Haryana

Charkhi Dadri

cc/76/2020

Ram Singh - Complainant(s)

Versus

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

Sh. Dinesh Bhardwaj

18 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHARKHI DADRI

                              

                                                              Complaint No.: 76 of 2020.

                                                                             Date of Institution: 10.11.2020.

                                                                             Date of Order: 18.07.2024

 

Ram Singh S/o Sh. Ram Swarup r/o Village Dohka Hariya, Block Badhra, District charkhi Dadri

                                                                                    ….Complainant.

                                                                                                             

                                                Versus

 

The New India Assurance Company Ltd.  Branch Office Charkhi Dadri through Branch Manager.

 

…...Opposite party.

 

                        COMPLAINT UNDER THE CONSUMER PROTECTION ACT.

 

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

                        Hon’ble Sh. Dharam Pal Rauhilla, Member,

                       

Present:          Shri Dinesh Bhardwaj, Advocate for complainant.  

Shri Vinod Kumar Chahar, Advocate for the OP.

                       

ORDER

                        The case of the complainant in brief, is that he was owner of two Murrah Buffalos which were insured from opposite party for a sum of Rs.80,000/-each  vide cover note No.165842 and  paid the premium amount of Rs.200/- for both for insurance for which policy for the period w.e.f. 27.12.2019 to 26.12.2020 vide insurance policy No. 31270047190400000503 was issued by the OP. It is further alleged that the opposite party put an ear tag No.160037925766 & 160037925447 in the ears of the insured Buffalos. Unfortunately the Buffalo of complainant having ear tag No.160037925766 died on 27.12.2019 and Post Mortem of it was conducted by the Veterinary Surgeon, Govt. Veterinary Hospital, Chhapar, Charkhi Dadri. It is further alleged that complainant informed the opposite party regarding death of Insured Buffalo. After completion of formalities, he had submitted claim form but no attention was given by opposite party in the matter even on several visits. It was further averred that learned counsel for the complainant sent a legal notice to the opposite party but opposite party did not reply the same. Till date the opposite party company has failed to pay the claim amount. The complainant further alleged that due to the act and conduct of the opposite party company, 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  vide OP’s letter dated 10.02.2020 stating that  claim is not payable in terms of insurance policy as death of animal took place within 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 learned counsel for the complainant in support of his case has filed affidavit Ex.CW-1/A and document Ex. C1 and closed the evidence on 10.04.2023.

4.                     On the other hand, learned counsel for the OP has tendered affidavit Ex.RW-1/A and documents Ex.R1 to Ex. R12 and closed the evidence on 14.09.2023

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 not tenable. It is reveals from the cover note (Ex.R2) that two Buffalos were insured with the opposite party and the complainant paid Rs.200/- on 24.12.2019 for both cattles as premium of the insurance value of Rs.80,000/- each. It is clearly established from the evidence placed on record by both the parties that the Buffalo for which claim was sought was insured. It has been observed from the policy (Ex.R3) that the Cattle Insurance Policy was issued in the name of Haryana Live Stock Development Board as “Insured” having details of 651 animals (Ex.R3). The detailed terms & conditions of the policy might have not been shared with each and every owner of the cattles insured under the policy as no evidence has been placed on record in this regard. In the present case policy no. 31270047190400000503 for the period from 27.12.2019 to 26.12.2020 was issued mentioning Haryana Live Stock Development Board as insured for bulk of cattles mentioning name of  each and every owner of cattle, tag number etc. The owner of the cattles viz. Sh. Ram Singh paid insurance premium of Rs.200/- on 24.12.2019 for two buffalos. The OPs has repudiated  the claim stating that the claim is not payable as death of the cattle took place within 15 days under shelter of special condition mentioned in the last of the policy issued to Haryana Live Stock Development Board as “Proposer” and “Insured” which provides as under:-  

            “Death due to disease contracted prior to and within 15 days of commencement of risk are not payable for Non-scheme Cattle.”

  This plea of the opposite party is not tenable as the complainant was not made aware of the terms and conditions of the policy at the time of accepting premium and issuing cover note. From the perusal of record, it has been observed that no evidence has been placed on record by the OP that the complainant had ever been made aware of the terms and conditions of the policy as the policy was not shared with the complainant. Even the complainant was not known about the sum insured as he had paid premium for Rs.200/- for two buffalos for sum insured of Rs.80,000/- each having tag no. 160037925766 and tag no.160037925447 (Ex.R2) while sum insured for deceased buffalo having tag no. 160037925766 is Rs.50,000/- as mentioned at serial no. 297 of the policy issued by the  OP to Haryana Live Stock Development Board (Ex.R4). Further, the said clause may be relevant for the cattle who has disease prior to the commencement of risk under the policy. But in this case the same may not be applicable as at the time of making payment of insurance premium, a Health Certificate was issued (Ex.R2) wherein it was certified by the Veterinary Surgeon that the buffalos bearing Tag no. 160037925766 and tag no.160037925447 were checked and found healthy in all respect. Hence the said clause becomes infractuous in this case and taking shelter of the said clause has no valid ground for redpuaition of the claim. The claimant has claimed insured amount of Rs. 80,000/-. However, on perusal of the insurance policy submitted by OP (Ex.R3), the name of the complainant has been mentioned at serial no. 297, where sum insured for the died buffalo is Rs.50,000/-. Hence, the complainant is entitled for Rs.50,000/- only against his claim  of  Rs. 80,000/-.  It corroborates the fact that details of terms and conditions of the policy were not shared with the complainant.

7.                     In view of the above-mentioned facts, we are of the 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. 50,000/- to the complainant along with interest @ 6% p.a. from the date of filing of complaint till its final realization.
2. To pay Rs. 2,000/- as compensation towards pain, mental agony.
3. To pay Rs.2,000/- as litigation expenses.  

8.                     The above order be complied within 45 days from the date of this order, failing which further interest @9% will be paid by the OP for the delayed period.  Certified copies of the order be sent to the parties free of costs. The Order be promptly uploaded on the website of this Commission.  File be consigned to the record room, after due compliance.