Punjab

Moga

CC/17/52

Jaswant Singh - Complainant(s)

Versus

The Manager, Universal Sompo Gen. Ins. Co. - Opp.Party(s)

Miss Divya Rani

15 Nov 2017

ORDER

THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.

 

 

                                                                                      CC No. 52 of 2017

                                                                                      Instituted on: 19.05.2017

                                                                                      Decided on: 15.11.2017

 

Jaswant Singh son of Avtar Singh resident of village Noorpur Hakiaman, Tehsil Dharamkot, District Moga.

                                                                                ……… Complainant

 

Versus

1.       The Manager, Universal Sompo General Insurance Company Ltd. Branch Office at 5^th Floor, SCO 10-11, Feroze Gandhi Market, Ludhiana (Fax no.0161 4381761 & Mobile no.84688-69272.

 

2.       The Branch Manager, Universal Sompo General Insurance Company Ltd. Branch office at SCO no.9, Sector 10, Panchkula, Haryana.  

 

                                                                           ……….. Opposite Parties

 

 

Complaint U/s 12 of the Consumer Protection Act, 1986.

 

 

Quorum:    Sh. Ajit Aggarwal,  President

                   Smt. Vinod Bala, Member

                   Smt. Bhupinder Kaur, Member

 

Present:       Ms. Divya Rani, Advocate Cl. for complainant.

                   Sh. Jasvinder Singh, Advocate Cl. for opposite parties.

 

 

ORDER :

(Per Ajit Aggarwal,  President)

 

1.                Complainant has filed the instant complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as the "Act") against The Manager, Universal Sompo General Insurance Company Ltd. Branch Office at 5^th Floor, SCO 10-11, Feroze Gandhi Market, Ludhiana and others (hereinafter referred to as the opposite parties) directing them to pay Rs.50,000/- in respect of cow covered under Insurance policy no.3016/55899854/00/000 valid from 21.02.2016 to 20.02.2017. Further they be directed to pay Rs.1,50,000/- as compensation for causing illegal harassment, as well as mental tension, agony to complainant alongwith interest @ 2% p.m. from the date of death of cow till actual realization or any other appropriate relief, which this Forum may deems fit and proper be awarded to the complainant.

2.                Briefly stated the facts of the case are that the Universal Sompo General Insurance Co. is having its registered office at Unit no.401, 4^th Floor Sangam Complex Andheri Kurla Road, Andheri (East) Mumbai and having joint venture with various financial institutions and deals in insurance of cattle & Live Stock. The complainant approached the Allahabad Bank at Moga for the grant of loan for dairy purposes i.e. for the purchase of cows, construction of shed and purchase of machinery which was sanctioned and granted to the complainant for dairy farming purposes. The complainant purchased cows, constructed cattle shed and installed machinery for the said purposes. The complainant is having approximately 90 cows in his cattle shed. The opposite parties have joint venture with Allahabad Bank, Moga from whom the complainant has borrowed the loan for Diary farm purposes. Eighteen cows of the complainant were insured by opposite parties, vide policy no.3016/55899854/00/000 valid from 21.02.2016 to 20.02.2017. The complainant paid premium of Rs.36,068/- through cheque to opposite parties. The opposite parties duly issued receipt of said amount to complainant. Out of the insured cows of the complainant, unfortunately one cow bearing Tag no.600252 died on 25.06.2016. The complainant immediately approached to opposite parties and informed regarding the death of said cow and submitted his claim accordingly. The claim of the complainant was registered with opposite parties vide CL no.16026503. On 25.06.2016, surveyor of opposite parties visited the cattle shed of complainant and inspected and verified all the facts relating to the death of insured cow. After proper verification and spot inspection, the surveyor submitted his report to opposite parties. The complainant was directed by opposite parties to complete various formalities, so as per directions of opposite parties the complainant completed all the requisite formalities and also submitted proof relating to the death of cow. The opposite parties assured the complainant that insured amount of Rs.50,000/- will be made within few days. After that the complainant visited the office of opposite parties a number of times and requested them to pay the insured amount of cow, but they put off the matter on one pretext or the other. The complainant also filed various applications on the same subject matter, but all in vain. On 06.04.2017, the complainant again moved an application-cum-notice to opposite parties for payment of the insurance claim, but to no effect. Thereafter the opposite parties flatly refused to pay the claim amount to complainant without defining any reason. This act of opposite parties amounts to deficiency in service. Due to the aforesaid acts of opposite parties, the complainant has suffered mental tension, agony and harassment and he has to spend sufficient amount for the completions of requisite formalities for insurance claim. Hence this complaint.

