Punjab

Rupnagar

CC/17/72

Sarwan Ram - Complainant(s)

Versus

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

05 Jun 2018

ORDER

BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM, ROPAR

                                 Consumer Complaint No. :  72 of 13.11.2017

                                 Date of decision                    :     05.06.2018

 

Sarwan Ram son of Sh. Santu alias Sant Ram, resident of Village Dollowal, Tehsil Anandpur Sahib, District Rupnagar. 

                                                                 ......Complainant

                                             Versus

 The Oriental Insurance Company Limited, Regional office SCO No.108-110-111, Surendra Building Sector 17-D, Chandigarh, through its Regional Manager    

                                                                         ....Opposite Party

                                   Complaint under Section 12 of the                                                      Consumer Protection Act, 1986

QUORUM

 

                        SH. KARNAIL SINGH AHHI, PRESIDENT

                        SMT. SHAVINDER KAUR, MEMBER

 

ARGUED BY

 

Sh. Sarwan Ram, complainant in person  along with his counsel Sh. Tarun Kumar, Advocate.

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

 

                                           ORDER

 

              SH. KARNAIL SINGH AHHI, PRESIDENT

 

1.         Complainant has filed the present complaint seeking directions to the opposite party to pay Rs.50,000/- as insurance claim; to pay Rs.20,000/- as damages for harassment; along with Rs.20,000/- as litigation expenses.  

2.    Brief facts made out from the complaint are that in the month of December 2016, the complainant applied for dairy loan from the Agricultural Cooperative Bank limited, Anandpur Sahib, and the same was sanctioned by the said bank to him. The Agricultural Cooperative Bank Limited, Anandpur Sahib sanctioned the loan for the sum of Rs.5 Lac i.e. 2 lack for the construction of shed/room for animals and Rs.3 Lac for the purchase of buffaloes and cows. The complainant purchased four buffaloes and two cows for the sum of Rs.50,000/- each. After the purchasing the said cows the same were got insured with the O.P. as per the directions of the Agricultural Cooperative Bank Limited, Anandpur Sahib. Moreover, before the insurance the animals (four buffaloes and two cows) of the complainant were duly got medical examined by the O.P. from the Govt. Veterinary doctor and the health certificate were duly issued by the Dr. Y.P.C. Mehta. As per the terms and conditions after medically examined the tags were also inserted in the ear of each animals. On 10.07.2017, one cow of the complainant suddenly fallen ill and died on the same day. The complainant gave the information to the O.P. as well as bank officials. After receiving the information regarding the death of one cow the bank officials sent the investigator Dr. Y.P.C. Mehta, who investigated the death of the cow and the photographs of the cow were also taken and said doctor submitted his report to the O.P. Post mortem was conducted on 11.7.2017 by the doctor Vijay Kumar Chabba. Thereafter, the complainant applied for the insurance claim of Rs.50,000/- of the cow before the O.P. and all the formalities i.e. Health Certificate of the cow, Post mortem report, tag which was affixed in the ear of the cow, photographs of the cow were sent, as per the directions of the O.P. The complainant approached and requested the O.P. to release the claim of the cow but the O.P. putting the matter on one pretext or the other. Hence, this complaint.       

 3.   On notice, O.P. appears through counsel and filed written reply taking preliminary objections; that the present complaint is not maintainable; that the complainant breach the policy condition which states that claim under the policy in the event of death of animal will not be entertained without tailing the description and ear tag; that this Hon'ble Forum has no jurisdiction to decide the said complaint, there are so many complicated facts are involved in the present case, which cannot be decided in the summary nature without recording the evidence and there cross examination, only civil case as jurisdiction to decide the present complaint. On merits, it is stated that the O.P. had insured the animal after taken the Health Certificate of the cow and issued tag No.27542. After receiving the intimation O.P. (insurance company) had deputed investigator Dr. YPS Mehta (Retd. Joint Director) who investigate the case of the complainant and gave the report to insurance company. As per the report of independent investigator, description of the cow died did not match with the description of the insured cow, thereby not confirming the death of insured cow. Moreover, tag was freshly inserted manually in the right ear inserted of as usual in left ear. Hence, the said claim is not tenable/admissible under the said policy. 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.C1 along with documents Ex.C2 & Ex.C7 and closed the evidence. The learned counsel for the O.P. has tendered sworn affidavit of Sh. A.P. Singh, Senior Divisional Manager, Ex.OP1, sworn affidavit of Sh. YPS Mehta, Investigator Ex.OP2 along with documents Ex.OP3 to Ex.OP12 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. Tarun Kumar, argued that Sarwan Ram, purchased four buffaloes and two cows for the sum of Rs.50,000/- each obtaining loan from the Agricultural Cooperative Bank Limited, Anandpur Sahib. After purchase, the veterinary doctor tagged the cow and issued medical certificate. unfortunately, one of the cow suddenly fell ill on 10.07.2017 and died. On 11.7.2017 post mortem was conducted and O.P was duly informed then the claim was processed. Complainant came to know on 10.10.2017 when received a letter dated 04.10.2017 from the O.P. vide which the claim of the complainant was repudiated. The order of repudiation dated 04.10.2017 is illegal as complainant has complied with all the legal formalities. Denial of claim amounts to deficiency in service and prayed to allow the complaint with cost.

