the ground for repudiation of the claim of the complainant that the animal has suffered from disease since 01.10.2009 i.e. within 15 days of the issuance of the policy. The Insured animal had died on 03.11.2009 as such according to exclusion clause of the policy, the claim is not payable as such the same is repudiated. As per the terms and conditions of the policy, the intimation with regard to the death of the animal has to be given within 24 hours but no intimation has been given within the prescribed period as such the claim is not payable. The opposite party No.2 has further taken the legal objection that this Forum has got no jurisdiction to try and entertain the present complaint as there is no branch office of the Insurance Company at Bathinda.
12. The Insured animal had died on 03.11.2009 and the validity of the Insurance Policy was from 09.10.2009 to 08.10.2010. The opposite party No.2 has not placed on filed any evidence to prove that the animal of the complainant was suffering from pre-existing disease or the complainant has failed to take proper care of the said animal.
13. A perusal of Ex.C-13 shows that earlier, the claim has been allowed and then repudiated. The Post Mortem report shows that the date and time of start of trouble is 21.10.2009 and the animal had died on 03.11.2009. Thus, the ground for repudiation of the claim is not tenable as the buffalo had died on 03.11.2009 i.e. approximately after one month of the issuance of the policy. Thus, the said buffalo has not died within 15 days of the commencement of the policy.
14. Moreover, with regard to the ground for repudiation that the intimation has not been given within 24 hours, is also not tenable as the complainant has sent the intimation to the opposite party No.3, in turn the opposite party No.3 has to send the information regarding the claim of the complainant to the opposite party No.2.
15. With regard to the legal objection taken by the opposite party No.2 that this Forum has got no territorial jurisdiction to try and entertain the present complaint as there is no branch office of the opposite party No.2 at Bathinda. A perusal of record shows that Deputy Director, Animal Husbandry and Diarying (Pashupalan), Bathinda vide Ex.C-9 sent the intimation to the Insurance Company vide letter No.3584 dated 12.11.2009. Thus, one of the opposite party is holding its office at Bathinda as such the said legal objection is also not tenable and this Forum has got territorial jurisdiction to try and adjudicate the present complaint.
16. Therefore, in view of what has been discussed above, this Forum is of the considered view that there is deficiency in service on the part of the Insurance Company i.e. opposite party No.2. Hence, this complaint is accepted with Rs.2,000/- against the opposite party No.2 and dismissed qua opposite party No.3. The opposite party No.2 is directed to pay the IDV of Rs.30,000/- of the Insured Animal to the complainant. Compliance of this order be done within 45 days from the date of receipt of copy of this order. In case of non-compliance, interest @ 9% p.a. will yield on the amount of Rs.30,000/- till realization.
A copy of this order be sent to the parties concerned free of cost and file be consigned for record. '
Pronounced in open Forum
10-02-2012
(Vikramjit Kaur Soni)
President
(Amarjeet Paul)
Member
(Sukhwinder Kaur)
Member
