DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
CC.No.400 of 09-08-2011
Decided on 10-02-2012
Bhola Singh, aged about 42 years, son of Karnail Singh, Resident of V.Goniana Khurd, Tehsil & Distt. Bathinda. .......Complainant
Versus
The Reliance General Insurance Co. Ltd., Reliance Office, Prime Time, SCO 5, Ahta Pritam Singh Sidhu, Amrik Singh Road,
Bathinda, through its Branch Manager/Incharge. (Deleted)
The Reliance General Insurance Co. Ltd., Regional Office: SCO 212, 213, 214, Ist Floor, Sector 34, Chandigarh, through its
Regional Manager.
Deputy Director, Animal Husbandry, Bhagu Road, Bathinda.
......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986
QUORUM
Smt. Vikramjit Kaur Soni, President
Sh. Amarjeet Paul, Member
Smt. Sukhwinder Kaur, Member
Present:-
For the Complainant: Sh.Varun Gupta/Sh.Pritam Singh, counsels for the complainant
For Opposite parties: Sh. Sunder Gupta, counsel for opposite party No.2
Sh. Dhan Singh, A.R. of opposite party No.3
Opposite party No.1 deleted
ORDER
Vikramjit Kaur Soni, President:-
1. The present complaint has been filed by the complainant under Section 12 of the Consumer Protection Act, 1986 as amended up-to-date (Here-in-after referred to as an 'Act'). The brief facts of the complaint are that the complainant is owner of a buffalo of Murrah breed and he insured the said buffalo with the opposite party Nos.1&2 after getting certificate of Health cum Evaluation Certificate from Veterinary Officer, Civil Veterinary Hospital, Balahar Vinju. The Doctor after examination, declared that the said animal is free from any disease and is in good health and recommended for Cattle Insurance. A Tag No.R-106432 was issued by the officials of the opposite party Nos.1&2 to the said buffalo which was attached in the ear of the said buffalo. The said buffalo was insured with the opposite party Nos.1&2 for IDV Rs.30,000/- vide Insurance certificate No.106432 for the period from 02.11.2009 to 01.11.2010. The complainant has alleged that the opposite party Nos.1&2 did not supply any terms and conditions of the policy to him till date. The said buffalo of the complainant died and the post mortem examination of the said buffalo was conducted by Veterinary Officer, Civil Veterinary Hospital, Balhar Vinju. The intimation was sent to the opposite party Nos.1&2 for the payment of the claim through opposite party No.3 and all the documents with claim Form and Tag were submitted by the complainant to the opposite party No.3 for forwarding the same to the opposite party Nos.1&2. The opposite party No.3 lodged the claim of the complainant with the opposite party Nos.1&2 with all the said documents and Tag but the opposite party Nos.1&2 have repudiated the claim of the complainant vide letter dated 12.07.2010, addressed to the opposite party No.3. This intimation with regard to the repudiation of the claim, was not given to the complainant. The complainant had come to know about the repudiation of his claim about two months back from the opposite party No.3. Hence, the complainant has filed the present complaint for seeking directions of this Forum to pay the IDV of the insured animal to the tune of Rs.30,000/- along with cost and compensation.