7.    Sh. Rajesh Kumar Sharma, counsel for the OP. argued that no doubt loan was sanctioned, complainant purchased the cows and policy was issued but the cow died had the different description in compare to the insured cows. The insured cow had the different description whereas in the ear of the died cow the tag was manually fixed, lastly prayed that claim has rightly been repudiated, the complaint is without merit and same be dismissed.   

8.    Complainant obtained loan and then purchased cows and cow died on 10.07.2017, post mortem was conducted and claim was repudiated vide letter dated 04.10.2017. 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 or not. It is the pleaded case of the complainant that four buffaloes and two cows were purchased at the rate of Rs.50,000/- each and purchase amount of Rs.3,00,000/-. To this extent qua purchase and insurance is admitted by the O.P. whereas not denied the death, issuance of the policy and lodging the claim. But denied that the description of the dead cow does not tally with the cow insured. To meet out the arguments, complainant counsel has referred the documentary evidence i.e. Ex.C1 affidavit, Ex.C2, copy of post mortem which proves that the death of cow having colour black and white. Ex.C3 is the copy of the policy and in the column of the colour of the cow mentioned black with white. Ex.C4 is also the documents issued by the O.P. it proves the female cow having colour black and white of Rs.50,000/-. Ex.C5 is the common policy of the four buffaloes and two cows. Ex.C6 the certificate issued by the Veterinary Health Certificate qua the purchase of the dead animal. Ex.C7 is the letter dated 04.10.2017, vide which the claim of the complainant repudiated and its relevant portion is reproduced as under:-

           Sh. Sarwan Ram,

           S/o Sh. Santu

           Village Dollowal,

           Tehsil Anandpur Sahib

 

          Sir,

         

          Re:-     Claim under Pol. No.231100/47/2017/363, Cl                             No.230011/47/2017/030010

 

                      This is in reference to your claim intimation for death of cow on 10.07.2017

 

                      As per investigation, report, description of the cow died did not match with the description of the insured cow, thereby not confirming the death of insured cow. Moreover, tag was freshly inserted manually in its right ear instead of as ususal in left ear. Hence, the said claim is not tenable/admissible under the said policy and being filled as "No Claim".

 

       Thanking you

       Yours faithfully

 

       Deputy Manager 

 

            To rebut the claim of the complainant O.P. though tendered the affidavit of Dr. YPS Mehta, investigator, photocopy of the claim, photographs of the dead cow Ex.OP3 to Ex.OP8 including the tag etc. Again Ex.OP9 veterinary certificate, post mortem report Ex.OP10 showing the description of the cow black and white. Beside the policy and copy of the written request Ex.OP11 of complainant Sarwan Ram.

10.       Arguments heard in length of both the counsel and perused the record, purchase of the cow and issuance of the policy, then deposit of premium are the admitted facts. Complainant come forward that one cow having the description/colour black and white died on 10.07.2017, then post mortem was conducted on 11.7.2017, whereas O.P. has taken the stand that description of the cow does not tally with the insured cow but on close scrutiny the Forum has come to the conclusion that the cow which was purchased for the sum of Rs.50,000/-, the veterinary doctor issued the certificate which is in consonance to the policy as well as post mortem report. The only negative view taken by the O.P. is based upon the two angle i.e. No.1 description and No.2 tag in left ear and manually fixed. Both the said pleas are without merit because the documents on file proves the description of the dead cow in consonance to the document prepare while purchasing and at the time of tagging in the ear. So far the right or left tag is concern i.e. not much material and that depends upon the doctor either to fixed on the right ear or left ear. O.P. not denied that the tag recovered does not belonging to the insurance or is manufactured privately.  So complainant has been able to prove the deficiency in service and as such, complainant is entitled to the claim on account of death of cow insured by the O.P.

11.       In the light of above discussion, the complaint stand allowed with the direction to the O.P. to pay Rs.50,000/- to the complainant along with interest @ 7.5% per annum w.e.f. date of death of cow i.e. 10.07.2017 till realization with cost of Rs.5000/-.

12.       The O.P. is 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.

13.  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 .05.06.2018                          PRESIDENT
 

 

 

                                                          (SHAVINDER KAUR)

                                                                             MEMBER