BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.
Complaint No.:249 of 2014.
Date of Institution: 28.08.2014.
Date of Decision:14.03.2017
Vijay Kumar son of Sh. Birbal Ram, resident of village Atela Khurd, Tehsil Charkhi Dadri, District Bhiwani.
….Complainant.
Versus
The Oriental Insurance Company Limited Regd. Office: Oriental House, A-25/27, Asaf Ali Road, New Delhi, having its Branch Office at 174-Circular Road, Bhiwani, through its Branch Manager.
...Opposite Party.
COMPLAINT U/S 12 & 13 OF CONSUMER PROECTION ACT.
BEFORE: - Shri Rajesh Jindal, President
Mrs. Sudesh, Member
Present:- Shri Jagdish Sheoran, Advocate, for complainant.
Shri Rajbir Singh, Advocate for OP.
ORDER:-
Rajesh Jindal, President:
The case of the complainant in brief, is that the complainant was the owner of Murrah buffalo aged about 4 years, which was duly insured with the respondent’s company, vide policy No. 261204/47/2014/1864 dated 13.12.2013 valid for 14.12.2013 to 13.12.2014. It is alleged that the complainant had paid the premium of Rs. 1124/- on 10.12.2013 and the OP issued a Tag bearing No. OIC/27111, which was affixed on the left ear of the complainant’s buffalo. It is alleged that on dated 14.12.2013 at about 5:00 p.m., the buffalo of the complainant was died and the postmortem of the dead buffalo was conducted by the veterinary surgeon vide PMR No. 05/2013 25/002714 dated 15.12.2013. It is alleged that the complainant had informed the OP about the death of the buffalo and the OP had sent his surveyor, who took the photographs of the dead buffalo & collected all the necessary documents from the doctor as well as from the complainant. It is alleged that the complainant visited at the office of OP for settle the claim of dead buffalo, but the complainant was mis-leaded every time saying that his case was sent to the head office for its approval. It is alleged that the complainant had received a letter dated 24.07.2014 from the respondent’ s company, in which the respondent’s company made endorsement that “the claim of the complainant is under waiting period” hence claim of the complainant has been repudiated with remarks “No Claim”. The complainant had visited in the office of OP and made request to settle the claim, but to no avail. The complainant further alleged that due to the act and conduct of the respondent, he had to suffer mental agony and physical harassment. Hence, it amounts to deficiency in service on the part of respondent and as such he had to file the present complaint for seeking compensation.
2. On appearance, the OP filed written statement alleging therein that the claim file of the complainant was closed as “No Claim” and he informed accordingly vide letter dated 13.02.2014. It is submitted that the complainant has not come to this Forum with clean hands. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of opposite party and complaint of the complainant is liable to be dismissed with costs.
3. In order to make out his case, the counsel for complainant has tendered into evidence affidavit Mark A and documents Annexure C-1 to Annexure C-8 alongwith supporting affidavit.
4. In reply thereto, the counsel for opposite party has tendered into evidence documents Annexure R-1 to Annexure R-4 alongwith supporting affidavit.
5. We have gone through the record of the case carefully and have heard the learned counsels for the parties.
6. Learned counsel for the complainant reiterated the contents of the complaint. He submitted that the buffalo in question was insured with OP vide policy dated 13.12.2013 valid from 14.12.2013 to 13.12.2014. He submitted that unfortunately the buffalo in question was died on 14.12.2013 at about 5 p.m. The Post Mortem Report is Annexure C-2. The complainant informed about the death of the buffalo to the OP and also lodged the claim with OP. The OP vide letter dated 24.07.2014 repudiated the claim of the complainant. He submitted that the OP is liable to pay the insured amount to the complainant.
7. Learned counsel for the OP reiterated the contents of the reply. He submitted that as per the terms and conditions of the insurance policy, there is a clause of 15 days waiting period. He submitted that the buffalo in question was insured by the OP on 14.12.2013 and the buffalo died on the same day at about 5.00 p.m. Hence, the said clause of 15 days waiting period is applicable in this case and the claim of the complainant has been rightly repudiated by the OP vide letter dated 13.02.2014 Annexure R-1 and also sent letter dated 24.07.2014 as Annexure R-2.
8. In the light of the pleadings and arguments of the parties, we have examined the relevant material on the record. Indisputably, the buffalo in question was insured by the OP on 14.12.2013 and the insurance was valid for one year upto 13.12.2014. The buffalo in question was died on 14.12.2013 on the very first day of effective insurance. The OP has filed the insurance policy Annexure R-3 and terms and conditions of the policy as Annexure R-4. Condition No. 15 of the said Annexure R-4 reads as under:-
Additional Policy Conditions
‘No tag – No Claim’ and 15 days waiting period would be additional conditions hence forthwith. Wording may be as under:
- 15 days’ waiting period
‘The Company is not liable to pay the claim in the event of death of insured animal due diseases occuring within 15 days from the commencement of risk’.
- No tag – No Claim.
From the plain reading of the said terms and conditions, it is clear that the said condition is applicable in the present case because the fresh insurance policy was issued by the OP for the buffalo in question. It is not the case of the complainant that the present policy was renewed by him without break in insurance. Therefore, we have no hesitation to hold that the claim of the complainant has been rightly repudiated by the OP. Resultantly, the complaint of the complainant is dismissed being devoid of merits. Certified copies of the order be sent to the parties free of costs. File be consigned to the record room, after due compliance.
Announced in open Forum.
Dated:14.03.2017.
(Rajesh Jindal)
President,
District Consumer Disputes
Redressal Forum, Bhiwani.
(Sudesh)
Member