2. Notice was issued to the opposite parties. The opposite parties after appearing before this Forum, have filed their separate written statements. The opposite party No.2 has taken the legal objection that the opposite party No.2 has no branch office within the territorial jurisdiction of this Forum. Merely by impleading Deputy Direct, Animal Husbandry and Dairying, Bathinda does not give right to the complainant to file the present complaint at Bathinda as no relief has been sought against him and the same has been impleaded as a party, just to create jurisdiction. The claim of the complainant has been repudiated as per exclusion clause of the policy printed on the backside of the Insurance Cover Note in which it has been stated that the said Insurance Company is not liable in case of death of animal due to disease contracted within 15 days from the date of commencement of the risk. According to the documents supplied by the complainant, the insured cattle died on 27.11.2009 and the said Insurance Policy bearing No.106432 was obtained on 02.11.2009 and the cattle was lying ill since prior to 19.11.2009 and had suffered from disease within 15 days of issuance of the said policy. According to the above said exclusion clause, the claim of the complainant is not payable. The opposite party No.2 has further pleaded that the intimation regarding the death of the insured animal has to be given within 24 hours but the complainant has failed to give intimation regarding the death of animal within stipulated period as prescribed in the terms and conditions of the policy. The opposite party No.2 has further pleaded that if this Forum comes to the conclusion that the Insurance Company is liable to pay any compensation, the liability of the Insurance Company is limited to Rs.30,000 only according to the Health cum Evaluation Certificate. The opposite party No.2 has further pleaded that the animal was suffering from pre-existing disease i.e. before 19.11.2009. The claim of the complainant has rightly been repudiated after thorough investigation and after receipt of documents from the complainant. Further, 134 death claims of the insured animals were received, out of which 94 lawful claims have been paid and only 27 have been rejected as per terms and conditions of the policy.
3. The opposite party No.3 has pleaded that the buffalo of Bhola Singh was insured with Reliance General Insurance Co. Ltd. for IDV of Rs.30,000/- and it had died on 27.11.2009. The Post Mortem was conducted and all the documents i.e. Post Mortem Report, Death Certificate, Treatment Chart, Tag and Photograph were deposited by the concerned Veterinary Officer in the office of the opposite party No.3 and thereafter, all the original documents were sent to the Reliance General Insurance Co. Ltd. through agent Sh. Sanjay vide letter No.395 dated 23.12.2009. The opposite party No.3 has further pleaded that the total claims were 134 on 12.07.2010 out of which 94 were settled/paid, rejected 27 and outstanding were 13. The opposite party No.3 has further pleaded that the no investigation of the said buffalo was done by the Company and no enquiry was conducted by any investigation official and the case of the complainant was rejected without any reason and there was no response from Reliance General Insurance Co. Ltd. by the opposite party No.3.
4. The opposite party No.1 is deleted vide order dated 30.09.2011.
5. Parties have led their evidence in support of their respective pleadings.
6. Arguments heard. Record along with written submissions submitted by the parties perused.
7. The undisputed facts between the parties are that the complainant had purchased the Insurance Policy/Cover Note bearing No.106432 from Reliance General Insurance Company Limited for his buffalo of Murrah breed after paying the requisite premium. The said buffalo was insured for the IDV of Rs.30,000/- and a Tag No.R-106432 was issued which was attached in the ear of the said buffalo. The policy was valid from 02.11.2009 to 01.11.2010. The Insured buffalo had died on 27.11.2009.
8. The disputed facts between the parties are that the complainant has specifically submitted that no terms and conditions of the policy have been supplied to him. He got Health-cum-Evaluation Certificate from Veterinary Officer, Civil Veterinary Hospital, Balahar Vinju to the effect that the animal is free from any disease and is in good state of health and recommended for Cattle Insurance. The Insured buffalo had died on 27.11.2009. The Post Mortem examination of the said buffalo was conducted by Veterinary Officer, Civil Veterinary Hospital, Balhar Vinju and the due intimation with regard to the claim of the said buffalo was sent by the complainant to the opposite party No.3 along with Tag and other requisite documents. The opposite party No.3 lodged the claim of the complainant with the Insurance Company i.e. opposite party Nos.1&2 and the Deputy Director and Diarying (Pashupalan) sent a letter No.3951 dated 23.12.2009 to Insurance Company but they have repudiated the claim of the complainant. The complainant had received repudiation letter of his claim about two months back from the opposite party No.3 before filing of this complaint.
