DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
CC.No.402 of 09-08-2011
Decided on 10-02-2012
Harnek Singh son of Jaggar Singh, aged about 52 years, Resident of village Poohla, 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 Mixor Breed buffalo of the complainant was insured with the opposite party Nos.1&2 for IDV of Rs.20,000/- vide Insurance Certificate No.104476 for the period from 05.09.2009 to 04.09.2010. The complainant has alleged that the opposite party Nos.1&2 did not supply any terms and conditions of the policy to him. The said buffalo of the complainant was insured with the opposite party Nos.1&2 after getting Health-cum-Evaluation Certificate from Dr. Subhash Mittal, Veterinary Officer, Civil Veterinary Hospital, Poohla. The doctor after examining the buffalo of the complainant, declared that the said buffalo is free from any disease and is in good state of health and recommended for Cattle Insurance. A Tag No.R-104476 was allotted to the said buffalo and attached in the ear of the said buffalo. The said buffalo of the complainant had died after 2/3 months of the insurance and the Post Mortem of the said buffalo was conducted by the Veterinary Officer, Civil Veterinary Hospital, Poohla and prepared a post mortem report. Thereafter, due intimation was sent to the opposite party Nos.1&2 for the payment of the claim of the complainant through the 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 along with all documents, Tag and photograph 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. The opposite party Nos.1&2 have never intimated the complainant about repudiation of his claim. He came to know about the repudiation of his claim 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 Rs.20,000/- along with interest, 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 pleaded that it has no branch office within the territorial jurisdiction of this Forum. Merely by impleading the Deputy Director, Animal Husbandry and Dairying, Bathinda does not give rise to the complainant to file the present complaint as no relief has been sought against the Deputy Director and has been impleaded as party, just to create jurisdiction before this Forum. 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 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 policy. As per documents supplied by the complainant, the Insured buffalo died on 19.10.2009 and the said Insurance Policy/Cover Note was obtained on 05.09.2009 and the cattle was lying ill since prior to 01.10.2009 and the cattle has suffered from disease within 15 days of issuance of the said policy as such the claim of the complainant is not payable as per the above said exclusion clause. The opposite party No.2 has further pleaded that the terms and conditions of the cattle insurance are printed on the backside of every cover note and the complainant has not intentionally produced the same before this Forum. As per terms and conditions of the policy, 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 insured animal within stipulated time to the Insurance Company. 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.20,000/- only being sum assured as per Health-cum-Evaluation Certificate. The opposite party No.2 has further pleaded that the buffalo of the complainant had died on 19.10.2009 and the animal was suffering from pre-existing disease i.e. before 01.10.2009 as such the insured animal has suffered from disease within 15 days of the issuance of the policy as such the claim of the complainant is not payable The opposite party No.2 has further pleaded that 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 Sh. Harnek Singh S/o Sh. Jaggar Singh, was insured with Reliance General Insurance Co. Ltd. for IDV of Rs.20,000/- for the period from 05.09.2009 to 04.09.2010. The Insured buffalo died on 19.10.2009 and the post mortem was conducted by Rural Veterinary Officer, Civil Veterinary Hospital, Poohla 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 the opposite party No.3 had sent all the original documents to the Reliance General Insurance Co. Ltd. through agent Sh. Sanjay vide letter No.3434 dated 28.10.2009. The Reliance General Insurance Co. Ltd. sent a list of 134 claims on 12.07.2010 in which 94 were settled, 27 were rejected and 13 were outstanding. The Deputy Director came to know that the case of the buffalo of Harnek Singh has been rejected. 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. to the opposite party No.3.
4. The opposite party No.1 is deleted as the separate statement suffered by the complainant on 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.104476 from Reliance General Insurance Company Limited for his buffalo of Mixor breed after paying the requisite premium. The said buffalo was insured for the IDV of Rs.20,000/- and a Tag No.R-104476 was issued which was attached in the ear of the said buffalo. The policy was valid from 05.09.2009 to 04.09.2010. The Insured buffalo had died on 19.10.2009.
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, Poohla 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 19.10.2009 and the Post Mortem examination of the said buffalo was conducted by Veterinary Officer, Civil Veterinary Hospital, Poohla and the due intimation with regard to the claim of the said buffalo was sent by the complainant through the opposite party No.3 along with claim Form, Tag and other requisite documents. The opposite party No.3 lodged the claim of the complainant with the Insurance Company i.e. the opposite party Nos.1&2 but they have repudiated the claim of the complainant.
9. The opposite party No.2 has submitted that the claim of the complainant has rightly 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 mentioned that the complainant is not entitled to get the death claim of the said animal as the insured buffalo had died on 19.10.2009 and the said Insurance Policy/Cover Note was obtained on 05.09.2009 and the cattle was lying ill since prior to 01.10.2009 and has suffered from disease within 15 days of issuance of the said policy. The opposite party No.2 has further submitted 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 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.20,000/- only according to the Insurance Policy.
10. The opposite party No.3 has submitted that no investigation of the said buffalo was done either by the Insurance Company or by any investigation official and the case of the complainant was rejected without any reason.
11. The Insured cattle had died on 19.10.2009 whereas the Insurance Policy/Cover Note bearing No.104476 was obtained on 05.09.2009 and the validity of the said policy was from 05.09.2009 to 04.09.2010. The opposite party No.2 has repudiated the claim on the ground that the insured cattle was ill prior to 01.10.2009 and the cattle had suffered from disease within 15 days from issuance of the policy. The opposite party No.2 has given the other ground for repudiation of the claim that the intimation with regard to the death of the insured animal, has not been given within 24 hours. The opposite party has taken the legal objection that there is no branch office of the Insurance Company at Bathinda as such this Forum has no jurisdiction to try and entertain the present complaint.
12. A perusal of documents placed on file shows that the Insured animal had died on 19.10.2009 and the validity of the policy was from 05.09.2009 to 04.09.2010. The Insured cattle had died approximately after 1½ months from the commencement of the policy. Moreover, the opposite party No.2 has failed to produce any evidence with regard to pre-existing disease of the insured cattle. Thus, this ground of repudiation of the claim, is baseless and the have wrongly repudiated the claim of the complainant.
13. According to the opposite party No.2, the intimation regarding the death of insured cattle has to be given within 24 hours but the complainant has failed to give the information regarding the same within stipulated time. The complainant has sent the information regarding the death of the insured animal to the opposite party No.3 within time and in turn, the opposite party No.3 has to send the information to the opposite party No.2. Thus, this ground for not paying the claim of the complainant, is also baseless.
14. The legal objection taken by the opposite party No.2 that there is no branch office of the Insurance Company at Bathinda as such this Forum has no jurisdiction to try and entertain the present complaint, is not tenable as the claim intimation regarding the death of the Insured cattle of the complainant has been sent by the Deputy Director, Animal Husbandry and Diarying (Pashupalan) vide letter No.3434 dated 28.10.2009 from Bathinda to the Insurance Company as such one of the opposite party is holding its office at Bathinda. Thus, this Forum has got jurisdiction to try and adjudicate the present complaint as per Section 11(b) of the 'Act'.
15. Therefore, in view of what has been discussed above, this Forum is of the considered view that the opposite party No.2 has wrongly repudiated the claim of the complainant and as such, 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/- as cost and compensation against the opposite party No.2 and dismissed qua opposite party No.3. The opposite party No.2 is further directed to pay the IDV of Rs.20,000/- 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.20,000/- 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
