Haryana

Karnal

CC/381/2020

Jai Veer - Complainant(s)

Versus

The Oriental Insurance Company Limited - Opp.Party(s)

Surjit Narwal

29 Aug 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 381 of 2020

                                                        Date of instt.21.09.2020

                                                        Date of Decision:29.08.2023

 

Jai Veer son of Shri Ram Dhan, resident of Village Kheri Naru, District Karnal.

                                               …….Complainant.

                                              Versus

 

The Oriental Insurance Company Limited, G.T. Road, Karnal, through its Divisional Manager.

                                                                      …..Opposite party.

 

Complaint Under Section 35 of Consumer Protection Act, as amended up-to-date.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary….Member

 

 Argued by: Ms. Deepika Sandhu, counsel for the complainant.

                    Shri Amit Gupta, counsel for OP.

 

                    (Jaswant Singh President)

ORDER:  

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant obtained an insurance policy No.1073234 dated 23.12.2016, under the scheme of government to insured the two buffalo and the complainant alongwith other persons have jointly insured their buffalows for a period of three years commencing from 23.12.2016 to 22.12.2019 and the complainant alongwith other persons paid the premium amount of Rs.59,336/- to the opposite party. The tag number of the buffalo of the complainant is 134045. The cost of the buffalo as assessed by the doctor at the time of insurance was Rs.50,000/- each. The buffalo of the complainant had expired on 27.06.2019 due to post parturient Hemotoma Globin Urea. The post mortem was conducted by the Veterinary Surgeon Government Veterinary Hospital, Jundla on dated 28.06.2019 at 01:00 PM. The duration of the insurance under the limit of the policy but the OP without any sufficient cause repudiated the claim of the complainant.  Thus, the act of the OP amounts to deficiency in service while repudiating the claim of the complainant. Hence, the present complaint.

2.             On notice, OP appeared and filed its written version and in the written version OP has raised preliminary objections regarding jurisdiction, maintainability, cause of action, non-joinder and mis-joinder of necessary parties, suppression of true and material facts, etc. On merits, it is submitted that an insurance policy bearing No.261303/47/201/1270 was issued by the OP in favour of Veterinary Surgeon, Jundla, Karnal in respect of indigenous milch buffaloes including  buffaloes bearing Tag No.134045 and 263973. The buffaloes covered under the said policy were insured for Rs.50,000/- each for a period of one year i.e. from 24.12.2016 to 23.12.2017. In the month of June, 2019, the complainant lodged a claim with the OP alleging that buffalo bearing Tag No.134045 has died on 27.06.2019 that the Veterinary Surgeon who conducted the post mortem has assessed the costs of the buffalo as Rs.50,000/- and as such, a compensation of Rs.50,000/- for death of bufallow be made to him. The OP got investigated the matter through Shri P.L. Sharma, Investigator, who after spot inspection and investigation, submitted his report dated 01.08.2019 with the OP. A perusal of claim lodged by the complainant and upon investigation of the said claim by the investigator it transpired that the buffalo bearing tag No.134045 has expired on 27.06.2019 i.e. after expiry of the policy issued by the OP. Since, the claim in question and reported after the expiry of insurance policy, therefore, the complainant was not eligible for payment of insurance amount. Hence, prayed for dismissal of complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel or the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of Aadhar Card Ex.C1, copy of cover insurance cover note Ex.C2, copy of application Ex.C3, copy of postmortem report Ex.C4, legal notice Ex.C5, postal receipt Ex.C6, reply to the legal notice Ex.C7 and closed the evidence on 19.05.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Ramesh Kumar, Manager, as Ex.OP1/1, copy of application Ex.OP1, copy of spot inspection report Ex.OP2, Policy schedule Ex.OP3 and copy of compliance of Section 64VB Ex.OP4 and closed the evidence on 17.05.2023 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that the complainant got insured his two buffalows for a period of three years i.e. from 23.12.2016 to 22.12.2019. Out of two buffalo, one buffalo bearing tag No. 134045 had expired during the subsistence of insurance policy. The value of said buffalo was assessed as Rs.50,000/- by the OP at the time of purchasing of insurance policy. The post mortem of the buffalo was got conducted.  Intimation with regard to death of buffalo was given to the OP and the claim was lodged for insured amount of the buffalo but the OP repudiated the claim of the complainant without any sufficient reason. Hence, prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that the complainant purchased an insurance policy and got insured his two buffalo. The buffaloes covered under the said policy were insured for Rs.50,000/- each for a period of one year i.e. from 24.12.2016 to 23.12.2017. In the month of June, 2019, the complainant lodged a claim with the OP alleging that buffalo bearing Tag No.134045 has died on 27.06.2019. The OP got investigated the matter through Shri P.L. Sharma, Investigator, who after spot inspection and investigation, submitted his report dated 01.08.2019 and on perusal of the same it transpired that the buffalo bearing tag No.134045 has expired on 27.06.2019 i.e. after expiry of the policy issued by the OP, thus, the claim of the complainant was rightly repudiated and prayed for dismissal of complaint.

