District Consumer Disputes Redressal Forum, Tarn Taran (Punjab)

C.C. No.               : 89/2014

Date of Institution  :  16.12.20114

Date of Decision    : 5.8.2015

Bhupinder Singh son of Sh. Resham Singh resident of village Kaleke Uttar, Tehsil Patti, District Tarn Taran.

                                                                   …Complainant

                                               Versus           

1. The Manager, New India Assurance Company Ltd. G.T. Road, Rayya-143112,
2. The New India Assurance Company Ltd. New India Assurance Building, 87 , Mahatma Gandhi Road, Fort, Mumbai – 400 001,
3. State Bank of India Branch Chuslewal, Camp at Patti, Tehsil Patti, District Tarn Taran through its Branch Manager.

…Opposite Parties

Complaint Under Section 12  & 13 of the Consumer Protection Act, 1986.

Present:      

For complainant                        Sh. A.K. Sharma Advocate

For opposite parties No. 1 & 2  Sh. Sanjay Kapoor Advocate

For Opposite party No. 3                   Sh. Sanjay Gupta Advocate

Quorum:     Sh. J.S.Khushdil,  President.

Sh. R.D.Shamra Member.

Smt. Jaswinder Kaur, Member

(Sh J S Khushdil, President)

1. Bhupinder Singh has filed this complaint under Section 12 and 13 of the Consumer Protection Act 1986 (herein-after called as ‘the Act’) against The Manager, New India Assurance Company Ltd. G.T. Road, Rayya-143112 and another (herein-after called as ‘Opposite Party Nos. 1, 2 -Insurance Company’) and against State Bank of India Branch Chuslewal, Camp at Patti, Tehsil Patti, District Tarn Taran through its Branch Manager (herein-after called as ‘Opposite Party No. 3 – Bank) supported by various documents levelling allegations of deficiency of service on the part of the opposite parties.

2        As per the complaint, he was carrying on the business of Dairy Farming after obtaining Dairy Loan of Rs. 2,50,000/- in the year 2013 from the opposite party No. 3-Bank. He purchased five buffaloes. As per his version, the opposite parties No. 1 and 2- Insurance Company insured the five buffaloes for three years up to 23.5.2014. The complainant paid the requisite premium. According to his version, the business of dairy farming is for his sole livelihood. It is alleged that his one insured buffalo suddenly fell ill on 12.12.2013 and the complainant provided treatment and later on the said buffalo expired. On 3.2.2014 two other insured buffaloes suddenly fell ill and the complainant provide treatment to them and they expired on 5.2.2014. On 10.3.2014 another insured buffalo suddenly fell ill and the complainant provided treatment to the said buffalo and said buffalo expired on 13.3.2014. The post mortems of the said expired buffaloes were got conducted by the complainant. The matter was reported to Sh. Raghbir Singh concerned official of the opposite parties No. 1 and 2- Insurance Company and he asked the complainant to give application to the concerned bank. On asking of the said Raghbir Singh an application dated 13.3.2014 was moved to the opposite party No. 3-Bank, but no action was taken by the opposite party No. 3-Bank. Rural Veterinary Officer, Incharge C.V.H. Varnala, Tehsil Patti, District Tarn Taran made physical assessment report and conducted postmortem of the expired buffaloes on 3.2.2014 and 13.3.2014. The complainant had personally as well as by way of written representation approached the opposite parties No. 1 and 2- Insurance Company but they were lingering on the matter under one pretext or the other, thus, it was alleged that the complainant has suffered mental agony, harassment and also alleged that the opposite parties are deficient in providing services to the complainant. His oral as well as written requests bore no fruit. The complainant, therefore, prayed to this Forum to accept his complaint and to award the following relief against Opposite Parties:-

(i)      To pay the insurance claim of 4 dead buffaloes of the complainant immediately without any further delay.

(ii)      To pay Rs. 1,00,000/- being damages on account of unnecessary harassment, inconvenience, agony and mental pain, tension suffered by the complainant.

