BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, JIND.
Complaint Case No. : 292 of 2020
Date of Institution : 23.07.2020
Date of Decision : 28.10.2022
Gurvinder Singh S/o Sh. Karan Singh R/o H.No.476/26, Ram Nagar, Rohtak Road, Jind Tehsil and District Jind.
.….Complainant
Versus
The New India Assurance Company Ltd. Jind Branch through its Branch Manager.
……Opposite Party
Complaint under Section 12 of the Consumer Protection Act, 1986.
CORAM: SH. A.K. SARDANA, PRESIDENT.
SMT. NEERU AGARWAL, MEMBER.
SH. G.D. GOYAL, MEMBER.
Present: Sh. Satyawan Singh, Adv. counsel for complainant.
Sh. Satish Bhardwaj, Adv. counsel for Opposite Party.
ORDER:
Shorn off unnecessary details, complainant got insured his buffalo with OP insurance Co. vide policy No.31270047180400000072 effective from 18.01.2019 to 17.01.2020 by paying premium of Rs.984/- for a sum of Rs.66,000/- and aforesaid policy was issued by OP after due health check up of the buffalo vide Tag No.160049307740. On 18.09.2019, said buffalo suddenly fell ill, so veterinary Surgeon called for treatment but buffalo could not be saved and died on 25.09.2019 at 5.45 p.m. Post Mortem of the buffalo was conducted on 26.09.2019 vide PMR no.7072 wherein value of dead buffalo was assessed at Rs. 80,000/- by the then Veterinary Surgeon, Jind. So, complainant submitted death claim of the buffalo with the OP but the same was repudiated vide letter dated 23.11.2019 alleging therein that Tag Number of dead buffalo does not match with Tag number mentioned in the PMR. Upon which, complainant visited the concerned Veterinary Surgeon who issued certificate on 31.01.2020 clarifying that due to inadvertent error Tag number in the PMR was wrongly mentioned by him as 160043907740 instead of actual Tag No.160049307740. Thereafter, complainant visited the OP Company for re-considering his claim but of no avail. As such, complainant has submitted that Op has illegally repudiated the claim of complainant which amounts to deficiency in service on the part of OP. Hence, the present complaint has been preferred by complainant seeking claim of insured amount of Rs.66,000/- alongwith interest @ 18% per annum from the date of death of buffalo to till payment and a sum of Rs.50,000/- on account of mental and physical harassment etc.
2. Upon notice, OP appeared through counsel and tendered reply raising preliminary objections qua neither cause of action nor locus standi rather suppression of material facts by the complainant and there is no deficiency in service on the part of OP. On merits, OP submitted that the buffalo in question was insured with it for the relevant period under Tag No.160049307740 subject to all terms and conditions of the policy but urged that as per PMR, tag number of dead buffalo is 160043907740 whereas as per policy, tag number of the buffalo of complainant is 160049307740 against a sum insured of Rs.66,000/-. OP has submitted that survey with regard to death of the buffalo of complainant was got conducted through Independent and Govt. approved Surveyor M/s Mittal Insurance Surveyor & Loss Assessor, who took photos of the dead buffalo and discussed the matter at length with villagers in the presence of insured and submitted his report dated 26.10.2019 which was duly considered by OP and found that tag number of insured buffalo do not match with the deceased buffalo and therefore, claim of complainant was repudiated vide letter dated 23.11.2019. As such, the OP submitted that there is no deficiency in service on their part and prayed for dismissal of complaint with costs.
3. To prove contention of the complainant, learned counsel for complainant tendered into evidence affidavit of complainant as Annexure CW1/A alongwith documents as Annexures C-1 to Annexures C-10 and closed his evidence. On the other side, learned counsel for OP tendered into evidence affidavit of Sh. G.C. Bhutani, Sr. Divisional Manager and Sh. Amit Mittal, Insurance Surveyor as Annexures OPW1/A & OPW1/B alongwith documents as Annexures OP-1 to Annexures OP-11 and closed the evidence on behalf of OP-insurance company.
4. We have heard learned counsel for the parties to complaint and evaluated the documents/evidence placed on file by both the parties.
5. Learned counsel for complainant has contended that during the insurance policy period, on 25.09.2019, buffalo of complainant died and while mentioning details in the PMR by Veterinary Surgeon, Tag number of the buffalo was wrongly mentioned as 160043907740 instead of 160049307740 which is an inadvertent mistake. OP insurance company on this ground repudiated the claim vide letter dated 23.11.2019 though concerned veterinary surgeon has also issued a certificate in this regard clarifying that the buffalo of complainant died on 25.09.2019, was bearing Tag No.160049307740 but by mistake it was written as 160043907740 in PMR which is a human error but inspite of that OP insurance company did not release the insurance claim to complainant which is admittedly a deficiency in service on the part of OP insurance company and prayed for accepting the complainant as well mentioned in prayer para of the complaint.
