Haryana

Charkhi Dadri

CC/65/2020

Rattan - Complainant(s)

Versus

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

Sh. Satender Sheoran

16 May 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHARKHI DADRI

                              

                                                              Complaint No.: 65 of 2020.

                                                              Date of Institution: 27.07.2020.

                                                               Date of Order: 16.05.2024

 

Rattan son of Tek Chand, through his legal heir, (a.) Rambir S/o Rattan Singh, resident of village Birhi Kalan, Tehsil & District Charkhi Dadri, (b) Anita daughter of Rattan Singh and wife Jagbir, (C)Meena D/o Rattan Singh and wife Vedpal, both residents of village Badesra, Tehsil Meham, District Rohtak.

                                                                   ….Complainant.

                                                                                       

                                      Versus

 

The New India Assurance Co. Ltd. Divisional Office-312700, NH-5/R-2, Badshah Khan Chowk, Faridabad-121001, District Faridabad through its Branch Manager.

 

…...Opposite party.

 

                   COMPLAINT UNDER THE CONSUMER PROTECTION ACT.

 

 

Sitting:        Hon’ble Shri Manjit Singh Naryal, President,

                   Hon’ble Sh. Dharam Pal Rauhilla, Member,

                  

 

Present:       Shri Satender Sheoran, Advocate for complainant.  

Shri Vinod Kumar Chahar, Advocate for the OP.

                  

ORDER

1.                The case of the complainants in brief, is that he was owner of a Murrah Buffalo which was insured from opposite party for a sum of Rs.70,000/- vide cover note No.105398 and  paid the premium amount of Rs.100/- for the period w.e.f. 13.03.2019 to 12.03.2020. It is further alleged that the opposite party inserted an ear tag No.160036536151 in the ear of the insured Buffalo. Unfortunately, the Buffalo of complainant died on 19.03.2019 at about 5:00 AM and Post Mortem was conducted by the Veterinary Surgeon, Govt. Veterinary Hospital, Birhi Kalan. It is further alleged that complainant informed the opposite party regarding death of Insured Buffalo. The insurance company sent surveyor, who took photographs of the dead buffalo as well as tag which was found intact and obtained all necessary information. After completion of formalities, he submitted claim form but no attention was paid by opposite party in the matter even on several visits. It was further averred that learned counsel for the complainant sent a legal notice on 10.06.2019 to the opposite party but opposite party did not reply the same. Till date the opposite party, insurance company has failed to pay the claim amount. The complainant further alleged that due to the act and conduct of the opposite party, he had to suffer mental agony, physical harassment and financial losses. Hence, it amounts to deficiency in service on the part of opposite party and as such, he had to file the present complaint.

2.                Opposite party on appearance filed the contested written statement and contested the claim of the complainant on the sole ground that the claim of the complainant was repudiated as Buffalo died within waiting period of 15 days. So, the insurance claim was rightly repudiated and as such, the complaint of the complainant is liable to be dismissed with costs.

3.                The complainant in support of his case has filed his affidavit Ex.CW-1/A and documents Ex. C1 to Ex.C-7 and closed the evidence on 25.04.2022.

4.                 On the other hand, learned counsel for the OP has tendered affidavit Ex.RW-1/A, RW-2/A and documents Ex.R1 to Ex. R5 and closed the evidence on 07.09.2022.

5.                We have heard the arguments advanced by learned counsel for both the parties. All the documents have been perused very carefully and minutely.

6.                After hearing the learned counsel for both the parties and having gone through the material available on the records, we are of the considered view that the complaint of the complainant deserves acceptance, as there is deficiency in service on the part of the opposite party because the claim of the complainant was wrongly and illegally repudiated on the ground that Buffalo died in the waiting period of 15 days is tenable. It is admitted fact that the Buffalo was insured with the opposite party and the complainant paid Rs.100/- as premium of the insurance value of Rs.70,000/- on 13.03.2019. It is clearly established and admitted as per the evidence placed on record by both the parties that the Buffalo was insured w.e.f. 13.03.2019 and OP issued insurance company for the period from 13.03.2019 to 12.03.2020. Now question arises whether the plea of the opposite party taken for repudiation of claim  that the Buffalo died during the waiting period i.e. 15 days may be accepted or not. In our view the said plea of the opposite party is not tenable. From the perusal of record prior to issuance of insurance policy on 25.03.2019, no instruction or any such document was brought into the notice of complainant at the time of accepting premium from the complainant on 13.03.2019 to prove that as per terms and conditions, the opposite party will be at liberty to repudiate the claim of the complainant on the grounds of waiting period. Moreover, there is no evidence that the complainant had ever been made aware of the terms and conditions regarding 15 days waiting period even after issuance of policy as the policy was not shared with the complainant. The same was submitted by the opposite party to this Commission vide Ex.R5. At that time, OP had handed over to the complainant only HLDB/ NLM (Risk Management/Insurance) Health Certificate No.105398 (Ex.C1) & (Ex.R4) which contains details of insured buffalo, tag number and its insurance from 13.03.2019 to 12.03.2020 and receipt of insurance premium of Rs. 100/- etc. The details of insurance policy i.e. Cattle Insurance Policy” (submitted by the OP vide Ex.R5) was issued on 25.03.2019 (the date mentioned in the policy as receipt date while the premium of insurance premium of Rs. 100/- was paid by the complainant on 13.03.2019 as per health certificate dated 13.03.2019 issued by the OP Ex.C1/Ex.R4) after the death of the buffalo on 19.03.2020. Hence, the question of sharing of the policy and knowing terms and conditions by the complainant does not arise. So, possibility cannot be ruled out that the opposite party had in-cooperated the terms that death due to diseases contacted prior to and within 15 days of commencement of risk, subsequently and the complainant was not made aware of the same knowingly. So, in these circumstances we are of the considered view that the claim of the complainant was wrongly repudiated. As such the complainant has suffered the mental as well as physical agony and financial losses. Hence, it amounts to deficiency in service on the part of opposite party. Therefore, the complaint of the complainant is allowed with costs and the complainant is entitled to the sum insured and opposite party is directed to:-

1. To pay Rs. 70,000/- to the complainant along with interest @ 8% p.a. from the date of repudiation till its final realization.
2. To pay Rs. 5,000/- as compensation towards pain, mental agony.
3. To pay Rs.5,000/- as litigation expenses.

 The above-said amount will be distributed equally amongst legal heirs of Sh. Rattan viz. (a)Rambir S/o Sh. Rattan Singh, resident of village Birhi Kalan, Tehsil & District Charkhi Dadri, (b) Smt. Anita daughter of Sh.Rattan Singh and wife  of Sh. Jagbir, (c) Smt. Meena D/o Rattan Singh and wife of Sh. Vedpal.

7.                The above order be complied within 45 days from the date of this order, failing which further interest @12% will be paid by the OP for the delayed period.  Certified copies of the order be sent to the parties free of costs.  File be consigned to the record room, after due compliance.