Haryana

Yamunanagar

CC/162/2013

Sanjay Kumar S/o Budh Ram - Complainant(s)

Versus

Robin - Opp.Party(s)

R.K.Kamboj

07 Oct 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, YAMUNA NAGAR AT JAGADHARI

 

 

Complaint no.162 /13.

Date of Institution. 28.02.2013.

Date of Decision:10.10.2016.

 

Sanjay Kumar aged 38 years S/o Sh. Budh Ram, Resident of village Rattangarh, Tehsil Jagadhri District Yamuna Nagar

                               ….Complainant.

                                                 Versus

 

1. Robin, authorized agent of Bajaj Allianz General Insurance company Limited, resident of House no. 150 Sector 17-HUDA Jagadhri Distt. Yamuna Nagar.
2. Bajaj Allianz General Insurance Company Limited, Branch Office SCO 139-140,Sector 8-C , 1st Floor Chandigarh though its Manager/Director
3. Bajaj Allianz General Insurance Company Limited 1st Floor Great Eastern Plaza, Airport Road, Great Eastern Plaza, Airport Road, Yerwada, Pune 411086 though its M.D.

 

                                                                                                                      ….Respondents.

                                  

Before: -      SH. ASHOK KUMAR GARG, PRESIDENT.

                   SH. SUBASH CHANDER SHARMA MEMBER.

 

Present: -    Sh. Rajender Kamboj, Adv. for complainant.

                   OP No.1.already ex parte vide order Dt.23.07.2013

                   Sh.Rajeev Gupta, Adv. for OP No.2 & 3.

 

ORDER (ASHOK KUMAR GARG, PRESIDENT)

 

 1.              This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Sanjay Kumar against Bajaj Allianz General Insurance Company Limited and others, the respondent (hereinafter referred as opposite parties).

2.                It is stated in the complaint that Complainant runs milk diary for earning livelihood for himself as well as his family and for that purpose, complainant got insured his one Cow bearing TAG No. BAGICL/52420, which he was having, from the OP No.2 & 3 Insurance Co. through op no. 1 agent. Vide policy bearing No.OG-12-1207-5004-00000601 valid from 21-03-2012 to 20-03-2013 comprehensively for a sum insured Rs.50,000/-.  The complainant’s Cow which was insured by OP No.2 & 3 died on 03-07-2012 due to illness mentioned in PMR dated 04-07-2012 and information regarding this incident was given to OPS Insurance Co and thereafter, the complainant made claim of the said Cow to OP No.2 & 3 for Rs.50,000/- but the OP No.2 & 3  has not made any payment till now. Even, the complainant also completed all the formalities necessary for claim as per policy. The Ops are legally bound to pay the amount of Rs.50,000/- to the complainant but they have not paid the amount to the complainant in spite of repeated requests and demands and repudiated the same illegally vide its letter 28-09-2012 (Annexure C-6) on the flimsy grounds. Thus, it amounts to deficiency in service on the part of Ops. Hence, in such like circumstances, the present complaint was moved by the complainant.

3                 Upon notice, opposite parties no.1 failed to appear despite service, hence he was proceeded ex parte vide order dated 23.07.2013

4                 whereas, OPs No.2 & 3 appeared through Shri Rajeev Gupta Advocate, and contested the complaint by filing written statement taking preliminary objections that the complaint is not maintainable in the present form; that the complainant has concealed the true and material facts from this Forum, as such the complainant is not entitled for any relief. The true facts are that in this case after receiving the intimation from the complainant, the Ops Insurance Co. immediately deputed Shri Sachin Gulati Investigator to investigate the matter who submitted his report dated 18-09-2012 mentioning there in that insured Cow was with his relative Sh. Balbir Singh at Village Badapur Distt Karnal at the time of death and complainant brought the same after loading in the TATA Ace which was re-loaded at insured’s Farm in the presence of the investigator. Investigator has further mentioned in his report that Insured had taken loan against 6 Cows from Punjab and Sind Bank Damla Distt Yamuna Nagar. Sh. Balbir Singh relative of the insured has admitted in his statement that Tag was in the possession of Sanjay Complainant at the time of death. Insured had taken loan for 6 Cows and 4 of which have already been sold. 10 other cows were lying at the insured’s house during his visit. After considering the report of the investigator the claim of the complainant has been rightly repudiated by the competent authority as “No Tag No Claim” vide letter dated 28.09.2012 and also on the following grounds:-

