BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FEROZEPUR
C.C. No.339 of 2014 Date of Institution: 12.9.2014
Date of Decision: 28.1.2015
Khajan Singh son of Karam Singh, resident of Village Wahge Wala, Post Office Khai Pheme Ki, Tehsil and District Ferozepur.
....... Complainant
Versus
1. The Manager, The Ferozepur Cantt Primary Co-operative Agriculture Development Bank Limited, Near Malwa Khalsa Senior Secondary School, Ferozepur City.
2. Branch Manager, The Oriental Insurance Company Limited, The Mall, Ferozepur City.
........ Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986.
* * * * *
PRESENT :
For the complainant : Sh. Amit Kumar Sharma, Advocate
For opposite party No. 1 : Sh. K.D.S. Sayal, Advocate
For opposite party No.2 : Sh. Ashwani Dhingra, Advocate
QUORUM
S. Gurpartap Singh Brar, President
S. Gyan Singh, Member
ORDER
GURPARTAP SINGH BRAR, PRESIDENT:-
Brief facts of the complaint are that the complainant, through the financial assistance of Rs.3,60,000/- obtained from opposite party No.1
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in the year 2011, had purchased four buffalos and two cows and at the time of sanctioning and disbursing of loan, opposite party No.1 got insured the said buffalos and cows from opposite party No.2 and deducted the insurance premium from the complainant. The said insurance policy renewed by opposite party No.1 after every year after deducting the amount of premium from the loan account of the complainant. Further it has been pleaded that one buffalos due to ill health, died on 25.3.2012 and second buffalo died on 12.5.2012 and intimation in this regard was sent to opposite party No.1, who assured that opposite party No.1 shall get the claim compensated from opposite party No.2. All the claim formalities, including filling of claim form and post mortem reports, were given to opposite party No.1 by the complainant. Since the opposite parties failed to settle the claim of the complainant, the complainant moved application before the Deputy Commissioner, Ferozepur on 30.9.2013, 11.11.2013 and 16.12.2013, respectively. Thereafter, the complainant received a letter from the Deputy Commissioner, Ferozepur dated 15.11.2013 in which it has been written that as per the inquiry conducted by the said office from the insurance company, the claim was not found to be genuine and the same has been declared as no claim. On 15.11.2013, the complainant came to know about rejection of his claim as opposite parties Nos.1 and 2 have never intimated regarding rejection of claim. Thereafter, the complainant
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approached the opposite parties and requested to return back the claim form and post mortem reports etc., but they failed to return the same. Pleading deficiency in service and unfair trade practice on the part of the opposite parties, the complainant has prayed that the opposite parties be directed to pay Rs.80,0000/- as insurance for the two dead buffalos along with interest. Further a sum of Rs.10,000/- has been claimed as compensation for harassment and Rs.8,000/- as litigation expenses.
2. Upon notice, the opposite parties appeared and filed their respective written replies to the complaint. In its written reply, opposite party No.1 has pleaded that the loan was obtained by the complainant in the year 2010. An amount of Rs.4,02,932/- as principal amount and Rs.1,56,261/- as interest, which was calculated upto 31.3.2014, is still outstanding in the loan account of the complainant. The complainant has not paid even a single penny to opposite party towards principal amount or interest. It is the matter between the complainant and opposite party No.2, who insured the animals of complainant. The complainant has to supply all the required documents directly to opposite party No.2 and opposite party No.2 has to settle the claim of complainant. Opposite party No.1 has only to pay the premium amount to opposite party No.2. There is no need to file any claim or to supply any documents to opposite party No.1. Opposite party No.1 has nothing to do with the work of opposite party No.2. Other
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allegations of the complaint have been denied and dismissal of the complaint has been prayed for.
3. In its written reply, opposite party No. 2 has pleaded that opposite party No.2 received the information from the complainant regarding death of buffalo on dated 25.3.2012. Thereafter, opposite party No.2 appointed Surveyor i.e. M.L. Mahla Investigator, who investigated the case and after investigation it was found that the place shown to the Investigator did not tally with the place visible in the photographs showing the dead buffalo. Therefore, the claim of the complainant was rightly repudiated as no claim and intimation in this regard was sent to him on 4.4.2013. However, opposite party No.2 has not received any intimation regarding death of another buffalo. Opposite party No.2 also received letter from the office of the Deputy Commissioner and they had duly replied the same vide reply dated 14.10.2013 and 12.11.2013. Other allegations of the complaint have been denied and dismissal of the complaint has been prayed for.