3        Notice of this complaint was issued to the opposite party Nos. 1 and 2 who appeared through their counsel and filed written version wherein various preliminary objections have been taken inter alia that the complaint is not maintainable as the complainant does not fall under the definition of consumer. He was carrying on the business of dairy farming for commercial purpose; that the present complaint is misuse of process of court; that the complainant has no locus standi to file the present complaint. The complainant has violated the terms and condition of the insurance policy. It was obligatory on the part of the complainant to give immediate intimation of death of insured buffaloes to the office of insurance company. The complainant did not give intimation to the opposite parties No. 1 and 2- Insurance Company immediately after the alleged death of buffaloes and no opportunity was afforded to the opposite parties No. 1 and 2- Insurance Company  to inspect the loss and carcass of the buffaloes which is violation of terms and conditions of Insurance Policy. The opposite parties No. 1 and 2- Insurance Company firstly received letter dated 15.3.2014 (mark H in two pages) on 27.3.2014 from the opposite party No. 3- bank qua the death of animals on 5.2.2014 and 13.3.2014 which was duly replied by the opposite parties No. 1 and 2 vide their letter dated 28.3.2014. The carcass of buffaloes were already disposed off, therefore, the insurance company could not inspect the same. Thus, the complainant neither gave immediate written intimation about the death of animals nor submitted any postmortem report nor claim form No. 160 and 161 duly filled by the insured as well as Veterinary Doctor and endorsed by the banker alongwith ear tags; that the complainant is estopped by his own act and conduct from filing the present complaint. On merit, it was reiterated that the complainant does not fall within the definition of consumer as he is allegedly carrying on business of dairy farming for commercial purposes. The death of one buffalo on 12.12.2013 was denied. It was also alleged that date of death of buffalo did not mention in the Para No. 2 of the complaint. They further pleaded that no written intimation was ever given to the opposite parties so as to inspect the carcass before its disposal. Similarly, it was pleaded that on 3.2.2014 two insured buffaloes were not fell ill and not died on 3.2.2014 and no other buffalo fell ill on 10.3.2014 and not died on 13.3.2014. It was further denied that any intimation was given by the complainant to the opposite parties No. 1 and 2 with regard to death of buffaloes. It was further alleged that the matter was not informed to the concerned authority of opposite parties No. 1 and 2. The photographs, postmortem report and medical fitness certificate of the dead buffaloes are forged and fabricated one. It was denied that the complainant informed about the death of animals to Raghbir Singh. It was alleged that the complainant has violated the terms and conditions of the policy, therefore, the opposite parties No. 1 and 2- Insurance Company pleaded that they rightly repudiated the claim of the complainant. The other allegations have been denied by the opposite parties No. 1 and 2- Insurance Company and dismissal of complaint was prayed for.

4        The opposite party No. 3 also appeared through counsel and filed written version and it was denied that the business of dairy farming is sole livelihood of the complainant. It was admitted that the complainant moved an application to the opposite party No.3 – Bank dated 13.3.2014 regarding the death of 3 buffaloes i.e. 2 buffaloes expired on 5.2.2014 and one buffalo expired on 13.3.2014. The opposite party No. 3- bank has no intimation regarding the death of two buffaloes. However, later on said letter was forwarded to the opposite parties No. 1 and 2- Insurance Company on 15.3.2014 vide letter No. BL/181/2013-14 (Mark H) for necessary action. It was pleaded that the opposite parties No. 1 and 2- Insurance Company through letter dated 28.3.2014 informed the bank that they had no intimation of the death of the buffaloes and immediate written intimation was to be given to opposite parties No. 1 and 2 which was mandatory as per terms and provisions of the policy. It was further submitted that there was no deficiency on the part of the opposite party No. 3. The other allegations have been denied by the opposite party No. 3 – Bank and dismissal of complaint was prayed for.

