| ORDER | DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PATIALA. Complaint No. CC/15/239 of 14.10.2015 Decided on: 25.2.2016 Jai Gopal, aged about 36 years S/o Sh.Mulakh Raj R/o Village Dhingi, Tehsil Nabha, Patiala. …………...Complainant Versus The Oriental Insurance Company Ltd., Branch Office, 126, Chhoti Baradari, Patiala, through its Branch Manager. …………….Op Complaint under Section 12 of the Consumer Protection Act. QUORUM Sh. A.P.S.Rajput, President Smt.Neelam Gupta, Member Smt.Sonia Bansal,Member Present: For the complainant: Sh.K.S.Thind , Advocate For Op: Sh.B.L.Bhardwaj,Advocate ORDER NEELAM GUPTA, MEMBER - The complainant had purchased insurance policy No.233503/47/2014/501 for the period 11.10.2013 to 10.10.2016 in respect of his ten cows. Before the Op insured the cows, it had obtained the veterinary health certificate of the cows from M/s Guru Ramdas Chipping Company Regd.Gurdev Enclave, Sanouri Adda, Patiala.
- The one cow bearing micro chip & tag No.900108001498344, HFC breed died on 11.12.2013 and the other cow bearing Micro chip and tag No.900108001498348 HFC breed died on 23.4.2014 and the complainant brought the said fact to the notice of Op and lodged the claim regarding the said dead cows whose market value was assessed at Rs.60,000/- each.
- The Op got the matter investigated and paid only Rs.40,000/- on 21.3.2014 and Rs.42000/- on 13.6.2014 as against the market value of the cows at Rs.60,000/- each. The act of the Op in having assessed the loss of the insured cow at a lesser value resulted into the harassment and mental agony undergone by the complainant. Accordingly he got the Op served with a legal notice dated 7.5.2015 but the Op failed to respond. Ultimately the complainant approached this Forum under Section 12 of the Consumer Protection Act,1986 ( for short the Act) for a direction to the Op to pay the claim amount of the insured cow and further to pay a sum of Rs.50,000/- by way of compensation on account of harassment and mental agony experienced by the complainant.
- On notice, the Op appeared and filed its reply to the complaint. It is admitted by the Op that the complainant got his 10 cows insured with the Op vide policy No.233503/47/2014/501 for the period 11.10.2013 to 10.10.2016. The plea taken by the Op is that the complainant had not paid the premium @ 7.54% and rather paid the same @ 5.07% which had been charged by the Op erroneously and inadvertently as the policy of the complainant falls under general category, a fact observed during the scrutiny of the claim of the complainant. Accordingly, the complainant was advised to pay the balance amount of Rs.20411/- in respect of which the detail was prescribed to the complainant so as to enable the Op to process the claim of the complainant for the two insured cows having died on 11.12.2013 and 23.4.2014.
- It is further averred by the Op that on receipt of the intimation regarding the loss, the investigator of the Op assessed the loss of the cow which died on 11.12.2013 at Rs.40,000/- regarding the cow which died on 23.4.2014, the matter was discussed and the complainant gave his consent for the full and final settlement of his claim in a sum of Rs.53000/- but after further oral negotiation with the complainant, the claim was settled for Rs.42000/- and the complainant has already accepted the claim amount of both the cows died on 11.12.2013 and 23.4.2014.
- It is further denied that the market value of the dead cow was Rs.60,000/-.After denouncing the other allegations of the complaint going against the Op, it was prayed to dismiss the complaint.
- In support of his case, the complainant tendered in evidence Ex.CA, his sworn affidavit alongwith documents Exs.C1 to C8 and the complainant closed his evidence.
- On the other hand, counsel for the Op tendered in evidence Ex.OPA, the sworn affidavit of Sh.A.S.Dhingra, Sr.Divisional Manager of the Op alongwith documents Exs.OP1 to Ex.OP9 and closed its evidence.
- The parties failed to file the written arguments. We have heard the learned counsel for the parties and gone through the evidence placed on record.
- Ex.C2 is the policy No.233503/47/2014/501 dated 11.10.2013 issued by the Op in favour of the complainant in respect of 10 milching cows HFC Breed, valid for the period 11.10.2013 to 10.10.2016 for the sum of Rs.6,00,000/-, the sum insured of each cow being Rs.60,000/-.
- As per the case of the complainant, his two cows bearing chip No.900108001498344 died on 11.12.2013 and the other bearing chip No.900108001498348 died on 23.4.2014, a fact not disputed by the Op but it is the case of the complainant that he was paid Rs.40,000/- and Rs.42000/- as against the insured value and Rs.60,000/-each of the insured cow.
