Punjab

Rupnagar

CC/17/74

Kulvir Singh - Complainant(s)

Versus

The oriental insurance company limited - Opp.Party(s)

Sh. T.S. Chahal

06 Jul 2018

ORDER

BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM, ROPAR

                                 Consumer Complaint No. :  74 of 01.02.2017

                                 Date of decision                    :       06.07.2018

 

Kulvir Singh, aged about 45 years, son of Bant Singh, resident of Village Fatehgarh, Tehsil Chamkaur Sahib, District Rupnagar. 

                                                                 ......Complainant

                                             Versus

1. The Oriental Insurance Company Limited, Registered & Head Office:A-25/27, Asaf Ali Road, New Delhi-110002, through its Managing Director/Manager
2. The Oriental Insurance Company. Ltd., Branch office, Nangal Road, Rupnagar, Tehsil & District Rupnagar through its Branch Manager.

 

   ....Opposite Parties

                                   Complaint under Section 12 of the                                                      Consumer Protection Act, 1986

QUORUM

 

                        SH. KARNAIL SINGH AHHI, PRESIDENT

                        SMT. SHAVINDER KAUR, MEMBER

 

ARGUED BY

 

Sh. T.S. Chahal, Adv. counsel for complainant.

Sh. Rajesh Kumar Sharma, Adv. counsel for O.Ps. 

 

                                           ORDER

 

              SH. KARNAIL SINGH AHHI, PRESIDENT

 

1.         Complainant has filed the present complaint seeking directions to the opposite parties to pay Rs.50,000/- as insurance claim; to pay Rs.50,000/- as damages for harassment; along with interest @ 18% per annum on said both amounts from 12.8.2017 till payment by way of acceptance of this complaint. 

2.    Brief facts made out from the complaint are that with the assistance of the RCC Bank, Kainour, District Rupnagar, complainant had purchased a cow and the same was got insured with the O.P. Insurance Company Ltd. Vide insurance cover Note No.CHD-C 013952, commencement of policy from 25.10.2016 valid up to 25.10.2017. The said insured cow fell sick and ultimately died on 12.8.2017. After the death of the said cow, the information was sent to the O.P (insurance company) who deputed surveyor namely Shri. A.P. Singh, for spot inspection who was of National Insurance Company Ltd. Who told him that he had been deputed for inspection by the O.P. company and he inspected the dead insured cow and took photographs  and tag No.NICRPR 569151 of the said cow, which was given to the insured cow at the time of its insurance, who vide writing dated 13.8.2017 informed the complainant that he has done spot verification of the dead cow, inspected the same and completed other formalities and vide said writing he directed him to get post mortem done from the veterinary doctor of the area. Thereafter, at the instance of O.P. and its said surveyor postmortem of the said cow was conducted by the veterinary doctor. The complainant approached the O.P. and on their asking submitted his claim along with entire documents as per their demands and at that time the official of the O.P. had taken his signatures on some blank papers also by saying that they require the same for settlement of the claim for payment of the insured amount and he had put his signatures on the same in good faith to get claim on account of death of the insured cow and the officials of the O.P. assured that his claim would be finalized and paid shortly. After submission fo the claim to O.P. complainant has made several visits to the office of the O.P. but in sprite of that the O.P. is not making payment of the same to the complainant. The claim of the complainant repudiated by the O.P. as “No Tag No Claim”. Hence, this complaint.         

 3.   On notice, O.Ps. appears through counsel and filed written reply taking preliminary objections; that the present complaint is not maintainable;  that this Forum has no jurisdiction to decide the present complaint; that there are so many complicated facts are involved in the present case, which cannot be decided in the summary nature; that the O.P. had repudiated the claim of the complainant after applying the mind, the complainant breach of the policy condition, so there is no deficiency on the part of the O.P. On merits, it is stated that the complainant has running dairy business and having 9-10 cows and taken bank loan from Co-operative Bank Kainaur, Branch for only one cow which is alleged insured under this policy rest of the other cows are uninsured. This cow was firstly insured by National Insurance Company and tag was inserted vide tag No.NIC56915. Answering O.P. renewed the same. After receiving the intimation O.P. insurance company had deputed investigator who investigate the case of the complainant and gave report to insurance company. As per report of independent investigator, ear tag missing from the year of the insured animal and the same was found from the bag of insured in his bedroom. The tag was only one sided other side not found. Moreover, as per the statement of complainant that tag had been displaced from the ear of the animal and you had kept the tag safely at some other place and complainant had shown the ear tag in his hand, whereas in such cases animal should be retagged under proper notice to the insurance company. Rest of the allegations made in the complaint have been denied and prayer has been made dismissal thereof. 

4.    On being called upon to do so, the complainant has tendered his duly sworn affidavit Ex.CW1/A along with documents Ex.C1 & Ex.C5 and closed the evidence. The learned counsel for the O.Ps. has tendered sworn affidavit of Sh. A.P. Singh, Senior Divisional Manager, Ex.OP1, sworn affidavit of Sh. A.P Singh, Investigator Ex.OP2 along with documents Ex.OP3 to Ex.OP11 and closed the evidence. 