(i) That died Cow was in the possession of Mr. Balbir Singh at the time of death in village Badarpur Distt Karnal which is about 30Km away from the stabling. The same has been shifted without intimation to the insurance Co. which is violation of the condition no.3.6 which states that – “No indemnity is available hereunder for any claim directly or indirectly caused by, based on, arising out of or howsoever attributable” –Transport by air and sea .Transport by and beyond 25 Km from the place of stabling by any means other than by foot and beyond 50 km from the place of stabling in case of transit by foot.

(ii)  That As per statement of Balbir Singh on records at the time of death, ear Tag of the Cow was with Mr. Sanjay Complainant which suggests that at the time of death, tag was not intact and it was punched later on to take undue benefits of  the policy in hand.

(iii) It has been observed that complainant have another group of 10 Cows which are without tags and any other Insurance Coverage; this also indicates that the alleged Cow was not Insured Cow at all.  

On merits, it is not disputed that complainant had obtained a Insurance Policy No. OG-12-1207-5004-00000601 valid from 21-03-2012 to 20-03-2013 for covering the Risk of six (6) cows for Rs.3,00,000/- i.e. Rs.50,000/- each from OPs No.2 and 3. It is also not disputed that a claim was lodged with the OPs No.2 and 3. In view of the facts and circumstances mentioned above, there is no deficiency in service on the part of OPS and as such, the complaint of the complainant is liable to be dismissed with costs. The remaining contents of the complaint were denied. Preliminary objections were repeated. Prayer for dismissal of the complaint was made.

5.                In support of his case, Counsel for the complainant tendered into evidence affidavit of complainant as Ex.CW/A, Photostat copy of Claim Form as Ex.C-1, Photostat copy of Premium Receipt as Ex.C-2, Photostat copy of Health Certificate as Ex.C-3, Photostat copy of Post Mortem Report as Ex.C-4, Photostat copy of Blank claim discharge Voucher as Ex.C-5 and Photostat copy of repudiation letter as Ex C-.6 and closed the evidence.

6                 On the other hand, Counsel for Op No.2 & 3 tendered into evidence affidavit of Sarpreet Kaur Ahluwalia, Senior Law officer  Bajaj Allianz Gen Insurance Company Limited, as Ex.RW/A, affidavit of Sachin Gulati Investigator, as Ex.RW/B, Photostat copy of Investigator Report as Ex.R-1, Photostat copy of repudiation letter as Ex.R-2, Photostat copy of insurance policy with its terms and conditions as Ex.R-3, photo stat copy of statement of Sanjay complainant recorded by Investigator as Ex.R-4, statement of Balbir Singh  recorded by Investigator as Ex.R-5, and thereafter the OP No.2 &3  closed the evidence.

7.                We have heard learned counsel for the parties and have gone through the record carefully.

8.                It is argued by the learned counsel for OP No.2 & 3 that as per policy, the claim of Cow can only be disbursed to the complainant in case it is found that in fact the Cow insured has died and to identify the Cow a Tag is always inserted to the Cow in question and in case no tag is found, no claim can be given on the basis of “No Tag No Claim” and that is why vide Ex.R-2/ExC-6 the claim of the complainant has been repudiated. He has made the reference of Post Mortem Report Ex.C-4 in which the Veterinary Surgeon has not mentioned any Tag number in it, meaning thereby that there was “No ear tag in the ear”.  He has further argued that in such like circumstances, it cannot at all be said that the Cow which was insured by the complainant has died. Ld Counsel for the Ops 2 &3 argued that died Cow was in the possession of Mr. Balbir Singh at the time of death in village Badarpur Distt Karnal which is about 30Km away from the stabling. The same has been shifted without intimation to the insurance Co. which is violation of the condition no.3.6 which states that – “No indemnity is available hereunder for any claim directly or indirectly caused by, based on, arising out or howsoever attributable.