9.             We have duly considered the rival contentions of the parties.

10.           The claim of the complainant has been repudiated by the OP vide letter dated 19.06.2020 Ex.OP1, the relevant portion of which is reproduced as under:-

i)      Since the policy has been expired on 23.12.2017 and date of death is 27.06.2018, which is not covered.

ii)     Policy period is 24.12.2016 to 23.12.2017. Investigator concluded in final report that buffalo was died on 27.06.2019 which is not falls under the scope of expired policy. Hence, claim is not payable and treated as “No Claim”.

 

11.           The complainant has got insured his two buffaloes for three years i.e. from 23.12.2016 to 22.12.2019, out of them one buffalo bearing Tag No.134045 has been expired.

12.           In order to prove his case, the complainant has placed on record copy of insurance cover note Ex.C2 wherein it has been specifically mentioned that the buffaloes and cows of eleven persons have been got insured for a total sum insured of Rs.14,70,000/-, for the period of three years i.e. from 23.12.2016 to 22.12.2019 and received an amount of Rs.59,336/- as premium. The insured buffalo had died during subsistence of insurance policy. The cover note Ex.C2 has not been denied by the OP.

 13.          The OP has placed on record copy of policy schedule Ex.OP4 showing the insurance policy valid from 24.12.2016 to 23.12.2017 and premium amount as Rs.19,799/-. If the said amount multiplies by three it came to be Rs.59,337/- and as per the complainant, the OP had received an amount of Rs.59,336/- for three years. It may be that OP issues policy schedule separately year by year and only in order to repudiate the claim, the OP has placed on file policy schedule only for the period from 24.12.2016 to 23.12.2017. Furthermore, the policy schedule Ex.OP4 is without signature only a rubber stamp is appended on it, hence, the same has no value in the eyes of law. It seems that the insurance company is only interested in earning the premium and is not interested to give claim to the insurer. In this regard we place reliance on the authority of Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, wherein it has been held that:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.

14.           Keeping in view, the ratio of the law laid down in aforesaid judgment, facts and circumstances of the present complaint, we are of the considered view that act of the OP while denying the claim of the complainant amounts to deficiency in service and unfair trade practice which is otherwise proved genuine one.

15.           Thus, as a sequel of above discussion, we allow the present complaint and direct the OP to pay Rs.50,000/- as insured value of buffalo alongwith interest at the rate of 9% per annum from the date of repudiation till its realization.  We further direct the OP to pay Rs.10,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.5500/- for the litigation expense. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:29.08.2023                                                                     

                                                                  President,

                                                       District Consumer Disputes

                                                       Redressal Commission, Karnal.

 

(Vineet Kaushik)             (Dr. Rekha Chaudhary)

                     Member                         Member