9. The opposite party No.2 has submitted that the claim of the complainant has been repudiated as per exclusion clause of the policy printed at the back side of the Insurance Policy/Cover Note in which it has been stated that the complainant is not entitled to get the death claim of the said animal due to disease contracted within 15 days from the date of commencement of the policy. The said insured buffalo had died on 27.11.2009 and the complainant had obtained the policy in question on 02.11.2009 and the cattle was lying ill since prior to 19.11.2009 and was suffering from disease within 15 days of issuance of the said policy. According to the above said exclusion clause, the claim of the complainant is not payable.
10. The other point of arguments of the opposite parties is that the intimation regarding the death of the Insured Animal has to be given within 24 hours but the complainant has failed to give intimation regarding the death of animal within stipulated period as prescribed in the terms and conditions of the policy and has further submitted that if this Forum concludes that the Insurance Company is liable to pay any compensation, then the liability of the Insurance Company is limited to Rs.30,000/- only according to the Health cum Evaluation Certificate. The said animal has been suffering from pre-existing disease i.e. before 19.11.2009.
11. The opposite party No.3 has submitted that no investigation of the said buffalo was conducted by any investigation official of Insurance Company and the case of the complainant was rejected without any reason.
12. The opposite party No.2 has taken the legal objection that this Forum has no territorial jurisdiction to try and entertain the present complaint as there is no branch office of the Insurance Company within territorial jurisdiction of this Forum and the opposite party No.3 has been impleaded by the complainant just to create jurisdiction.
13. The first ground for not paying the claim of the complainant, taken by the opposite party No.2 is that the said animal had died within 15 days from the date of commencement of the policy as the said animal has been suffering from pre-existing disease before 19.11.2009. The second ground for repudiating the claim is that the intimation regarding the death of the animal has not given within 24 hours from the date of death.
14. The first ground for not paying the claim, the opposite party No.2 has failed to placed on file any evidence regarding the pre-existing disease of the animal. Moreover, the animal had died on 27.11.2009 i.e. approximately after 25 days from the date of commencement of the policy. The second ground for not paying the claim that no intimation has been given within 24 hours, is also baseless as its terms and conditions have not been supplied to the complainant as these were not signed by the complainant which shows that these were never conveyed to him. Moreover, at the bottom of Ex.C-5, it has been mentioned:-
“For complete terms and conditions of the policy reference is to be made to the master policy issued to PLDB along with MOU.”
No complete terms and conditions have been placed on file by the opposite parties. No MOU is also produced on file which has been issued to PLDB. Moreover, the complainant has sent the intimation to the opposite party No.3. The opposite party No.3 in turn has intimated the insurance company and lodged the claim with it.
15. Further, with regard to the legal objection taken by the opposite parties that this Forum has got no jurisdiction to try and entertain the present complaint as there is no branch office of the Insurance Company at Bathinda, is also not tenable as a perusal of documents placed on file reveals that the insurance claim of the complainant has been sent by Deputy Director, Animal Husbandry & Diarying (Pashupalan), Bathinda vide its letter No.3951 dated 23.12.2009 to the Insurance Company. Moreover, one of the opposite parties holds and runs its office at Bathinda. Thus, this Forum has jurisdiction to try and entertain the present compliant u/s 11(b) of the 'Act'.
16. Therefore, in view of what has been discussed above, this Forum is of the considered view that there is deficiency in service on the part of the Insurance Company i.e. opposite party No.2. Hence, this complaint is accepted with Rs.2,000/- against the opposite party No.2 and dismissed qua opposite party No.3. The opposite party No.2 is directed to pay the IDV of Rs.30,000/- of the Insured Animal to the complainant. Compliance of this order be done within 45 days from the date of receipt of copy of this order. In case of non-compliance, interest @ 9% p.a. will yield on the amount of Rs.30,000/- till realization.
A copy of this order be sent to the parties concerned free of cost and file be consigned for record. '
Pronounced in open Forum
10-02-2012
(Vikramjit Kaur Soni)
President
(Amarjeet Paul)
Member
(Sukhwinder Kaur)
Member