5        The complainant in order to substantiate his claim tendered in to evidence his duly sworn affidavit Ex. C-1 alongwith following documents

Ex. C-2        Courier Receipt

Ex. C.3        Representation dated 22.5.2014 of the complainant to the Chief Managerand General Manager (Network I) of the State Bank of India Local Head Office Sector 17-B Chandigarh 160 017

Ex. C.4        Courier Receipts

Ex. C.5        Representation dated 27.8.2014 of the complainant addressed to The Manager, The New India Assurance Company Limited, G.T.Road, Rayya, 143112

Ex. C.6        Courier Receipt

Ex. C.7        Letter dated 22.4.2014 of complainant addressed to Manager State Bank of India Branch Patti by the complainant

Ex. C.8        letter dated 7.4.2014 of State Bank of India addressed to the complainant.

Ex. C.          9        Post Mortem Report dated 13.3.2014 of death

animal

Ex. C.10.     Photograph of dead animal.

Ex. C.          11      Photograph of dead animal.

Ex. C.12      Photograph of dead animal.

Ex. C.13      Photograph of dead animal.

Ex. C.14      Photograph of dead animal.

Ex. C.15      Photograph of dead animal.

Ex. C16.      Photograph of dead animal.

Ex. C.17      Photograph of dead animal.

Ex. C.18      Photograph of dead animal.

Ex. C.19      Post mortem report dated 6.2.2014 of dead animal.

Ex. C.20.     Post mortem report dated 5.2.2014 of dead

animal.

Ex. C.21      Photograph  of dead animal.

Ex. C.22      Photograph of dead animal.

Ex. C.23      Photograph  of dead animal.

Ex. C.24      Photograph  of dead animal.

Ex. C.25      Representation dated 22.4.2014 of the complainant addressed to Sh. Manik B. Sonawane, Office of the Insurance Ombudsman, S.C.O. No. 101, 102 & 103, 2^nd Floor, Batra Building, Sector 17D, Chandigarh 160 017

Ex. C.26      Affidavit of Dr. Gurdeep Singh Veterinary Officer.

Mark A        Photostat copy of Copy of cattle Insurance policy

Mark B        Photostat copy of Activity Report

Mark C        Photostat copy of Letter written to Manager State Bank of India Branch Patti by Bhupinder Singh complainant

Mark D        Photostat copy of Medical fitness certificate dated 7.7.2012 of buffalo.

Mark E        Photostat copy of Medical fitness certificate dated 7.7.2012 of buffalo.

Mark F        Photostat copy of Medical fitness certificate dated 7.7.2012 of buffalo.

Mark G        Photostat copy of letter dated 13.3.2014 to Manager State Bank of India Branch Patti by Bhupinder Singh complainant.

Mark H        Photostat copy of letter dated 15.3.2014 of State Bank of India addressed to Manager The New India Assurance Co. Ltd. Rayya, Amritsar

Mark I         Letter dated 7.4.2014 of State Bank of India addressed to the complainant.

and closed the evidence.

6        On the other hand, to rebut the evidence of the complainant,  opposite party Nos. 1 and 2 have tendered in to evidence affidavit of S.S. Gill Ex. OP1, 2/1 alongwith following document

          Ex. OPs 1, 2/2       Self attested copy of letter dated 28.3.2014

          (also marked H      of the New India Assurance Company

in two pages)         Ld. Branch office, G.T. Road Rayya

                                      addressed to the Manager State Bank of

India Tarn Taran Road, Patti, District Tarn

Taran

          Ex. OPs 1, 2/3       Self attested copy of letter dated 15.3.2014

          (Also mark H         of State Bank of India addressed to

In two pages)        The Manager, the New India Assurance

                             Co. Ltd. Rayya, Amritsar.

          Ex. OPs 1, 2/4       Self attested copy of letter dated 7.4.2014 of

                                      State Bank of India addressed to the

complainant.

          Ex. OPs 1, 2/5       Self attested copy of letter dated 27.8.2014

of complainant addressed to the Manager,

The New India Assurance Company Limited G.T. Road, Rayya- 143112

          Ex. OPs 1, 2/6       Self attested copy of letter dated 2.9.2014

of the New India Assurance Company Ltd.

