Present         (1)      Nisha Nath Ojha,   

                              District & Sessions Judge (Retd.)                                                                               President

                    (2)      Sri Sheo Shankar Prasad Singh,

                              Member

                    (3)      Smt. Karishma Mandal

                              Member

Date of Order :  02.07.2015

                    Smt. Karishma Mandal

1. In the instant case the Complainant has sought for following reliefs against the Opposite party:-

1. To direct the opposite party to pay Rs. 35,000/- ( Rs. Thirty Five Thousand only ) being the sum assured.
2. To pay interest @ 12% per annum on such sum assured amount from four months after the claim date.
3. To pay Rs. 10,000/- ( Rs. Ten Thousand only ) as compensation.
4. To pay Rs. 10,000/- ( Rs. Ten Thousand only ) as litigation cost.

2. Brief facts of the case which led to the filing of complaint are as follows:-

1. The complainant Alok Kumar, was issued a “ Cattle Insurance Policy ” by United India Insurance Company Limited, insuring his 8 cattle for a sum assured of Rs. 35,000/- ( Rs. Thrity Thousand only ) each and a premium of Rs. 14,050/- ( Rs. Fourteen Thousand Fifty only ) was paid through the Financer, Canara Bank, Rajendra Nagar Branch, Patna.
2. The policy no. was 210900/47/08/01/00000120 and the period of cover was from 31.03.2009 till midnight of 30.03.2010. The buffalo placed at serial no. 2 was given an ID no. UII/22603. A policy bond to such effect was issued in favour of Alok Kumar. ( Vide Annexure – 1 )
3. The buffalo at serial no. 2 was seen very ill in the evening at around 6:45 P.M. of 30.03.2010 and the Vetenary Doctor Mr. Jitendra Prasad, Farm Vetenary Office, Exotic Cattle Breeding Farm, Patna was called immediately and despite his best efforts the said buffalo died at 7:00 P.M. on 30.03.2010 due to Tympanitin.
4. The complainant informed the Insurance Company about the death of the buffalo at around 12:05 P.M. on 31.03.2010 i.e. within 24 hours and also the fact that the post – mortem has already been done and as such requested that if an enquiry is to be done then it may be done as early as possible as he could not keep the body of the dead animal for long. The official informed that they were busy in closing but assured that they will try to send the investigator for enquiry as early as possible.
5. The complainant waited for the investigator till 8:00 P.M. in the evening. He even called the office to expedite the matter and despite assurance nobody turned up from the Insurance Company and thus the complainant, already under the pressure of the people in the locality to dispose of the animal which had started emitting bad odor, had to dispose of the body with the help of 5 people of the locality. The complainant on 05.04.2010 was issued claim form by the opposite party, who was the insurer of the said policy, as also a vetenary Certificate to be entered and signed by the Doctor who had examined and performed post- mortem on the said buffalo.
6. The nominee – complaint thereafter waited for almost 6 months for his claim to be settled but finding no response the complainant made an application under the RTI Act, 2005 asking for the status of his claim and as to why the claim has not been paid to him up till now ?
7. The complainant in reply to his application under RTI Act received a communication dated 02.11.2010 contained in letter no. 488/10 by the Divisional Manager, stating that as the claim is made after the expiry of the policy and hence without using the word it was communicated that the claim of the complainant has been repudiated by the opposite party. ( Vide Annexure – 3 )
8. The complainant felt lost and approached opposite party for redressal of his grievances but to no avail. The complainant also met the officials of the United India Insurance Company Limited who only assured him of some action on his pleas but nothing concrete happened.
9. The complainant then met an Advocate who suggested him to move to the Court for direction to settle his claim as the insurer, opposite party has erred in passing such order of repudiation as his claim was within time considering the period, as the occurrence had taken place within the period of policy and the information given in time.
10. The complainant was told by the Advocate that it is the settled law that the Insurance Company had to pass appropriate orders within 3-4 months of claim.
11. The opposite party has not only deliberately with wrongful intention delayed the settlement of claim they have rejected the same on frivolous and arbitrary ground with malafide intention as the complainant did not agree to the extraneous demands made by the officials and the investigator.
12. The complainant even talked to the officials and met the officials of the United India Insurance Co. Ltd. who said they cannot do anything about the same and he may raise this issue wherever he may want.
13. In view of the aforesaid facts the opposite party who had issued the policy and is also the settlement authority has shown gross deficiency in services by first not settling the claim within time and then repudiating the claim on frivolous and arbitrary grounds completely against the settled principles of law.

