Haryana

Ambala

CC/224/2017

Dinesh Kumar - Complainant(s)

Versus

The OIC - Opp.Party(s)

In Person

19 Apr 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

                                                          Complaint case no.          : 224 of 2017

                                                          Date of Institution          : 05.07.2017

                                                          Date of decision     : 19.04.2018

 

Dinesh Kumar son of Sh. Rattan Lal resident of village Sapehra P.O. Pilkhani, District Ambala.

……. Complainant.

Vs.

 

1.       The Oriental Insurance Co. Ltd. NMSC LIC Building, Ground Floor, Near Vijay Cinema, Ambala City.

2.       The Oriental Insurance Co.Ltd Registered Office: Oriental House No. A-25/27, Asaf Ali Road, New Delhi-110002.

 

Before:        Sh. D.N.Arora, President.

                   Sh. Pushpender Kumar, Member.

                   Ms. Anamika Gupta, Member.           

 

Present:       Complainant in person with Sh. Shashi Bhushan,  Advocate.

                   Sh. Rajeev Sachdeva, counsel for the OPs.

 

ORDER:

                   In nutshell, brief facts of the present complaint is that the complainant had purchased policy no.261101/47/2017/942 from  OP No.1 for the period from 27.03.2017 to 26.03.2018 for his three cows for the sum of Rs. 1,65,000/- i.e. Rs. 55,000/- for each cow and paid the premium of Rs. 3713/-.  The cows  of the complainant were healthy at the time of insurance.  The cows of  the complainant were allotted Tag Nos. 130002/153713, 160016/349001 and 160016/348576 and were  aged appx. 3-1/4 year, 4-1/4 years and 3-1/2 years respectively as per the Health Certificate  issued by Animal Husbandry & Dairying Department, Haryana vide their No.0156215 dated 22.03.2017 and the breed of each cow was HFX and colour of two cows were Back & White whereas the colour of 3^rd cow who was 3-1/2 years of the age was Darktan and all the  cows were having female calf. The complainant has been doing  his work after getting loan from the Gramin Bank of village Kardhan. Unluckily one of the cows who was 4-1/4 years old and was of black & white colour expired/died on 06.04.2017. He submitted his claim on account of death of his cow and also submitted all the connected documents but the OP No.1 repudiated the claim of him amounting Rs. 55,000/- for which the cow was insured vide their letter dated 14.6.2017 which is absolutely illegal. After receipt of letter dated 14.6.2017 the complainant met the OP several times but the officials of OP No.1 are not ready to adhere the genuine request of the complainant. Non-payment of the amount of claim is deficiency in service and unfair trade practice on the part of the Ops. Hence, the present complaint.

2.                Upon notice, OPs appeared through counsel and tendered written statement and stated that the animal has died within the 15 days from the commencement of the policy and as per terms and conditions of the policy is that “Insurance Company shall not be liable if the animal (s) had died  within the 15 days of the commencement of the policy”. In the present case Policy cover note was issued on 27.03.2017 and animal died on 06.04.2017 hence the same was held no claim/ non payment  as per the terms and conditions of the cattle insurance policy. The OP rightly repudiated the claim of the complainant and same was informed to the complainant. It is pertinent  to mention here that the complainant was informed time and again about the scope and limitations of the alleged policy. Therefore, the Ops are not rendered any deficiency of services and unfair trade practice and prayed for dismissal of the present complaint.

  3.              To prove his version complainant tendered his affidavit as Annexure C-A along with documents as annexure C-1 to C-13 and close his evidence. On the other hand, counsel for the Ops have also tendered affidavit as Annexure R/A  alongwith documents as Annexure R-1 to R-5 and close their evidence.

4.                We have heard learned counsel for the parties and carefully gone through the case file.  Learned counsel for the complainant has argued that there three cows were got insured from Ops for the period 27.03.2017 to 26.03.2018 after paying the premium amount Rs. 3,713/- but out of three cows one  cow had died on 06.04.2017 during the subsistence of the policy but the insurance company did not pay the insured amount on the ground that the cow died within a period of 15 days from the date of commencement of the risk as per the terms and conditions of  the policy “As in the event of the death due to disease contracted  within 15 days from the date of commencement of risk”. But the counsel for the complainant has argued that the above said terms and condition of the policy were not supplied to him.

On the other hand, counsel for the Ops has taken the plea that the claim is not payable as the cow died within a period of 15 days from the date of commencement of the risk and, as such, the insurance company is not liable to pay the claim and her claim was rightly repudiated. In support of his submission, learned counsel drew our attention to the following condition of Cattle Insurance Policy as Annexure R-2 clause 15(1) as under:

“The company is not liable to pay the claim in

the event of death of insured animal due to

disease occurring within 15 days from the

commencement or risk.”

 

5.                We have gone through the Annexure C-1 ie. Insurance cover note in respect of the insured the three cows on dated 27.03.2017. It is mentioned in the head of the important notes no.2 as under-“This Covernote is issued pending issue of stamped  policy of insurance. Failure to comply with and act in accordance with the terms and conditions of the policy due to ignorance shall be no excuse and by acceptance of this covernote the insured binds himself by such terms and conditions. A copy of the terms and condition will be supplied on application to the company”. The above said plea of the complainant is not tenable that the terms and conditions has not been supplied to him or signed by him. In view of the important note no.2, mentioned in the back of the cover note if the complainant required any terms and conditions he has to apply to the company for supplying the terms and conditions of the policy. It means that complainant has very much knowledge of terms & conditions and law laid down by Hon’ble National Commission in various decisions, the Consumer Fora cannot go beyond the terms and conditions of the policy. It is not disputed that as per the terms and condition of the policy the cow had died within 15 days within issuance of the policy, on account of the terms and condition of the cattle insurance policy, was absolved on any liability to pay the compensation or the assured to sum to the complainant.

6.                In view of the above discussion,  we are the confirm view that the complainant is bound by the terms and conditions  of policy, cow in question died within 15 days after issuing of the policy. Thus, the insurance company is not liable to pay any insured amount. There is no deficiency in the service on the part of the Ops. Hence, the present complaint is hereby dismissed with no order as to costs. Copy of this order be sent to the parties concerned, free of costs, as per rules. File after due compliance be consigned to record room.

Announced on : 19.04.2018

 

(PUSHPENDER KUMAR)       (ANAMIKA  GUPTA)          (D.N. ARORA)

Member                          Member                                 President