3.                Upon notice, opposite parties appeared through counsel and filed written reply submitting that the present complaint and other relief is not maintainable either in law or on the facts; that at the outset, it is submitted that unless specifically admitted by answering opposite parties in the instant reply, each and every averment made by the complainant in the statement of claim or complaint is specifically denied. No such averment may be deemed admitted by reason of specific non-traverse; that this Forum has got no jurisdiction to entertain the case, which is not maintainable in law being illegal, frivolous against the weight of record and fabricated with distorted facts. Further submitted that the complainant has not submitted any document or information to opposite parties and not deposited any receipt in support of his version. It is admitted that the company issued policy no.3016/55899854/00/000 for the period 21.02.2016 to 20.02.2017 under Cattle and Live Stock Policy Package policy Schedule subject to certain terms, conditions, exceptions and limitations of policy. They submitted that the cheque submitted by complainant bearing no.003012 of Allahabad Bank, Moga was not encashed. As per bank statement of the complainant it has not revealed that the said cheque has been encashed. It is true that loss of cattle was occurred. But the complainant intimated and registered the claim two days later i.e. on 27.02.2017. After information of loss company appointed Auto Investigator who submitted his report after inspection of the spot. The opposite parties directed the complainant to complete various formalities. There is no deficiency in service and unfair trade practice on the part of opposite parties. The opposite parties sent a repudiation letter dated 14.04.2017 and explained the reason or ground of repudiation is that “This policy Null and Void ab initio, if the cheque/any valid negotiable instrument as receipted by this company via this receipt is dishonoured by the bank. Issuance of the receipt is not a proof of risk acceptance.” All other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with costs has been made.

4.                In order to prove the case, complainant tendered in evidence his duly sworn affidavit as Ex. C-1 and copies of documents Ex.C-2 to Ex.C-4 and closed the evidence. 

5.                On the other hand, opposite parties tendered in evidence duly sworn affidavit of Sh.Ashwani Gaba, Head Claims as Ex.OPs-1and copies of documents Ex.OPs-2 & Ex.OPs-3 and closed the evidence.

6.                We have heard ld. counsel for the parties and have very carefully gone through record placed on file.

7.                The case of the complainant is that he is a farmer and with the financial help of Allahabad Bank, he started Dairy Farming business and purchased cows, constructed cattle shed and installed machinery for the said purposes by raising loan from Allahabad Bank. The Allahabad Bank has tie up with opposite party insurance company. The complainant got insured his 18 cows from opposite parties for the period 21.02.2016 to 20.02.2017 and paid premium of Rs.36,068/-, through cheque no.003012 of Allahabad Bank, Moga. The opposite parties duly issued receipt of said amount to complainant and issued insurance policy. On 25.06.2016 out of insured cows one cow bearing tag no.600252 died. The complainant immediately gave intimation regarding the death of cow to opposite parties, who registered his claim. On 25.06.2016, surveyor of opposite parties visited the cattle shed of complainant and inspected and verified the facts relating to death of insured cow. After proper verification and spot inspection the surveyor submitted his report to opposite parties. The complainant fulfilled all the formalities and submitted all the required documents as directed by opposite parties for the processing of his claim. The opposite parties assured the complainant that the insurance amount of Rs.50,000/- will be paid within few days, but they failed to pay this amount despite several visits of complainant. The complainant filed various applications and made requests to opposite parties for the payment of his claim, but all in vain. Now, the opposite parties flatly refused to pay the claim amount, which amounts to deficiency in service and trade mal practice on their part.

