Haryana

Karnal

CC/157/2018

Mohit Kumar - Complainant(s)

Versus

The Divisional Manager Oriental Insurance Company Limited - Opp.Party(s)

Gandhi

23 May 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 157 of 2018

                                                          Date of instt. 03.07.2018

                                                          Date of Decision 23.05.2019

 

Mohit Kumar son of Ramesh Chand, resident of Saunkra Road, near Bharat Gas Godown, Taraori, Tehsil Nilokheri, District Karnal.

 

                                                                                 …….Complainant

                                        Versus

 

1. The Divisional Manager, Oriental Insurance Company Limited  behind Bus Stand, near Mahila Ashram, Karnal.

2. The Branch Manager, Oriental Insurance Company Ltd. Sabharwal Market Railway Road, Kurukshetra-163118.

                                                                        …..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

 

 Present:  Shri Gandhi Advocate for complainant.

                  Shri Karamvir Mandhan Advocate for opposite parties.

 

                   (Jaswant Singh President)

 

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant got insured his cows with the OPs under the scheme of Animal Insurance under Scheme SCSP/GO1/State vide cover note no.1073315, vide which two cows of the complainant were insured for a sum of Rs.1,00,000/- for a period of three years commencing from 31.12.2016 to 30.12.2019. A sum of Rs.4036/- was charged from the complainant towards premium for the said period of three years. At the time of issuance of the said policy, the cows were tagged, vide tags no.917538 and 917460 for identification purpose. Unfortunately on 02.08.2017, one cow bearing Tag no.917460 fell ill and died on same day. The dead body of the cow was taken to Veterinary Suregeon Taraori and the postmortem was conducted on 03.08.2017 and in the postmortem report, the doctor concerned opined that the animal died because of acute surra deceased. The said postmortem was conducted, vide PMR no.54950 dated 3.8.2017. The complainant provided the relevant tag and postmortem report to the officials of the OP, who visited the site. Thereafter, the complainant had been regularly making the requests to the OPs for settlement of the claim but OPs did not settle the claim and lastly declined the claim of the complainant on the false pretext of different description of the dead cow with the health certificate and the post mortem report. This is a false ground for repudiation of the claim. Thereafter, complainant sent a legal notice dated 12.03.2018 to the OPs in this regard but it also did not yield any result. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed written version raising preliminary objections with regard to maintainability; locus standi; cause of action and concealment of true and material facts. On merits, it is pleaded that as per policy cover note the actual amount insured was Rs.80,000/- instead of Rs.one lac and premium amount of Rs.3538/- was paid by the complainant instead of Rs.4036/- for two cattles. It is further pleaded that as per documents and claim papers submitted by complainant to the OPs the case was got investigated by OPs and it has been found that description does not tally with the Health Certificate, as per Health Certificate the colour of cow is black and white whereas as per physical inspection it is of black colour and forehead is white spot whereas there is no mentioning in the Health Certificate and PMR. The OPS have rightly repudiated the claim of the complainant as per terms and conditions of the Insurance Policy, vide letter dated 15.01.2018. Hence there is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C7 and closed the evidence on 7.1.2019

4.             On the other hand, OPs tendered into evidence affidavit of Mahavir Singh Ex.RW1/A, affidavit of R.N. Sharma Investigator Ex.RW1/B and documents Ex.R1 to Ex.R7 and closed the evidence on 14.05.2019.

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.             The case of the complainant is that complainant had got insured his cows with the OPs under the scheme of Animal Insurance under Scheme SCSP/GO1/State vide cover note no.1073315, vide which two cows of the complainant were insured for a sum of Rs.1,00,000/- for a period of three years commencing from 31.12.2016 to 30.12.2019. A sum of Rs.4036/- was charged from the complainant towards premium for the said period of three years. At the time of issuance of the said policy, the cows were tagged, vide tags no.917538 and 917460 for identification purpose. Unfortunately on 02.08.2017, one cow bearing Tag no.917460 fell ill and died on same day. The dead body of the cow was taken to Veterinary Suregeon Taraori and the postmortem was conducted on 03.08.2017. The complainant provided the relevant tag and postmortem report to the officials of the OP, who visited the site. Thereafter, the complainant had been regularly making the requests to the OPs for settlement of the claim but OPs did not settle the claim and lastly declined the claim of the complainant on the false ground of different description of the dead cow with the health certificate and the post mortem report.

7.             On the other hand, the case of the OP is that as per policy cover note the actual amount insured was Rs.80,000/- instead of Rs.one lac and premium amount of Rs.3538/- was paid by the complainant instead of Rs.4036/- for two cattles. As per documents and claim papers submitted by complainant to the OPs the case was got investigated by OPs and it has been found that description does not tally with the Health Certificate, as per Health Certificate the colour of cow is black and white whereas as per physical inspection it is of black colour and forehead is white spot whereas there is no mentioning in the Health Certificate and PMR. The OPs have rightly repudiated the claim of the complainant as per terms and conditions of the Insurance Policy, vide letter dated 15.01.2018.

8.             Admittedly, complainant got insured his two cows with the OP. It is also admitted that  one cow died during the subsistence of the policy. The post mortem was conducted by Veterinary Surgeon and he prepared the post mortem report Ex.C5/Ex.R6 in which cause of death was mentioned as that animal had died due to acute Surra Typhoo Somiasis . We have gone through the description note prepared at the spot by the investigator of the OP which is as Ex.R3. There is no difference in breed HF Cross, horn was dehorned, tail of the cow was Below Hock Joint, Switch white and only colour was black and white as per health certificate and as per investigation black, white star on forehead, whereas in Post Mortem Report and Health Certificate the colour of the animal was black and white. There is no dispute regarding the ear tag no.917460 as the ear tag was found intact at the time of  investigation. The claim of the complainant was repudiated by OP only on the ground of difference in colour of the cow, which is not justified in the eyes of law while other all description tally each other in all records . Hence, we are of the considered view that the act of the OPs amounts to deficiency in service and unfair trade practice

9.             Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OPs to pay the insured amount to the complainant with interest @9% from the date of repudiation of the claim till its realization. We further direct the OP to pay Rs.10,000/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expense. 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:23.05.2019                                                                       

                                                                      President,

                                                              District Consumer Disputes

                                                               Redressal Forum, Karnal.      

 

        (Vineet Kaushik)         

            Member