Haryana

Karnal

CC/165/2019

Satish Kumar - Complainant(s)

Versus

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

Vikramjeet

21 Jan 2020

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 165 of 2019

                                                          Date of instt.19.03.2019

                                                          Date of Decision 21.01.2020

 

Satish Kumar son of Shri Faqir Chand, resident of village Ganjogarhi, District Karnal.

 

                                                 …….Complainant.

                                              Versus

 

The Oriental Insurance Company Limited, Branch office situated at Behind Bus Stand, over Mahindra Finance, Karnal through its Branch Manager.

 

                                                                         …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri Vikramjeet Advocate for complainant.

                   Ms. Saroj Bala Advocate for opposite party.

                 

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant is a farmer and he was having cow and he got insured his cow from the OP, vide policy no.261303/47/2017/1815 against Tag no.16001/156446 dated 10.03.2017 which was valid for three years i.e. upto 10.03.2020 and premium was paid by the complainant to the OP. The insured amount under the abovesaid cattle policy was Rs.40,000/-. The insured cow of the complainant fell ill and complainant got treated her from Dr. A.K. Sinha, Veterinary Surgeon, HVS-I, I/c Govt. Veterinary Hospital, Uncha Samana, Karnal but unfortunately, the abovesaid cow of the complainant died on 27.08.2018 from 9.30 a.m. to 10.30 a.m. and post mortem was also conducted by the doctor concerned on the same day and photographs were also taken. As per abovesaid policy, the complainant was entitled to an amount of Rs.40,000/- from the OP and as such, the complainant completed all the requisite formalities and submitted his claim application dated 27.08.2018 alongwith all the necessary original documents such as such insurance policy, post mortem report photographs etc. with the OP but the OP did not bother to decide the claim case of the complainant and failed to pay even a single penny to the complainant on account of claim despite the repeated request of the complainant and ultimately, the OP vide letter dated 28.09.2018 repudiated the claim of the complainant on false ground i.e.”No Claim.” The OP also sought reply from the complainant before closing the claim file. In this regard, concerned doctor who treated the said car, wrote a letter dated 18.10.2018 to the OP regarding the said claim application of the complainant thereby giving the clarification but the OP did not pass the claim of the complainant. The complainant again approached the OP and pleaded that his claim has been rejected on false and frivolous grounds and as such, they should reconsider the claim case of the complainant but nothing was heard. The complainant also demanded his original documents which he had submitted to the OP for passing of claim but the concerned officer told that the original documents submitted by the complainant are with head office. In this way there was deficiency in service on the part of the OP. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OP, who appeared and filed written version raising preliminary objections with regard to locus standi and maintainability. On merits, it is pleaded that as the description of the dead cow does not tally with the health report as well as the post mortem report as per the investigation report dated 09.09.2018, submitted by the investigator, Shri P.L. Sharma. According to the report of the Investigator, the dead cow was black & legs white, dehorned & having white star on her forehead, but there is no such mention in the Health Certificate and the Post Mortem Report of Dr. A.K. Sinha, Veterinary Surgeon HVS-1 I/C Govt. Veterinary Hospital, Uncha Samana, Karnal. The Health Certificate and Post Mortem Report of the Dr. A.K. Sinha gave the description of the dead cow black and white and no horns. So, the claim is repudiated as per terms and conditions of the insurance policy. It is further pleaded that the dead cow was not insured with the OP, vide policy no.263103/47/2017/1815 against Tag no.16001/156446 dated 10.03.2017 and the insured amount was Rs.40,000/-, but now the cow, who was having white star on her forehead.  There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C13 and closed the evidence on 25.11.2019.

4.             On the other hand, OP tendered into evidence affidavit of Anil Rehlan Deputy Manager Ex.OP1/A and closed the evidence on 06.01.2020.

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

6.             The case of the complainant, in brief, is that complainant got insured his cow from the OP for the sum assured of Rs.40,000/-, vide policy no.261303/47/2017/1815, against Tag no.16001/156446 dated 10.03.2017 which was valid for three years i.e. upto 10.03.2020. The insured cow of the complainant fell ill and complainant got treated her from Dr. A.K. Sinha, Veterinary Surgeon, HVS-I, I/c Govt. Veterinary Hospital, Uncha Samana, Karnal but unfortunately, the abovesaid cow of the complainant died on 27.08.2018. Post mortem was also conducted by the doctor concerned on the same day. As per abovesaid policy, the complainant was entitled to an amount of Rs.40,000/- from the OP and as such, the complainant completed all the requisite formalities and submitted his claim application dated 27.08.2018 alongwith all the necessary original documents such as such insurance policy, post mortem report photographs etc. with the OP but the OP did not bother to decide the claim of the complainant and lastly repudiated the same on the false ground.

7.             On the other, the case of the OP in brief, is that as per the investigation report dated 09.09.2018, the dead cow was black & legs white, dehorned & having white star on her forehead, but there is no such mention in the Health Certificate and the Post Mortem Report of Dr. A.K. Sinha, Veterinary Surgeon HVS-1 I/C Govt. Veterinary Hospital, Uncha Samana, Karnal. The Health Certificate and Post Mortem Report of the Dr. A.K. Sinha gave the description of the dead cow black and white and no horns. So, the claim is repudiated as per terms and conditions of the insurance policy.

8.             Admittedly, complainant got insured his cow from the OP for the sum assured of Rs.40,000/-. The cow of the complainant died on 27.08.2018 and in this regard intimation was given to the OP by the complainant. OP appointed his investigator Shri P.L. Sharma who submitted his report and as per his report that the cow was black and legs white, dehorned and having white star on her forehead. The post mortem of the cow was got conducted vide PMR Ex.C8. Photographs of the dead cow are Ex.C1 to Ex.C7 taken by the investigator on 27.08.2018.

9.             The claim of the complainant has been repudiated by the OP on the ground that the dead cow was black and legs white, dehorned and having white star on her forehead, but there is no such mention in the health certificate and post mortem report (Ex.C8) of Dr. A.K. Sinha, Veterinary Surgeon. The health certificate and the post mortem report gave description of the dead cow black and white and no horns.

10.            It is not disputed that the tag was not intact. When the tag on the cow was intact, the OP cannot take the shelter of the minor description as alleged by the OP. Thus, we are of the considered view that the act of the OP amounts to deficiency in service and unfair trade practice.

11.            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP to pay Rs.40,000/- to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization. We further direct the OP to pay Rs.15,000/- 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 30 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:21.01.2020                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

       

        (Vineet Kaushik)          (Dr. Rekha Chaudhary)

            Member                           Member