BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.80 of 2015

Date of Instt. 03.03.2015

Date of Decision : 14.07.2016

Munish son of Jagjit Singh R/o Mohalla Malahan, Gulab Kothi, Phillaur, District Jalandhar.

..........Complainant

Versus

1.The Punjab National Bank, Main, Phillaur, District Jalandhar-144410 through its Branch Manager.

2.The Oriental Insurance Company Ltd., Sawan Chambers, above PNB, GT Road, Phagwara through its Branch Manager.

3.The Oriental Insurance Company Ltd., Oriental House, A25/27, Asaf Ali Road, New Delhi-110002 through its Authorized Signatory.

.........Opposite parties

Complaint Under Section 12 of the Consumer Protection Act.

Before: S. Bhupinder Singh (President)

Sh.Parminder Sharma (Member)

Present: Sh.Jaswant Singh Adv., counsel for the complainant.

Sh.Ishar Singh Adv., counsel for the OP No.1.

Sh.Brijesh Bakshi Adv., counsel for OPs No.2 & 3.

Order

Bhupinder Singh (President)

1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act against the opposite parties (hereinafter called as OPs) on the averments that complainant purchased two buffaloes for Rs.50,000/- each by getting loan of Rs.90,000/- from OP No.1 bank. Complainant further submitted that OP No.1 bank got the said buffaloes insured with OP No.2 and said insurance policy was valid from 1.6.2013 to 31.5.2014. On 25.5.2014 one of the aforesaid two buffaloes of the complainant died and the complainant informed OP No.1 Bank on phone on 25.5.2014 and thereafter he gave information in this regard to bank official in writing on 26.5.2014 but no action was taken by OP No.1. Complainant gave written reminder on 5.8.2014 to OP No.1 who forwarded the claim case of the complainant to OP No.2 vide letter dated 6.8.2014 with copy to complainant. Thereafter, OP No.1 informed the complainant vide letter dated 11.9.2014 that insurance company has rejected the claim of the complainant vide letter dated 21.8.2014 on the ground that they are unable to entertain the claim at this stage since dead animal has to be inspected by their investigator before disposal and immediate intimation was required to be given. Complainant submitted that complainant informed OP No.1 immediately but it is the OP No.1 who did not inform OP No.2 insurance company. So, there is no fault on the part of the complainant but deficiency of service on the part of the OPs. On such averments, the complainant has prayed for directing the OPs to pay the claim amount of the insured buffalo alongwith interest. He has also claimed compensation and litigation expenses.

2. Upon notice, OPs appeared through counsels and filed their written replies. In its written reply, OP No.1 pleaded that complainant has not come to this Forum with clean hands. He had never informed about the death of animal to OP No.1 on 25.5.2014 on the phone or on 26.5.2014 in writing. This entire story is concocted one. There is no privity of contract between complainant and OP No.1 as the insured policy was issued by OPs No.2 & 3 and the complainant had to inform about the death of the insured buffalo to OPs No.2 & 3 and not to the OP No.1. Complainant informed about the death of the buffalo to OP No.1 in writing vide letter dated 5.8.2014 which was received by bank official on 6.8.2014 and prior to this letter the complainant never informed the OP No.1 about the death of buffalo either in writing or verbally or on the phone. The said letter of the complainant received on 6.8.2014 was forwarded by OP No.1 on the same day i.e. 6.8.2014 to the insurance company vide letter dated 6.8.2014. So, it was OPs No.2 and 3 who are to decide the claim case of the complainant and not by OP No.1.

3. In its written reply, OPs No.2 & 3 pleaded that for identification of the insured animal as per Livestock (cattle insurance) policy clause 8-insured animal has to be identified by means of brass button ear tag of 'Polyurethene E', Natural descriptive features such as age, sex, colour, height and special markings, if any, noted in the proposal and veterinary certificate and incorporated in the policy. In the present case also, tagging was made on the insured buffaloes and tearing off of the same from the corpse in one condition precedent for entertainment of the claim besides other conditions like immediate claim, intimation and inspection of the corpse of the insured animal. As per clause 11 of the policy, the claim process involves the immediate intimation to the insurance company within 7 days and submission of the following within 30 days-

1.Duly completed and signed claim form.

2.Death certificate from a qualified Veterinary Surgeon.

3.Postmortem Report.

4.Submission of ear tag.

4. Even as per addition policy, the conditions 'No tag-No Claim' and 15 days waiting period are additional conditions. Company is not liable to pay the claim in the event of death of insured animal due to diseases occurring within 15 days from the commencement of risk. In the event of death of animals covered under the policy, claims shall not be entertained unless the ear tags are surrendered to the company. As per terms and conditions of the policy, in case of loss of ear tags, it is the responsibility of the insured to give immediate notice to the company to get the animal retagged. In this case, the intimation regarding the death of animal was given for the first time to OPs No.2 & 3 by OP No.1 vide letter dated 6.8.2014 alongwith request letter of the complainant dated 5.8.2014 copy of which was also sent to the complainant. Whereas the buffalo had expired on 25.5.2014 i.e. after a lapse of a period of 72 days from the date of alleged death of such buffalo. OPs No.2 & 3 have been deprived of inspection of the corpse of the deceased buffalo to verify the tag number, identity, etc. No postmortem report of the deceased buffalo was produced by the complainant. Rather the corpse was disposed off at their own level without informing the company. No intimation was given to the OPs No.2 & 3 regarding the death of animal either by the complainant or by the OP No.1 on 25.5.2014 or 26.5.2014 as alleged by the complainant. So, as per terms and conditions of the policy, the OPs No.2 & 3 were justified in repudiating the claim of the complainant.