4. Learned counsel for complainant tendered into evidence Ex.C-1 to Ex.C-10 and closed evidence on behalf of the complainant. On the other hand, learned counsel for opposite party No.1 tendered into evidence Ex.OP-1/1 to Ex. OP-1/2 and closed evidence on behalf of opposite party No.1. Similarly, learned counsel for opposite party No.2 tendered into
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evidence Ex.OP-2/1 to Ex.OP-2/9 and closed evidence on behalf of opposite party No.2.
5. We have heard the learned counsel for parties and have also gone through the file.
6. It is the admitted case of the parties that the complainant had purchased 6 cattle i.e. four buffaloes and two cows by obtaining loan from opposite party No.1 and the said cattle were got insured by opposite party No.1 with opposite party No.2. The grievance of the complainant is that during the subsistence of the policy, two buffaloes out of his insured buffaloes died i.e. first on 25.3.2012 and second on 12.5.2012, but insurance claim in respect of the same has been declined by the opposite parties despite fulfillment of all the required formalities as well as despite repeated visits/representations by the complainant. So far as claim regarding the insured buffalo died on 25.3.2012 is concerned, the complainant had given intimation regarding death of the said buffalo to opposite party No.1 vide application dated 25.3.2012 Ex.C-8, which was duly received by opposite party No.1, as is evident from the seal of the bank appended on the bottom of this application itself. Opposite party No.2 has pleaded that on receipt of information from the complainant regarding death of the buffalo on 25.3.2012, opposite party No.2 appointed M.L. Mahla, Investigator, who investigated the case and after investigation it
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was found that the place shown to the Investigator did not tally with the place visible in the photographs showing the dead buffalo and as such, the claim of the complainant was rightly repudiated as no claim and intimation in this regard was sent to him on 4.4.2013. Opposite party No.2 has also placed on the file copy of the Investigation Report of the said Investigator as Ex.OP-2/8, a perusal of which reveals that the said Investigator had visited the village of the complainant to conduct enquiries into the matter only on 13.3.2013, whereas, admittedly the insured buffalo in question had expired on 25.3.2012 and intimation in this regard was also received by opposite party No.2 on the same day i.e. on 25.3.2012. In his report, the said Investigator has mentioned that during the course of investigations, the insured handed over the photographs of a dead buffalo, which according to him were arranged by him at his own level; the insured was asked to show the place where buffalo under report had expired and photographs arranged; the insured at the first showed him a place in his Ahata/residence; the description of that place was not tallied with that of description visible in the photographs; when the insured was pointed out about this fact, he showed him another place, description of which too was not tallied with that of description visible in the photographs. But the alleged photographs have not been placed on the file by opposite party No.2. Even otherwise, the said Investigator had visited the premises of the complainant only after
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about one year from the date of death of the insured buffalo and intimation thereof and during this long duration, change in the description of the place/premises (though not proved on the record by opposite party No.2) due to white wash or other construction cannot be ruled out. In his investigation report, the said Investigator has further mentioned that his investigation report is based on the basis of an information collected through different channels and resources during the course of his investigation. But there is no reference of any alleged channel and resource, except the alleged non-tallying of description of place shown to him with the description visible in the alleged photographs, has been given in the investigation report. In the subject of Investigation Report Ex.OP-2/8, it has been mentioned that Investigation about the death of one buffalo Tag No.39520 owned by Khajan Singh son of Karam Singh, resident of Village Baghe Wala, District Ferozepur, insured vide Policy No.47/2012/00467 w.e.f. 16.12.2011 to 21.7.2012, but the Investigator has not written even a single word as to whether he had made any investigation regarding Tag Number, breed and other features of the dead insured buffalo. The Investigator also has not mentioned that buffalo bearing Tag No.39520 was standing alive in the Ahata/Premises of the complainant at the time of his investigation. No explanation has been given by opposite party No.2 at to why the claim of the complainant has not got investigated
