Order dictated by:

Sh.Anoop Sharma, Presiding Member

1.       Sh.Rajwinder Singh has brought the instant complaint under section 12 & 13 of the Consumer Protection Act, 1986 on the allegations that  he purchased the cattle with loan amount from Opposite Party No.2 and the bank got cattle insurance policy for the buffaloes bearing Policy No. 36050247120400000327 w.e.f. 6.3.2013 to 5.3.2016 and used to make the regular premium for  renewal each and every year, hence the complainant became the consumer qua the Opposite Parties as the complainant got the aforesaid policy for his own benefit. The complainant paid the requisite amount towards premium to the Opposite Party in this respect. On 27.12.2014, a buffalo of the complainant died and he immediately informed Opposite Party No.2 as the insurance was got done by Opposite Party No.2 at the time of loan. The post mortem was conducted on the dead body of the insured animal and as per the post mortem the animal died due to acute tympanitis. Health certificate is also enclosed. Thereafter, the complainant lodged the claim with Opposite Party No.2 and also informed the Opposite Party No.1 with the signatures of the Sarpanch and others, but the Opposite Party refused to make the genuine claim of the complainant stating that the complainant should provide the ear tags, but on providing the ear tags, it was revealed that the person who ear tagged the animals tagged the buffaloes wrongly and the ear tag given to the present complainant belonged to some other person namely of the same village.  Vide instant complaint, the complainant has sought the following reliefs.

a)       Opposite Party may be directed to reimburse the cost of buffalo to the tune of Rs.50,000/-.

b)      Opposite Party be directed to pay compensation of Rs.40,000/- on account of harassment, mental tension and agony suffered by the complainant at the hands of the Opposite Parties.

c)       Opposite Parties be directed to pay Rs.10,000/- being the costs of litigation. 

Hence, this complaint.

2.       Upon notice, Opposite Party No.1 appeared and contested the complaint by filing  written statement taking preliminary objections therein inter alia that in the present case the claim has already been rejected as no claim vide rejection letter informing that the claim is not entertain able by the  insurance company and as such, the same is rejected as no claim. The said letter was addressed to Opposite Party No.2 through whom the insurances of the animal was done and intimation was submitted by Opposite Party No.2. While sending the said letter it was clearly mentioned as under:-

a)       The cattle was died on 27.12.2014 while the information to the insurance office was received on 12.1.2015 i.e. after the gap of about 16 days from the death of animal. The terms and conditions of the policy stipulates immediate intimation of loss to the office. Thus by intimating the death of cattle after a gap of 16 days, the complainant has violated the terms of the policy, but deprived them to legitimate their right to investigate the case.

b)      Vide letter reference dated 17.2.2015, the complainant was informed that ear tag is lost. In the absence of ear tag, it is not possible to establish the identity of the dead cattle. Moreover, the policy terms and conditions loudly speaks ‘no tag no claim’.

c)       the veterinary doctor also did not give any reference of ear tag which  is mandatory for identification of the dead cattle.

d)      The complainant has failed to provide them the policy particulars.

As the claim has already been rejected on merits, therefore, there is no question of any deficiency in service on the part of the answering Opposite Party.  On merits, the Opposite Party No.1 took almost same and similar pleas as taken by them in the preliminary objections.        Remaining facts mentioned in the complaint are also denied and a prayer for dismissal of the complaint with cost was made.

3.       Opposite Party No.2 in its separate written reply contested the complaint by filing  written statement taking preliminary objections therein inter alia that the answering Opposite Party bank has acted as prudent banker as the bank has forwarded the intimation regarding death of buffalo on the same date of receiving the information i.e. on 5.1.2015. The ear tags of the animal were to be tagged by the insurance company and replying Opposite Party bank has no concern with the ear tag. Remaining facts mentioned in the complaint are also denied and a prayer for dismissal of the complaint against answering Opposite Party  with cost was made.

4.       In his bid  to prove the case, complainant tendered into evidence  affidavit Ex.C-1 in support of the allegations made in the complaint and also produced copies of documents Ex.C2   to Ex.C 8  and closed his evidence.

5.       On the other hand, to rebut the evidence of the complainant, the Opposite Party No.1 tendered into evidence the affidavit of Sh.Sunil Mahajan, Senior Divisional Manager Ex.OP1/1 alongwith copies of documents Ex. Ex.OP1/2 to Ex.OP1/6 and closed the evidence on behalf of the Opposite Party.  Similarly, Opposite Party No.2 also tendered into evidence the affidavit of Sh.Mohinder Pal Manager Ex.OP2/1 alongwith copies of documents Ex.OP2/2 to Ex.OP2/3 and closed the evidence on behalf of Opposite Party No.2 Bank.

6.       We have heard the ld.counsel for the parties and have carefully gone through the evidence on record and also perused the written submissions produced by the parties on record .