5. In support of his complaint, learned counsel for the complainant has tendered into evidence affidavits Ex.CA to Ex.CC alongwith copies of documents Ex.C1 to Ex.C7 and closed evidence.

6. On the other hand, learned counsel for opposite party No.1 has tendered affidavit Ex.OP-1 alongwith copies of documents Ex.OP1/A to Ex.OP1/C and closed evidence. Further learned counsel for the OPs No.2 & 3 has tendered affidavit Ex.OP-3/A alongwith copies of documents Ex.O1 to Ex.O3 and closed the evidence.

7. We have heard the Ld. counsel for the parties, minutely gone through the record and have appreciated the evidence produced on record by both the parties with the valuable assistance of Ld. counsels for the parties.

8. From the record i.e. pleadings of the parties and the evidence produced on record by both the parties, it is clear that complainant purchased two buffaloes for Rs.50,000/- each by getting loan of Rs.90,000/- from OP No.1 bank. Complainant further submitted that OP No.1 bank got the said buffaloes insured with OP No.2 and said insurance policy was valid from 1.6.2013 to 31.5.2014. On 25.5.2014 the aforesaid two buffaloes of the complainant died and the complainant informed OP No.1 on phone on 25.5.2014 and thereafter he gave information in this regard to bank official in writing on 26.5.2014 but no action was taken by OP No.1. Complainant gave written reminder on 5.8.2014 Ex.C2 to OP No.1 who forwarded the claim case of the complainant to OP No.2 vide letter dated 6.8.2014 Ex.C3 with copy to complainant. Thereafter, OP No.1 informed the complainant vide letter dated 11.9.2014 Ex.C4 that insurance company has rejected the claim of the complainant vide letter dated 21.8.2014 Ex.C5 on the ground that they are unable to entertain the claim at this stage since dead animal has to be inspected by their investigator before disposal and immediate intimation was required to be given. Learned counsel for the complainant submitted that complainant informed OP No.1 immediately but it is the OP No.1 who did not inform OP No.2 insurance company. So, there is no fault on the part of the complainant but deficiency of service on the part of the OPs qua the complainant. As such, they are liable to compensate the complainant.

9. Whereas the case of the OP No.1 is that complainant has not come to this Forum with clean hands. He had never informed about the death of animal to OP No.1 on 25.5.2014 on the phone or on 26.5.2014 in writing. This entire story is concocted one. There is no privity of contract between complainant and OP No.1 as the insured policy was issued by OPs No.2 & 3 and the complainant had to inform about the death of the insured buffalo to OPs No.2 & 3 and not to OP No.1. Complainant informed about the death of the buffalo to OP No.1 in writing on 5.8.2014 vide letter Ex.OP1/A which was received by bank official on 6.8.2014 and prior to this letter the complainant never informed the OP No.1 about the death of buffalo either in writing or verbally or on the phone and the said letter of the complainant was forwarded by OP No.1 on the same day i.e. 6.8.2014 to the insurance company vide letter dated 6.8.2014. So, it was OPs No.2 and 3 who are to decide the claim case of the complainant and not by OP No.1. Learned counsel for the OP No.1 submitted that there is no deficiency of service on the part of the OP No.1 qua the complainant.

10. Whereas the case of the OPs No.2 & 3 is that for identification of the insured animal as per Livestock (cattle insurance) policy clause 8-insured animal has to be identified by means of brass button ear tag of 'Polyurethene E', Natural descriptive features such as age, sex, colour, height and special markings, if any, noted in the proposal and veterinary certificate and incorporated in the policy are to be confirmed. In the present case also, tagging was made on the insured buffaloes and tearing off of the same from the corpse in one condition precedent for entertainment of the claim besides other conditions like immediate claim, intimation and inspection of the corpse of the insured animal by the OP. As per clause 11 of the policy, the claim process involves the immediate intimation to the insurance company within 7 days and submission of the following within 30 days-

1.Duly completed and signed claim form.

2.Death certificate from a qualified Veterinary Surgeon.

3.Postmortem Report.

4.Submission of ear tag.