9.                On the other hand, the learned counsel for complainant argued that genuine claim of the complainant has been repudiated on flimsy ground that died cow was in the possession of one Balbir Singh at a distance of 30 KM. The learned counsel for complainant has also made a reference of an authority cited as Oriental Insurance Company Limited Versus Mahavir Singh and others 2013 (1) Consumer Law Today, 447, in which the Hon’ble Haryana State Consumer Disputes Redressal Commission, Panchkula has held that when the insured Cow died due to fall in pond and insurance claim was repudiated on the ground that the deceased Cow was not having tag in the ear which was inserted at the time of issuing the insurance policy. It was held that plea taken by the insurance that the identity of the deceased insured Cow was doubtful is not sustainable in the eyes of law. It was observed that the PMR prepared by the Veterinary Surgeon and certificate issued by the Sarpanch of the village with respect to the identity of the deceased Cow cannot be discarded. It was also found that the non existence of the tag in the ear of the Cow is hardly significant because the tag has fallen in the Pond wherein the Cow had fallen and died.

10.              We have gone to the above said authority. The above said authority is not applicable to the facts of the present case. In the authority cited, the Sarpanch had certified with regard to the identity of the deceased Cow. However, in the present case, no such certificate is there issued by any respectable of the village. Moreover, in the above said authority, it was found that the ear tag had fallen in the pond, whereas it is not so in the present case. In the present case, in the post mortem report, the Veterinary Doctor has not disclosed any Tag Number i.e. there was no ear tag in the ear of the deceased Cow. It is basic condition of the policy of insurance that the tag should be inserted in the ear of the animal and no claim will be paid in the absence of ear tag. In such like circumstances, it cannot be said that the identity of the deceased Cow has been established with the Cow which was got insured.

11.              Moreover, it is also worthwhile to mention here that the insurance company had got investigated the matter through the investigator Shri Sachin Gulati, who is independent and qualified person to investigate the cases.  During the investigation, the Investigator recorded the statements of complainant’s Relative Balbir Singh (Annexure R-5). No doubt, the said Balbir Singh  has stated that there was no ear tag in the ear of the deceased Cow as the same was with Sanjay Kumar, Complainant at the time of death.  However, Complainant has stated in his statement (Annexure R-4) that tag was tagged in the ear but the same is not believable as the Veterinary Doctor could not find the same in the ear of the deceased cow at the time of PMR. In such like circumstances, it cannot at all be said that the Cow which was insured has died.

12.              We can see the case from another angle also. The complaint has not disclosed in his complaint that complainant has another group of 10 Cows which are without tags and any other Insurance Coverage and further he has obtained loan only for 6 Cows from the Punjab and Sind Bank Village Damla out which he had already sold 4 Cows. Even, the complainant has not disclosed in his complaint that died Cow was in the possession of one Balbir Singh at the time of death in village Badarpur Distt Karnal which is about 30Km away from the stabling and the same has been shifted without intimation to the insurance Co. which is violation of the condition no.3.6 which states that – “No indemnity is available hereunder for any claim directly or indirectly caused by, based on, arising out of or howsoever attributable. So, we are of the considered view that complainant has not come to court with clean hands and has concealed true and material facts due to reasons best known to him.

13.              In view of our discussion noted above, we are of the considered opinion that the claim of the complainant has been rightly repudiated by the Ops Insurance Co. as “No Tag No Claim” vide letter dated 28.09.2012(Annexure R-2/C-6). Hence, the complaint is without any merit and the same is hereby dismissed. File be consigned to record after due compliance.  Copy of this order, be communicated to the parties.

Announced in open Court

Dt. 10.10.2016                                                        

                                                                                    

(ASHOK KUMAR GARG)

PRESIDENT

DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, YAMUNANAGAR

AT JAGADHRI

 

                                   (SUBHASH CHANDER SHARMA)

                        MEMBER