5.    We have heard the learned counsel for the parties and have gone through the record of the file, carefully.

6.    Complainant counsel Sh. T.S. Chahal, argued that Kulvir Singh, running small dairy and having cows for selling the milk. One cow was purchased and it was insured with the O.Ps. for the period from 25.10.2016 to 25.10.2017 against a sum of Rs.50,000/- and deposited the premium Rs.2300/-. At the time of issuance of the policy, O.Ps. assured that in any case cow died unnatural death then the insured amount shall be paid. The learned counsel further argued that on 12.08.2017 the insured cow fell sick and died during the night. O.Ps were informed, investigator was appointed, post mortem was conducted and claim was lodged. But the claim of the complainant repudiated by the O.Ps. vide letter dated 24.10.2017 Ex.C5 on the ground that the tag was not attached with the ear of the animal insured. However, not denied the death, insurance, tag, post mortem report and photographs etc. The learned counsel prayed that some time prior to 12.8.2017 the tag of the insured cow was lost and later on it was find out then produced before the Investigating Officer. To ascertain the claim, the investigator and the O.Ps. should relied upon the policy, animal health certificate, post mortem report and the claim forwarded. Denying the claim only on the ground of tag is not proper appreciating the facts. Denial of the claim amounts to deficiency in service and prayed to allow the complaint.  

7.         O.Ps. counsel Sh. Rajesh Sharma, argued that tag is the primary piece of evidence which is attached with the ear of the insured animal and it was found missing. Neither the tag is mentioned in the report of post mortem nor in any other document. O.Ps. has rightly come to the conclusion relied upon the report of the investigator that when the tag was not affixed with the ear of the animal then complainant is not entitled to the claim in any way. Rather O.Ps. has rightly held no claim appreciating the evidence on file. Learned counsel then referred the evidence adduced in this complaint by both the parties and prayed to dismiss the complaint.

8.    So far the point whether it is a consumer dispute or the complaint is maintainable or not is not the much controversial point in this complaint, because O.Ps counsel not disputed the purchase of the cow, issuance of the policy and death. Only dispute that the tag was not affixed with the ear of the dead animal. So it is a consumer dispute and complaint is maintainable.

9.    Coming to the real controversy, whether complainant has been able to prove deficiency in service on the part of the O.Ps. or not. Complainant in support of his evidence has firstly placed on file his own affidavit which is inconsonance to the complaint, then policy w.e.f. 25.10.2016 to 24.10.2017 and the sum assured Rs.50,000/-, premium Rs.2300/-. Ex.C2 is the animal health certificate dated 13.8.2015 signed by the Veterinary Officer, CVH, District Rupnagar and in this health certificate there is detail of the cow insured with description Sex Female, breed HF Cross, Colour mix black and white patches, horns disbudded, forehead white star, tail switch white, limbs as body colour. Then Ex.C3 i.e. letter dated 13.8.2017 qua the death of female cow. Ex.C4 is the post mortem certificate dated 16.8.2017 issued by the Dr. Rajinder Singh and in its report it is recorded colour of the cow Black and white, Forehead White Star, Horns disbudded. Ex.C5 is the letter issued by the O.Ps. qua the rejection of the claim dated 24.10.2017. Then to rebut the complainant evidence O.Ps. has placed on file the documents which has already been placed on file by the complainant and the new one is letter dated 13.8.2017 Ex.OP6, in which the complainant admitted that the tag from the ear of the deceased cow was lost. Other documents are health certificate, post mortem report etc.  Only during the course of arguments, O.Ps. counsel has relied upon Ex.OP5 & Ex.OP6 i.e. letter of repudiation and admission of complainant qua the lost of the tag.

10.  Admittedly the tag was not affixed with the ear of the deceased cow at the time of post mortem and O.Ps. has made sole criteria for the rejection of the claim on the basis of said tag. But forum while appreciating the claim has to evaluate the connecting evidence also. It is the primary duty of the complainant to prove that whether the cow died, whether has rightly been insured or not. Health certificate gives clarification on the points No.1 horns, colour, forehead and bread which are identical to the post mortem. Health certificate is dated 13.8.2015 i.e. prior to the commencement of the policy whereas at the time of conducting of post mortem upon the dead cow doctor was not aware what was the description of the cow insured and he gave the information qua the said facts i.e. horns, breed, colour etc, after watching directly the dead cow.

11.  The forum has come to the conclusion that health certificate of the animal dated 13.8.2017 and post mortem report dated 16.8.2017 speaks that the cow which was insured by the same cow whose post mortem was conducted on 16.8.2017. To rebut this version O.Ps. has not brought any documentary evidence on the file. Only relying upon the report of the investigator that the tag was not affixed with the ear of the animal is not good ground for the rejection of the claim. So complainant has been able to prove deficiency in service on the part of the O.Ps because of rejecting the claim relying upon the missing of tag is not the justice with the complainant. So complainant is held entitled for the claim.

12.  In the light of above discussion, the complaint stand allowed with the directions to the O.ps. to pay Rs.50,000/- along with interest @ 7.5% per annum w.e.f. date of death of cow i.e. 12.08.2017 till realization with cost of Rs.5000/-.

13. The O.Ps. are further directed to comply with the said order within the period of 30 days from the date of receipt of certified copy of this order.

14.  The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed and consigned to Record Room.

 

                     ANNOUNCED                                                    (KARNAIL SINGH AHHI)

                     Dated .06.07.2018                          PRESIDENT
 

 

 

                                                          (SHAVINDER KAUR)

                                                                             MEMBER