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within the reasonable period. Therefore, opposite party No.2 was not justified in repudiating the claim of the complainant on the basis of such like investigation report prepared after a considerable long period of about one year from the date of death of the insured buffalo and intimation thereof, which is also not based on any valid and cogent reason. Therefore, opposite party No.2 is liable to pay the insurance amount on account of death of the insured buffalo bearing Tag No.39520 along with interest. Copy of Livestock (Cattle) Insurance-Endorsement Schedule Ex.OP-2/9 reveals that 6 cattle of the complainant bearing Tag Nos.39518 to 39523 were insured with opposite party No.2 for Rs.2,60,000/-. Though description of sum insured for per cattle has not been given in the policy as well as by either of the parites, but by dividing the total sum insured of Rs.2,60,000/- by six cattle, sum insured for per cattle comes out to be Rs.43,333/- approximately. The complainant has claimed a sum of Rs.40,000/- as insurance claim on account of death of this buffalo and quantum of insurance claim has not been disputed by opposite party No.2. Therefore, opposite party No.2 is liable to pay a sum of Rs.40,000/- on account of death of insured buffalo bearing Tag No.39520 along with interest.
7. So far as insurance claim in respect second insured buffalo,
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which had died on 12.5.2012, is concerned, opposite party No.2 has specifically denied of having received any intimation regarding death of this buffalo. Denial of having received any intimation regarding death of another cattle also finds mentioned in letter dated 12.11.2013 written by opposite party No.2 to Complaints Cell, Deputy Commissioner Office, Ferozepur, copy of which has been placed on the file as Ex.OP-2/5 by opposite party No.2. In para No.4 of the complaint, the complainant has pleaded that second buffalo died on 12.5.2012 and intimation in this regard was sent to opposite party No.1, but in the concerned para of its written reply on merits, opposite party No.1 has denied that the alleged information was ever given to it. Opposite party No.1 has further pleaded that the complainant was to supply all the required documents directly to opposite party No.2 and opposite party No.2 was to settle the claim of the complainant and opposite party No.1 was only to pay the premium amount to opposite party No.2 and has nothing to do with the work of opposite party No.2. However, a perusal of application dated 12.5.2012 Ex.C-9 reveals beyond any doubt that second buffalo of the complainant had died on 12.5.2012 and intimation in this regard was given by the complainant to opposite party No.1 on the same day, which was duly received by opposite party No.1 on the same day on 12.5.2012, as is apparent from the seal of
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opposite party No.1 appended on the application Ex.C-9 itself. Admittedly, the insured cattle were purchased by the complainant by obtaining loan from opposite party No.1 and these cattle were got insured by opposite party No.1 with opposite party No.2 and premium of the policy was also paid by opposite party No.1 to opposite party No.2 by debiting the same into the account of the complainant, as is evident from photo copy of ledger Ex.OP-1/2. But there is no evidence on the record that intimation regarding death of the second buffalo of the complainant and insurance claim thereof was forwarded by opposite party No.1 to opposite party No.2 for settlement of the claim. Cattle of the complainant, being insured with opposite party No.2 through opposite party No.1, the complainant was to lodge the claim with opposite party No.1 and it was the duty of opposite party No.1 to forward the same, alongwith the documents, to opposite party No.2, but having failed to forward the claim of the complainant in respect of his second buffalo to opposite party No.2, opposite party No.1 has committed deficiency in service, as a result of which the complainant suffered loss of insurance claim on account death of second insured buffalo, as in case of forwarding the claim of death by opposite party No.1 to opposite party No.2, the complainant was to receive the insurance amount. In “The Sangrur Central Cooperative Bank Versus Jasbir Kaur and another”,