- It is the plea taken up by the Op that the complainant was obliged to pay the insurance premium in respect of the aforesaid insurance policy No.233503/47/2014/501 @ 7.54% but he paid the same @ 5.07% and therefore, he was obliged to pay the difference of Rs.20411/-.
- It is also the plea taken up by the Op that the Insurance policy No.233503/47/2014/501 dated 11.10.2013 ( copy Ex.C2) pertains to general category and that the premium for the general category had to be 7.54% but the complainant paid the same @ 5.07%. A perusal of the policy Ex.C2 does not show that it pertains to general category. There is nothing to show as to what was the tariff meant for the general category prevalent as on 11.10.2013. Even the Op has not lead any evidence, independently,in this regard. In case, after the issuance of the policy, the Op realized that they had wrongly charged the tariff @ 5.07% as against 7.54%, they should have raised a demand for the same in case it was permitted under the IRDA Regulations. The Op for the first time, sent an e-mail i.e. Ex.OP9 dated 22.1.2015 and that too when the complainant raised his claim in respect of policy No.233503/47/2014/501,Ex.C2. The Op then sent a reminder through e-mails dated 18.3.2015 and then again on 26.6.2015. The policy having been purchased by the complainant on 11.10.2013. The Op had no occasion and opportunity to raise the demand in the difference of the premium on 22.1.2015. Even the three mails sent by Op on 22.1.2015, 18.3.2015 and 26.6.2015, did not disclose as to on what basis the Op was demanding the difference in the premium as nothing was disclosed about the category of the complainant under which he had purchased the policy as also the tariff applicable to the general category.
- The learned counsel for the Op failed to show us any rules of the IRDA which provide for the recovery of the difference of premium paid by the insured in having purchased the policy from the insurer. To our mind, this approach of the Op amounts to unfair trade practice because the insurer has to apprise the insured about his liability qua the basis for the same but in this case no such demand was ever raised by the Op and the act of the Op in raising the demand in the proceedings of the claim lodged by the complainant, certainly amounts to an unfair trade practice.
- It is pertinent to mention that the complainant got the Op served with the legal notice dated 7.5.2015( copy Ex.C6) sent through registered post, postal receipts in this regard having been pasted on the notice itself but no reply was given by the Op taking up the plea that the complainant had agreed for the settlement of his claim regarding the second cow in a sum of Rs.42000/-. It would only go to show that this is a plea manipulated by the Op just to deny the rightful claim of the complainant , rather the complainant has specifically mentioned in para 6 of the complaint and para 4 of the legal notice that after investigation regarding the dead cows, Op deposited the claim amount of Rs.40,000/- and Rs.42,000/- in the Bank account of the complainant ignoring the insured value of the said cows i.e. Rs.60,000/- each.
- No explanation has been furnished by the Op as to why the value of the insured cows in the policy No.233503/47/2014/501 dated 11.10.2013 was assessed at Rs.60,000/- / in respect of each cow . There must be some basis for the plea to have been taken up by the Op that complainant got 10 cows insured having disclosed the excessive value of the cows. When the Op has charged the premium on the value of the cow, now it does not lie in the mouth of the Op to say that the complainant had disclosed the excessive value of the cows. Op has got no basis to assess the claim of the complainant for the insured cows bearing chip No.900108001498344 at Rs.40,000/- and the cow bearing chip No.900108001498348, at Rs.42000/- as against the insured value of Rs.60,000/- each and similarly they have no basis to claim any difference in the payment of the premium.
- We accordingly accept the complaint and direct the Op to make the payment of Rs.38,000/- i.e.(60,000-40,000=20,000 plus Rs.60000- Rs.42000/-+ 18,000/-), the remaining insured amount of the insured cows with interest @9% per annum from the date of the payment already made by the Op i.e. 21.3.2014 and 13.6.2014. The Op is also directed to make the payment of Rs.40,000/- by way of compensation on account of the harassment and mental agony experienced by the complainant and on account of unfair trade practice on the part of the Op in the matter of claiming the difference in the amount of premium as also the deficiency of service and also on account of the failure on the part of the Op to pay the balance amount of the insurance despite having been served with legal notice dated 7.5.2015 and the said compensation is inclusive of the costs of litigation. The order be complied by the Op within one month on receipt of the certified copy of the order.
Pronounced Dated:25.2.2016 Sonia Bansal A.P.S.Rajput Neelam Gupta Member President Member | |