8.                On the other hand, counsel for opposite parties argued that the present complaint is not maintainable. It is admitted that opposite parties issued insurance policy securing eighteen cows of the complainant as alleged by him, subject to terms, conditions, exceptions and limitations of policy. It is further admitted that the complainant submitted cheque bearing no.003012 amounting to Rs.36,068/- of Allahabad Bank, Moga as premium of policy. The opposite parties argued that the said cheque was not encashed. They further admitted that the complainant lodged the claim regarding the death of cow and his claim was registered. It is further admitted that opposite parties appointed investigator for the inspection and spot verification, who submitted his report. It is further admitted that the complainant completed all the formalities as per the directions of opposite parties for the processing of his claim. The opposite parties argued that there is no deficiency in service and trade mal practice on their part. The opposite parties repudiated the claim of the complainant vide letter dated 14.04.2017, as the cheque issued by the complainant for the premium of the policy in question was not encashed. So, as per terms and conditions, the policy was null and void ab initio. They submitted that the as per policy if the cheque/any valid negotiable instrument as receipted by the company via the receipt is dishonoured by the bank. Issuance of the receipt is not a proof of risk acceptance. They argued that as the cheque issued by complainant as premium was not encashed. So, the policy in question was treated as void ab initio. So, they rightly repudiated the claim of the complainant and the present complaint deserves dismissal.

9.                Now, it is admitted case of the parties that the complainant purchased the insurance policy from opposite parties and got insured his cows and paid requisite premium, through cheque to opposite parties and opposite parties issued receipt regarding it and also issued policy schedule. It is further admitted that out of the insured cows, one cow died during the insurance period and complainant informed the opposite parties regarding the said incident, who appointed investigator to inspect and spot verification, who submitted his report to opposite parties. It is further admitted that the complainant fulfilled all the necessary formalities for the processing of the claim. The only reason given by opposite parties for non payment of the claim amount is that the cheque issued by the complainant towards the premium of the policy was not encashed. As such the policy in question was void ab initio. To prove his case the complainant produced on record copy of policy schedule Ex.C-2 vide which the cattle regarding whom the death claim was filed is duly insured. He also produced copy of receipt regarding the payment of premium amount made through cheque no.003012 of Allahabad Bank, Moga as Ex.C3. The version of opposite parties is that cheque issued by the complainant as premium was not encashed and the policy became void ab initio. There is no case of opposite parties that they ever presented the cheque in question for encashment with the bank and bank dis-honoured the cheque due to insufficient fund or any other reason. They admitted that they received the cheque from the complainant towards the premium, then it was the duty of officials of opposite parties to present the cheque for encashment with bank in time, if he did not present the cheque for encashment and kept it with them, then it is only negligent and fault on the part of opposite parties themselves. There is no case of opposite parties that they ever informed the complainant regarding the non encashment of the cheque or regarding the cancellation of policy. On the other hand, complainant produced on record copy of statement of account of his bank, which proves that there was sufficient fund in his account to honour the cheque. He also produced the certificate issued by Manager of Allahabad Bank Branch Moga, whereas he certified that the cheque no.003012 never presented for encashment with bank, which clearly proves that there is gross negligence and fault on the part of opposite parties for non presentation of cheque for encashment and they kept it with them. Now, in case where it is only the fault and negligence on the part of opposite parties, then in that case they cannot make responsible for the same to complainant. They cannot cancel the policy unilaterarily without any notice to complainant due to their own fault for non-presenting the cheque for encashment and cannot escape from their liability to pay the genuine death claim of the insured cow of the complainant.

10.              From the above discussion, we are of the considered opinion that the opposite parties wrongly and illegally repudiated the claim of the complainant, which amounts to deficiency in service and trade mal practice on the part of opposite parties. Hence the present complaint stands allowed and they are directed to pay Rs.50,000/- as insured value of the death claim of the insured cow of the complainant alongwith interest @ 9% per annum from 25.06.2016 i.e. from the date of death of insured cow till realization. Further opposite parties are directed to pay Rs.5000/-(Five thousand only) to complainant consolidated as compensation on account of mental tension, agony and harassment suffered by him as well as litigation expenses. Compliance of the order be made within 30 days from the receipt of the copy of the order, failing which, the complainant shall be entitled to initiate proceedings under section 25 & 27 of the Consumer Protection Act. Copy of the order be sent to the parties, free of costs. File be consigned to record room.

Announced in Open Forum

Dated: 15.11.2017

 

                               (Bhupinder Kaur)                   (Vinod Bala)        (Ajit Aggarwal)

                                     Member                               Member                  President