3. The Opposite Party filed Written Statement denying the allegations of the complainant which are discussed here in below :-

1. From the perusal of the complaint case itself it will appear that allegedly said she buffalo was allegedly insured from 31.03.2009 to 30.03.2010. further from the case of the complainant itself it will appear that the opposite party was informed at 12:05 on 31.03.2010 i.e. after the expiry of the policy. However alleged intimated to the opposite party at 12:05 hours is denied and fact remains that the opposite party was informed at 5:25 P.M. on 31.03.2010.
2. On receiving the information at 5:25 P.M. on 31.03.2010 investigator was deputed on the same day. Investigator went for investigation and verification at 5:00 A.M. on 01.04.2010 and it was informed that the dead she buffalo has been dumped. It will be relevant to mention here that the investigator on receiving intimation of deputation contacted complainant on phone and requested to wait till early morning.
3. The investigator demanded relevant papers but those were not made available and complainant replied that the papers would be submitted subsequently but at the earlies.
4. The investigator submitted the report and it has been mentioned in the report that the claim of the cattle appears to be controversial.
5. The fact is somewhat otherwise and fact remains that the cattle died on 31.03.2010 and as the policy then had expired as such a case of death on 30.03.2010 was made out by the complainant. It is expressly denied that the she buffalo died on 30.03.2010.
6. The alleged PMR appears to be a collusive document. PMR annexed to the complaint in itself speaks much against the case of the complainant. It will be relevant to mention here that from the case of the complainant. It will appear that the said she buffalo was not treated and this goes on to falsify the case of the complainant.
7. The intimation to the opposite party was after the expiry of the policy as such the claim itself was not maintainable and the claim was rightly repudiated. That as per rule no claim can be lodged after expiry of the policy.
8. From perusal of the case of the complainant it will appear that the papers attached to the complaint case were supplied to the opposite party on 28.04.2010. Delay in submitting papers itself speaks much.
9. Taking into consideration the totality of the case it is clear that the complainant is making a wild attempt to usurp the public money by making a claim after expiry of the policy.

We have gone through the documents available on the record and have heard the learned counsel of complainant as non has appeared on behalf of the opposite party at the hearing stage.

From the record it transpires that the cattle was insured for the period from 31.03.2009 to 30.03.2010 and the complainant gave the information about the death of the cattle on 31.03.2010. Although the cattle died on 30.03.2010 at 7:00 P.M. Post – Mortem was done at 6:05 P.M. on 31.03.2010 and the information of death of cattle was given to the Insurance Company at 5:25 P.M. on 31.03.2010. As submitted by the opposite party although in the petition. It is submitted by the opposite party that intimation was given at 12:05 on 31.03.2010 and further more the opposite party has submitted as per report of the investigation of death of the buffalo appears to be controversial.

Having gone through the facts narrated in the complaint petition and the written statement. We are not convinced with the stand taken by the opposite party that the buffalo died on 31.03.2010 but the complainant managed to manufacture the documents in collusion with the authorities concerned to prove that cattle died on 30.03.2010, the date on which the policy was to expire but actually the cattle died on 30.03.2010 which is proved by the Doctor and other authorities.

In our view the submissions of the complainant appears to be correct and accordingly we direct the opposite party to pay to the complainant Rs. 35,000/- ( Rs. Thirty Five Thousand only ), being the sum assured, within a period of two months from the date of receipt of this order failing which an interest @ 9% ( Nine) per annum will be levied on the aforesaid amount till it is finally paid.

Further the opposite party is directed to pay Rs. 5,000/- ( Rs. Five Thousand only ) as compositecharge for compensation and litigation costs to the complainant within the aforesaid period of two months.

Thus the complaint petition stands allowed to the extent indicated above.

                                        Member ( F )                              Member                            President