7.       Ld.counsel for the Opposite Party No.1 has vehemently contended that  in the present case the claim has already been rejected as ‘no claim’ vide rejection letter informing that the claim is not entertain able by the  insurance company and as such, the same is rejected as no claim. The said letter was addressed to Opposite Party No.2 through whom the insurances of the animal was done and intimation was submitted by Opposite Party No.2. While sending the said letter it was clearly mentioned that the cattle was died on 27.12.2014 while the information to the insurance office was received on 12.1.2015 i.e. after the gap of about 16 days from the death of animal. The terms and conditions of the policy stipulates immediate intimation of loss to the office. Thus by intimating the death of cattle after a gap of 16 days, the complainant has violated the terms of the policy, but deprived them to legitimate their right to investigate the case.  It was further argued that vide letter reference dated 17.2.2015, the complainant was informed that ear tag is lost. In the absence of ear tag, it is not possible to establish the identity of the dead cattle. Moreover, the policy terms and conditions loudly speaks ‘no tag no claim’. Furthermore, the veterinary doctor also did not give any reference of ear tag which  is mandatory for identification of the dead cattle.  But however, the complainant has failed to provide them the policy particulars.

8.       But however, the contentions of the complainant are that he purchased the cattle with loan amount from Opposite Party No.2 and the bank got cattle insurance policy for the buffaloes bearing Policy No. 36050247120400000327 w.e.f. 6.3.2013 to 5.3.2016 and used to make the regular premium for  renewal each and every year, hence the complainant became the consumer qua the Opposite Parties as the complainant got the aforesaid policy for his own benefit. The complainant paid the requisite amount towards premium to the Opposite Party in this respect. On 27.12.2014, a buffalo of the complainant died and he immediately informed Opposite Party No.2 as the insurance was got done by Opposite Party No.2 at the time of loan. The post mortem was conducted on the dead body of the insured animal and as per the post mortem the animal died due to acute tympanitis. Health certificate is also enclosed. Thereafter, the complainant lodged the claim with Opposite Party No.2 and also informed the Opposite Party No.1 with the signatures of the Sarpanch and others, but the Opposite Party refused to make the genuine claim of the complainant on the false and frivolous grounds.

9.       We have heard the rival contentions and perused the material on record.  It is undisputed that the animal was insured when it was died on 27.12.2014 during the currency of the insurance. The main contention of the Opposite Party No.1 is that by intimating the death of cattle after a gap of 16 days, the complainant has violated the terms of the policy and deprived the insurance company to legitimate their right to investigate the case.  It was further argued that vide letter reference dated 17.2.2015, the complainant was informed that ear tag is lost. In the absence of ear tag, it is not possible to establish the identity of the dead cattle. Moreover, the policy terms and conditions loudly speaks ‘no tag no claim’. Hon’ble Haryana State Commission, in 2013 (1) CLT titled as Oriental Insurance Company Vs. Mahabir Singh has held that insured buffalo died due to fall in pond-insurance repudiated claim on the ground that the deceased buffalo was not having tag in the ear which was inserted at the time of issuing the insurance policy. Plea taken by the insurance that the identity of the deceased insured buffalo was doubtful, is not sustainable in the eyes of law. The PMR prepared by Veterinary Surgeon and certificate issued by the Sarpanch of the village with respect to the identity of the deceased buffalo cannot be discarded. Moreover, the non existence of the tag in the ear of the buffalo is hardly significant because the tag had fallen in the pond wherein the buffalo had fallen and died. Thus the only issue for determination in this complaint is whether or not despite of violation of terms and conditions of the insurance policy, the complainant  is entitled to his claim on non – standard basis.   Hon’ble National Commission in the matter of United India Insurance Co. Ltd. Vs. Gian Singh (2006) 2 CPJ 83 (NC) while confronted with the above noted controversy has held that in the case of violation of condition of policy, the claim ought to be settled on non – standard basis.  While coming to the aforesaid opinion, National Commission has relied upon the judgment of the Supreme Court in the matter of National Insurance  Co. Ltd. Vs. Nitin Khandelwal (2008) 11 SCC 259.

10.      The question for determination in this complaint  is whether despite of aforesaid violation, the complainant is entitled to insurance claim on non standard basis?

11.       The above issue is no more resintegra.  Similar question came up for consideration before the National Commission in the matter  of United India Insurance Company Limited Vs. Gian Singh (2006) 2 CPJ 83 (NC) wherein it has been held that in case violation of conditions of the policy, the claim ought to be settled on a non-standard basis.

13.       The question whether the insurance company is justified in repudiating the claim of the insured for violation of the terms and conditions of the insurance policy before the Hon’ble Supreme Court in the matter of  National Insurance Company Limited Vs.  Nitin Khandelwal (2008) 11 SCC 259. 

12.     Hence,  Keeping in view the facts and circumstances of the case, the complainant is entitled to the  claim of his insured animal upto the extent of Rs.37,500/- i.e 75 % of the insured amount of Rs.50,000/-, on non standard basis  from Opposite Party No.1-Insurance Company. Opposite Party No.1 is also directed to pay Rs.5,000/- to the complainant  on  account of compensation for causing mental tension and harassment besides Rs.1,000/- as costs of litigation. Compliance of this order be made within 30 days from the receipt of copy of the order; failing which, awarded amount shall carry interest @ 9% p.a from the date of passing of order until full and final recovery. Complaint against Opposite Party No.2-Bank strands dismissed. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.

Announced in Open Forum

Dated: 24.01.2017.