Branch Office G.T. Road Rayya-143112 addressed to the complainant.

          Ex. OPs 1, 2/7       Attested copy of Policy valid from

30.5.2013 to 29.5.2014

          Ex. OPs 1, 2/8       Attested copy of certificate in respect of

compliance of Section 64 V.B.

          Ex. OPs 1, 2/9       Self attested copy of terms and conditions

of the Policy.

and closed the evidence.

7        The opposite parties No. 3 has also tendered in evidence affidavit of Arun Kumar Arya Branch Manager S.B.I. Branch Patti Ex. OP.3/1 alongwith following documents.

Ex. OP.3/2            Self attested copy of claim application of complainant addressed to the Manager State Bank of India Branch Patti

Ex. OP.3/3            Self attested copy of letter dated 17.7.2014 of State Bank of India Branch Patti addressed to the Regional Manager, State Bank of India Regional Business office Dhangu Road Pathankot

Ex. OP.3/4            Self attested copy of letter dated 14.1.2014 of the New India Assurance Company Ltd. Branch G.T. Road, Rayya addressed to the Branch Manager, State Bank of India, Tarn Taran Road, Patti, District Tarn Taran.

Ex. OP.3/5            Self attested copy of letter dated 28.3.2014 of  the New India Assurance Company Limited Branch Office G.T. Road Rayya addressed to the Manager State Bank of India Tarn Taran Road Patti, District Tarn Taran          

Ex. OP.3/6            Self attested copy of letter dated 11.3.2014 of State Bank of India Branch Tarn Taran Road Patti, District Tarn Taran addressed to the Manager, The New India Assurance Co. Ltd. Rayya, Amritsar.

and closed the evidence on behalf of opposite party No. 3.

8        We have heard the ld counsel for the complainant as well as Opposite parties and also perused the evidence produced on record by the parties with the assistance of ld. counsel for the parties. However, none of the party filed written arguments and therefore, the statements of ld.counsel for the parties got recorded accordingly.  

9        Ld. Counsel for the complainant submitted that the complainant has obtained loan of Rs. 2,50,000/- from the opposite party No. 3 and he purchased 5 buffaloes for doing dairy farming business which was sole livelihood of the complainant. It was submitted that 4 buffaloes were admittedly got insured from the opposite parties No. 1 and 2- Insurance Company. Ld. counsel for the complainant invited our intention towards the mark A as well as O.Ps. 1, 2/7. It is submitted that 4 buffaloes died due to sickness. The complainant provided them treatment but four buffaloes died. The post mortem of the carcass of the dead buffaloes was got conducted by Veterinary Doctor. The reference was made to the post mortem reports as well as photographs. It was argued that intimation of expired buffaloes was firstly given to Raghbir Singh and on asking by him, the intimation was given to the opposite party No. 3 who inturn informed to the opposite parties No. 1 and 2- Insurance Company in writing. It was submitted that the plea of the insurance company that intimation has not received intimation is not tenable. It was submitted that 5 buffaloes were purchased after taking the loan from the opposite party No. 3- Bank and opposite party No. 3- Bank is now claiming the loan amount. The dairy business of the complainant has totally failed and complainant is unable to return the loan amount and the opposite parties No. 1 and 2- Insurance Company is not releasing the rightful insurance claim and is taking the lame excuses to repudiate the genuine claim of the complainant. It was submitted that there was not the fault of the complainant if the opposite parties No. 1 and 2- Insurance Company has not inspected the carcass of the buffaloes after receiving the intimation through Raghbir Singh and through Bank also. It is submitted that the claim of the complainant is genuine. Ld counsel for the complainant urged before us that death of three 3 buffaloes was natural and the opposite parties have failed to prove that it was unnatural or suspicious one.  Finally, it was prayed to accept the claim and to award the relief as claimed.