On the other side, learned counsel for Op has urged that while considering the claim of complainant, it was found that tag number of dead buffalo is 160043907740 whereas tag number of the buffalo of complainant as per insurance policy is 160049307740, so under the terms and conditions of the insurance policy, claim of complainant was rightly repudiated. The counsel further argued for dismissal of complaint with costs.
6. After hearing learned counsels of both the parties and perusing the record placed on file, it is admitted fact on record that the buffalo of complainant died during the period of insurance cover and was having insured value of Rs.66,000/-. But the OP insurance company rejected the claim of complainant vide letter dated 23.11.2019 (Annexure OP-1) on the ground that ‘Tag number of buffalo in question does not match with the Tag No. as mentioned in PMR report’ It is also not in dispute that in PMR report (Annexure OP-6), Tag number of the buffalo as mentioned by veterinary surgeon is 160043907740 whereas in the insurance policy (Annexure OP-10) Tag number of the buffalo is 160049307740 which is an inadvertent mistake in the record and the Veterinary Surgeon Sh. Balwant Singh who conducted the Post Mortem vide his certificate dated 31.01.2020 (Annexure C-9) clarified that the buffalo of complainant-Gurvinder Singh died on 25.09.2019 was having Tag number 160049307740 whereas by mistake it was written as 160043907740 and the said contention of Dr.Balwant Singh Veterinary Surgeon qua inadvertent mistake is also proved from the minutely perusal of Live Stock Claim Form (Annexure OP-5) duly submitted by complainant Gurvinder Singh to OP insurance company whereupon aforesaid Veterinary Surgeon Dr. Balwant Singh has duly certified in Clause (e) as well as in description of animal of ‘DEATH CERTIFICATE’ that buffalo of complainant Gurvinder Singh died on 25.09.2019 at 5.45 P.M. was bearing Tag No.160049307740. So in these circumstances, it emerges that Tag number of the buffalo in question was inadvertently mentioned wrong in PMR whereas other contents viz. owner of buffalo, date of death and other identification of the buffalo are correct and not objectionable to the OP insurance company. Apart from this, the insurance surveyor and loss assessor who investigated the aforesaid buffalo claim case of complainant and enquired from the villagers of the complainant by recording their statements (Annexure OP8 & OP9) wherein they also confirmed the death of buffalo bearing tag no.160049307740 and submitted his report (Annexure OP-2) by giving observation that ‘The claim is genuine and can be considered for the insurance claim.’
7. In view of the detailed facts discussed above, we are of the confirmed view that the OP insurance company has arbitrarily and illegally repudiated the genuine claim of complainant even ignoring the observation of their surveyor that claim of complainant is genuine and can be considered for the insurance claim. Accordingly, we have no hesitation in holding that the OP insurance company is negligent and deficient in providing proper services to the complainant which must have caused monetary loss, mental agony and physical harassment to him. Therefore, the complaint is allowed and OP is directed to comply with the following directions within thirty days from the date of communication of this order:-
- To pay a sum of Rs.66,000/- (Rs.Sixty six thousand only) to complainant alongwith simple interest @ 9% per annum from the date of institution of complaint to till date.
- To pay a sum of Rs.10,000/- (Rs. Ten Thousand only) as compensation on account of mental agony and harassment etc.
- Also to pay Rs. 5500/- (Rs. Five thousand five hundred only) as litigation expenses including counsel’s fee.
Further the directions issued above must be complied with by the OP within the stipulated period failing which all the awarded amounts mentioned at (i) to (iii) above shall further attract simple interest @ 12% per annum for the period of default. Copies of this order be supplied to the parties concerned, as per rules. File be consigned to the record room after due compliance.
Announced on: (A.K. SARDANA) PRESIDENT
(Neeru Agarwal)
Member
(G.D. Goyal) Member
Complaint Case No. : 292 of 2020
Present: Sh. Satyawan Singhroha, Adv. counsel for complainant.
Sh. Satish Bhardwaj, Adv. counsel for OP.
Arguments concluded. Vide our separate order of even date, the present complaint is allowed. File after due compliance be consigned to record room.
Dated: Member Member President
DCDRC, Jind.