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First Appeal No.955 of 2011, decided on 3.7.2014, husband of the complainant was having Savings Bank account in the appellant bank and by virtue of the account holder, he was covered under the scheme “Saving Bank Sehkari Bima Yojna” and as per that scheme, in case of any accidental tragedy/accidental death, a sum of Rs.1,00,000/- was payable. Husband of the complainant died of snake bite. The complainant submitted the claim regarding the death of her husband with the appellant bank and also submitted the requisite documents, but the appellant bank failed to forward the claim application to the insurance company, as a result of which the complainant was deprived of insurance amount. The Hon’ble State Commission, Punjab, Chandigarh, holding the appellant bank deficient in service, dismissed the appeal of the appellant bank and upheld the order of the District Forum directing the appellant bank/opposite party No.1 to pay Rs.1,00,000/- along with interest at the rate of 9% per annum from the date of death of the deceased insured till realization, with Rs.11,000/- as compensation for harassment and mental agony and Rs.5100/- as litigation expenses. In the present case also, the claim of the complainant on account death of second insured buffalo has been declined by opposite party No.2 due to non-submission/forwarding of claim of the complainant by opposite party No.1. Therefore, opposite party No.1 is
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liable to make good the loss of the complainant suffered by him due to non-submission/forwarding of insurance claim of the complainant on account of death of his second insured buffalo by opposite party No.1 to opposite party No.2. The complainant has also claimed a sum of Rs.40,000/- as insurance claim on account of death of his second insured buffalo. A perusal of copy of Claim Form (Cattle) Ex.C-3 reveals that the complainant had raised claim of Rs.40,000/- in respect of buffalo of mixed breed, colour black bearing Tag No.39522. Copy of Post Mortem Report Ex.C-4 reveals that buffalo bearing Tag No.39522 having same description, as has been given in Claim Form Ex.C-3, had died on 12.5.2012. Copy of Livestock Claim Form-cum-Valuation Certificate reveals that valuation of this buffalo was assessed as Rs.40,000/- by the Veterinary Officer, CVH, Mamdot. These documents have not been challenged/rebutted by either of the opposite parties. Moreover, quantum of insurance claim of Rs.40,000/- on account of death of second insured buffalo of the complainant bearing Tag No.39522 has also not been disputed by the opposite parties. Therefore, opposite party No.1 is liable to pay a sum of Rs.40,000/- as insurance claim on account of death of second insured buffalo bearing Tag No.39522 along with interest to the complainant. First insured buffalo of the complainant died on 25.3.2012 and the second insured buffalo of the complainant died on 12.5.2012 and intimation in this regard was also given
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to the opposite parties by the complainant immediately, as discussed above, but repudiation of the claim of the complainant has come to light for the first time with letter dated 15.11.2013 Ex.C-3, written by the office of the Deputy Commissioner, Ferozepur to the complainant that too after making repeated representations in this regard by the complainant to the Deputy Commissioner, Ferozepur vide letter dated 30.9.2013, 11.11.2013 and 16.12.2013, copies of which have placed on the file as Ex.C-5, Ex.C-6 and Ex.C-7, respectively. Letter dated 4.4.2013 does not disclose the final repudiation of the claim of the complainant, which ever otherwise has not been proved to be delivered to the complainant. Therefore, harassment of the complainant also cannot be ruled out. The complainant has to file the present complaint to seek redressal of his grievance by engaging a counsel. Therefore, the opposite parties are also liable to pay suitable compensation for harassment and litigation expenses to the complainant.
8. In view of what has been discussed above, this complaint is accepted and opposite party No.1 is directed to pay a sum of Rs.40,000/- as insurance claim on account of death of insured buffalo bearing Tag No.39522 along with interest at the rate of 9% per annum from 12.5.2012 till realization and opposite party No.2 is directed to pay a sum of Rs.40,000/- as insurance claim on account of death of insured buffalo bearing Tag No.39520 along with interest at the rate of 9% per annum from
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25.3.2012 till realization. Further opposite party Nos.1 and 2 are directed to pay a sum of Rs.5000/- each as compensation for harassment and Rs.3000/- each as litigation expenses to the complainant. This order is directed to be complied with by the opposite parties within a period of thirty days from the date of receipt of a copy of this order. File be consigned to the record room.
Announced
28.1.2015
(Gurpartap Singh Brar) President
(Gyan Singh) Member