10      On the other hand, ld counsel for the opposite parties No. 1 and 2 submitted that first of all the complainant does not fall within the definition of consumer as he is doing the dairy farming business for commercial purpose. It is argued that the complainant did not give immediate written intimation to them qua the insured dead buffaloes. In this way, the complainant has violated the terms and conditions of the insurance policy. It was submitted that the insurance company was deprived of the opportunity to inspect the carcass of the death of the alleged buffaloes and therefore, they could not ascertain the exact cause of death of buffaloes. It was also submitted that no intimation was ever given to Raghbir Singh official of the opposite parties No. 1 and 2. It was submitted that the alleged post mortem reports of three buffaloes as alleged are forged and fabricated documents and are not intimating that the death of buffaloes was natural. It was argued that each animal was carrying an ear tag. Our attention was drawn to the insurance policy Ex. OPs1, 2/7. In case of death of insured animal, it is the duty of the person concerned to inform the insurance company which inspects the dead animal and identify the dead animal from the tag so issued vide the insurance policy Ex. OPs 1, 2/7. It was essential for the complainant to deposit the ear tag. It was contended that in this case, neither ear tag has been deposited nor Insurance company was given opportunity to identify the insured animal. Tag number has been duly mentioned in the insurance policy. While drawing our intention to the post mortem reports on the record, the ld. counsel for opposite parties No. 1 and 2 submitted that there is no mention of tag number in the post mortem reports from which the dead animal could be identified, more so, to the effect that it was the same animal which was insured. It is also submitted that no ear tag has been produced in the court. Ld. Counsel for the opposite party Nos. 1 and 2 drawn our intention towards the terms and conditions of insurance policy where the claim without the ear tag is not payable. The identification of the animal for which the claim is made by the complainant is not established without the ear tag. Therefore, the complainant is not entitled for any claim. Ld. Counsel for the opposite parties No. 1 and 2- Insurance company further submitted that first time, the opposite parties No. 1 and 2 received intimation through opposite party No. 3- bank on 27.3.2014 vide letter dated 15.3.2014.  The complainant was at liberty to examine Raghbir Singh if he has given intimation to him the alleged officer of the opposite parties No. 1 and 2- Insurance Company.  Ld. Counsel for the opposite parties No. 1 and 2 argued that there is delay in furnishing the inf ormation to the opposite parties No. 1 and 2 regarding the alleged death of buffaloes and there is no mention of tag Number in the post mortem reports from which the insured  animal could be identifiable. To strengthen his view, ld. Counsel for the opposite parties No. 1 and 2 has placed reliance on the judicial pronouncement titled Rajinder Kumar Vs United India Insurance Co. Ltd. dated of order 22^nd April, 2013 by the National Consumer Disputes Redressal Commission, New Delhi. It was prayed for dismissal of the complaint.  

11      The Ld. Counsel for the opposite Party No.3- Bank submitted that the intimation regarding the death of three buffaloes received on 13.3.2014 and two buffaloes expired on 5.2.20214 and one buffalo expired on 13.3.2014. The opposite party No. 3- Bank forwarded the letter to the opposite parties No. 1 and 2- Insurance Company vide letter NO. BL/181/2003-14. It was argued that opposite party No. 3 has no intimation regarding the death of other two buffaloes. It was submitted that there was no deficiency in services on the part of the opposite party No. 3 and it was prayed for dismissal of the complaint.   

12      We have taken in to consideration the contentions and rival contentions of the parties in the light of record.

13      The averment of the complainant being consumer has been refuted by the opposite parties in their respective written versions. The complainant has taken this plea that he is doing the dairy farming for his own livelihood. There is no contrary evidence led by the opposite parties, therefore, we hold that the complainant is a consumer of the opposite parties and this complaint is maintainable.

