Haryana

Karnal

CC/432/2021

Mahavir - Complainant(s)

Versus

The New India Assurance Company Limited - Opp.Party(s)

Amrit Bissyer

05 Mar 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 432 of 2021

                                                        Date of instt.25.08.2021

                                                        Date of Decision:05.03.2024

 

Mahavir son of Shri Gayasan, resident of village Jani, District Karnal.

 

                                               …….Complainant.

                                              Versus

 

The New India Assurance Company Ltd., through its Divisional Manager, Divisional Office, Karnal.

                                                                      …..Opposite Party.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr.  Suman Singh…..Member

 

 Argued by: None for complainant.

                    Shri S.K. Patlan, counsel for the OP.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OP’) on the averments that complainant got his buffalo insured with the OP on 17.09.2020, vide policy no.31270047202700053398 against the tag no.102175/596928, valid for the period from 17.09.2020 to 16.09.2021. The said buffalo had died on 28.09.2020 regarding which an intimation was given to the OP. The postmortem was got conducted of the deceased buffalo by the Veterinary Surgeon I/c Government Veterinary Hospital Jundla, District Karnal. The complainant has submitted his claim form dated 27.09.2020 alongwith all the requisite documents including tag, some photographs of the dead buffalo, but till today, official of the OP neither passed the claim. At the time of death of buffalo, the buffalo was providing 10 ltrs milk. The complainant has suffered a great financial loss on account of death of his buffalo since the value of the said buffalo has been assessed as Rs.80,000/-. Complainant was earning his livelihood by selling the milk of said buffalo. Complainant visited the office of OP so many times and requested to settle the claim of complainant but OP did not pay any heed to the request of complainant and lingered the matter on one pretext or the other and lastly repudiated the claim of complainant on the false and frivolous ground. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version, raising preliminary objections with regard to maintainability; jurisdiction; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant has rightly been repudiated by the OP because the buffalo of the complainant has died just 10 days after getting insurance policy, which is not covered under the terms and conditions of the insurance policy. In the policy issued to the complainant, it is specifically mentioned that death due to disease contracted prior to and within 15 days of commencement of risk is not payable. Hence, in view of the abovesaid specific conditions of insurance policy, the claim of the complainant has been repudiated by the OP, vide letter dated 16.11.2020. It is further pleaded that complainant by concealing the true facts about the health of his buffalo got the same insured from the OP in order to extract money from the OP. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A and closed the evidence on 28.02.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence copy of letter dated 03.10.2021 Ex.OP1, copy of repudiation letter dated 16.11.2021 Ex.OP2, copy of detail of animal policy Ex.OP3, copy of insurance policy Ex.OP4, copy of investigation report of Shri S.K.Aggarwal Ex.OP5 and closed the evidence on 25.08.2023 by suffering separate statement.

6.             We have heard the learned counsel for the OP and have also gone through the evidence led by the parties.

7.             It is pertinent to mention here that neither today nor on the last adjourned three dates no one has put into appearance on behalf of complainant. The complaint pertains to the year 2021. Hence, complaint is to be decided on merits.

8.             Learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that the claim of the complainant has been duly processed and the same has been repudiated being not payable on the ground that the insured cattle has been died within 15 days of the commencement of the policy, which risk is not covered/payable under the policy terms and conditions and prayed for dismissal of the complaint.

9.             The claim of the complainant has been repudiated by the OP, vide letter Ex.OP2 dated 16.11.2020 on the ground that the insured cattle has been died within 15 days from the commencement of the policy.

10.           The onus to prove its version was relied upon the OP. To prove its version, OP has relied upon the insurance policy Ex.OP4.  As per terms and conditions of the insurance policy ‘the death due to disease contracted prior to and within 15 days of commencement of risk is not payable’. As per post mortem report the buffalo has expired on 27.09.2020. The date of commencement of the policy is 17.09.2020 to 16.09.2021. The buffalo has died within ten days from the commencement of policy and as per the specific condition of the policy, the risk is not payable. Thus, in view of the above, complainant is not entitled for the claim on account of death of insured buffalo.

 11.          Thus, as a sequel to abovesaid discussion, the present complaint is devoid of merit and same deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Dated:05.03.2024

                                                                       

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

                (Vineet Kaushik)        (Dr. Suman Singh)    

Member                       Member