11. Even as per addition policy, the conditions 'No tag-No Claim' and 15 days waiting period are additional conditions. Company is not liable to pay the claim in the event of death of insured animal due to diseases occurring within 15 days from the commencement of risk. In the event of death of animals covered under the policy, claims shall not be entertained unless the ear tags are surrendered to the company. As per terms and conditions of the policy, in case of loss of ear tags, it is the responsibility of the insured to give immediate notice to the company to get the animal retagged. In this case, the intimation regarding the death of animal was given for the first time to OPs No.2 & 3 by OP No.1 vide letter dated 6.8.2014 Ex.C3 alongwith request letter of the complainant dated 5.8.2014 Ex.C2, copy of which was also sent to the complainant, whereas the buffalo had expired on 25.5.2014 i.e. after a lapse of a period of 72 days from the date of alleged death of such buffalo. OPs No.2 & 3 have been deprived of inspection of the corpse of the deceased buffalo to verify the tag number. No postmortem report of the deceased buffalo was produced by the complainant. Rather the corpse was disposed off at their own level without informing the company. No intimation was given to the OPs No.2 & 3 regarding the death of animal either by the complainant or by the OP No.1 on 25.5.2014 or 26.5.2014 as alleged by the complainant. So, as per terms and conditions of the policy, the OPs No.2 & 3 were justified in repudiating the claim of the complainant. As such, there is no deficiency in service on the part of the OPs No.2 & 3 qua the complainant.

12. From the entire above discussion, we have come to the conclusion that complainant purchased two buffaloes for Rs.50,000/- each as alleged by complainant by taking loan of Rs.90,000/- from OP No.1 bank. Complainant through OP No.1 got insured the buffaloes from OP No.2 vide insurance policy Ex.O1 for the period from 1.6.2014 to 31.5.2015 under Market Agreement on Cattle Insurance Ex.O2. Complainant submitted that one of his buffalo died on 25.5.2014 and he informed the OP No.1 bank on the same date i.e. 25.5.2014 orally on phone and on 26.5.2014 in writing. But the complainant never produced any such letter dated 26.5.2014 allegedly written by complainant to OP No.1 and OP No.1 has categorically denied that complainant has ever informed about the death of his buffalo on 25.5.2014 on phone or on 26.5.2014 in writing. Complainant had sent letter for the first time to the OP No.1 i.e. letter dated 5.8.2014 Ex.C2 in this regard and OP No.1 sent the same to OP No.2 regarding claim for insurance of the buffalo on 6.8.2014 vide letter Ex.C3 with copy to the complainant in which it was categorically written by OP No.1 that they had not received any information regarding the death of buffalo earlier. So, the complainant has failed to prove on record that he has given any information regarding the death of the buffalo to OP No.1 on 25.5.2014 through telephone or in writing on 26.5.2014 to OP No.1. Had the complainant informed the OP No.1 through telephone on 25.5.2014 or in writing on 26.5.2014 regarding the death of his buffalo why he did not raise objection to the OP No.1 on receipt of copy of this letter dated 6.8.2014 Ex.C3. Moreover, the complainant has full awareness that he got the buffalo insured with OPs No.2 & 3 but he did not inform the insurance company i.e. OPs No.2 & 3 regarding the death of the buffalo. So, it stands fully proved on record that complainant never informed the OP No.1 or OPs No.2 & 3 regarding the death of the buffalo prior to 5.8.2014 i.e. about 72 days after the death of buffalo.

13. Moreover, the complainant has submitted that he got the aforesaid buffalo insured with the OP which was valid form 1.6.2013 to 31.5.2014 but no such insurance policy has been produced by the complainant. Rather the OPs No.2 & 3 have stated in their written version as well as in their evidence that the complainant got the buffalo insured vide policy Ex.O1 for the period from 1.6.2014 to 31.5.2015. Whereas, the buffalo in question of the complainant has expired on 25.5.2014 which is not covered under this insurance policy.

14. Apart from this, as per terms and conditions of the policy and also it is in the knowledge of the insured i.e. complainant that OPs No.2 & 3 i.e. insurance company has to verify the death of the insured buffalo and the OP has to get the identity of the insured animal verified from the tag number which was fixed in the ear of the insured animal as to whether the said buffalo was duly insured with the OP insurance company or not but no such tag was retained by the complainant before disposing of the corpse of the dead buffalo nor any tag number was mentioned by the complainant in the application Ex.C2 nor in the present complaint. So, how the OPs No.2 & 3 could get it verified whether the deceased buffalo of the complainant was duly insured with the OPs No.2 & 3. The complainant neither got the postmortem of the dead buffalo conducted from the Veterinary Officer/Doctor nor got the corpse of the deceased buffalo inspected from the OPs No.2 & 3. So, OPs No.2 & 3 were justified in repudiating the claim of the complainant as there are serious lapses on the part of the complainant which are not condonable and the OPs No.2 & 3 have been deprived of their right to inspect the corpse of the deceased buffalo, to verify the tag number of the deceased buffalo, to verify the cause of death of the deceased buffalo, etc.

15. Resultantly, we hold that the OPs No.2 & 3 were justified in repudiating the claim of the complainant vide letter dated 21.8.2014 Ex.O3. Consequently, we hold that there is no merit in this complaint and the same is hereby dismissed with no order as to cost. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.

Dated Parminder Sharma Bhupinder Singh

14.07.2016 Member President