14      As per version of the complainant, he purchased 5 buffaloes by raising loan of Rs. 2,50,000/- from the opposite party No. 3. Admittedly, the four buffaloes were insured by the opposite parties No. 1 and 2 and this is apparent from the policy Ex. OP1, 2/7. The validity period of the insurance was from 30.5.2013 to 29.5.2014. It would be worth while to give the relevant table of the policy which is as under:-

It is apparent that the insurance is in respect of 5 buffaloes and this is admitted fact that the complainant raised loan of Rs. 2,50,000/- for purchasing 5 buffaloes. The reference may be given to Para No. 2 of the written version filed by the opposite party No. 3. As claimed by the complainant, four buffaloes died because of sickness. One buffalo fell ill on 12.12.2013 but no date of death has been mentioned in Para No. 3 of the complaint. The opposite parties No. 1 and 2 have also taken this plea regarding non-mentioning of death of buffalo. Post mortem reports of two buffaloes died on 5.2.2014 are Ex. C.19 and C.20 and the post mortem report of buffalo died on 13.3.2014 is Ex. C.9. Thus, it is clear that there are post mortem reports of only 3 buffaloes against 4 dead buffaloes being claimed by the complainant, therefore, we have concentrated the claim of complainant qua three buffaloes. As mentioned earlier all 5 buffaloes were insured. It would be just and appropriate to have a look on the terms and conditions of the insurance policy of the buffaloes.  The terms and conditions of the cattle insurance is Ex. OPs 1, 2/9 and Clause 7(B)(ii) of Cattle Insurance Policy is as follows:

7(B)   Specific Exclusions:

                    (i)      xxxxxxxxxx

                    (ii)      All the claims received without ear tag.

The relevant clause 8(ii) of the Cattle Insurance Policy is as follows:-

          8        Additional Policy Condition

                   (i)      xxxxxxxxxx

(ii)      The provision of No Tag No Claim should be included as policy condition No. 9. The wording may be as under:-

          “In the event of death of animal/s covered under the policy, claim/s shall not be entertained unless the ear tag/s are surrendered to the company. In the event of loss of ear tag/s, it is the responsibility of the insured to give immediate notice to the company and get the animal retagged.”

The relevant condition No. 10 of the Cattle Insurance Policy is as follows:-

          All insured animals should be suitably identified by one or more of the following methods:

(a)     Ear tag made of suitable material may be used. The cost of ear-tags and tagging charges will be borne by the Insurer.   

(b)     Natural Identification marks and colour should be clearly noted in the proposal form and Veterinarian’s Report.

(c)     Photographs of animals may be insisted in case of high value animal.

15      In this way, as per terms and conditions of the policy, the identity of animal is necessary to be established by insurer to lodge the claim before the insurance company. In this case, the perusal of post mortem reports mentioned above reveal that there is no mention of Tag Number of the animals for which the concerned Veterinary Officer performed the post mortems of the dead buffaloes. It is again necessary to make a mention that in the insurance policy there is clear cut mention of Tag Number of 5 buffaloes. The complainant was further required to establish the identity of the dead animal which were insured with the opposite parties No. 1 and 2 and then to lodge the claim. It is notable point that no tag has been deposited by the complainant at the time of lodging his claim or produced before the doctor who performed post mortems of the dead buffaloes or in this Forum. The identity of the dead animal could only be established from tag Number or from any method mentioned in condition No. 10 mentioned supra. We are of the considered view that the claim of the complaint is vague without clear identity of the buffalo which was insured. We are further of the view that the complainant has not given in time intimation to the insurance company to enable it to inspect the carcass of the dead buffaloes. No doubt mere delay in giving the information cannot be a ground to dislodge the claim of the complainant. However, we are of the view that the identity of the buffaloes has not been established by the complainant and there is no deficiency in service on the part of the opposite parties in rejecting/ repudiating the claim of the complainant.

16      In view of above discussion, we do not find any merit in the complaint and the same is dismissed. In peculiar circumstances of this case, the parties are left to bear their own costs. Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room. 

Pronounced in open Forum.

Dated: 5.8.2015

                                                    (J.S.Khushdil)

                                                           President

                           (Jaswinder Kaur  Dolly)            (R.D.Sharma)

                                        Member                            Member