Haryana

Yamunanagar

CC/1298/2012

Bhago Devi W/o. Rameshwar Dass - Complainant(s)

Versus

United India Insurance Co.Ltd. - Opp.Party(s)

Satpal Singh Saini

14 Dec 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                                Complaint No. 1298  of 2012.

                                                                                                Date of institution: 17.12.2012

                                                                                                Date of decision:  14.12.2016

Bhago Devi wfire of Shri Rameshwar Dass, resident of village Daulatpur, P.O. Hafizpur, Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                                                                                          

                                                                                                                                    …Complainant.

                                                Versus                                                

1.  United India Insurance Co. Ltd. Branch Office: Near Telephone Exchange, Yamuna Nagar through its Branch Manager.
2. State Bank of Patiala, Harnaul, Tehsil Jagadhri, Distt. Yamuna Nagar through its Branch Manager.
3. Ms. Shivani, Self Help Group, through Smt. Nirmala w/o Sh. Shish Pal, r/o village Daulatpur, Tehsil Jagadhri, District Yamuan Nagar.                                                                                                                                                        

                                                                                                                                    …Respondents 

Before:               SH. ASHOK KUMAR GARG, PRESIDENT

                            SH. S.C.SHARMA, MEMBER

Present: Sh. Satpal Singh Saini, Advocate, counsel for complainant.   

              Sh. Karnesh Sharma, Advocate, counsel for respondent No.1.

              Sh. Mukesh Sehgal, Advocate, counsel for respondent No.2.

              Respondent No.3 already given up vide order dated11.07.2016.  

                                                                                                                                                                                                                       

ORDER

1.                     Complainant Bhago Devi has filed the present complaint under section 12 of the Consumer Protection Act 1986 praying therein that the respondents (hereinafter referred as OPs) be directed to pay insured amount alongwith interest and further to pay compensation as well as litigation expenses.

2.                     Brief facts of the present complaint, as alleged by the complainant, are that complainant belongs to a poor family and also member of Self-Help Group and the said SHG has obtained a loan from OP No.2 bank for purchase of buffalos for the members of SHG and accordingly the complainant has also purchased two buffalos on loan with OP No.2 Bank i.e. Tag ID No. UII/2503 and UII-2504 for a sum of Rs. 24,500/- each under SGSY Scheme of the Govt. and the same were insured with the OP No.1 Insurance Company vide policy No. 110101/47/11/01/0000036 w.e.f. 20.05.2011 to 19.05.2014. Unfortunately on 27.09.2012 the buffalo bearing Tag No. UII-2504 fell ill and died all of sudden even medical could not be provided. The postmortem on the dead body of the buffalo was conducted by Veterinary Surgeon GVH, Farakpur on 28.09.2012. Thereafter, the complainant intimated the OPs and furnished claim papers for the death of the buffalo with the OP No.1 but OP No.1 is still sleeping over the matter and has not released the amount of insurance on account of death of buffalo. However, the OP No.2 is also pressurizing the complainant to deposit the loan amount whereas the Op No.1 despite receiving the entire relevant documents form the complainant has not released the insured amount to the complainant.  Hence this complaint.

3.                     Upon notice, OPs No.1 & 2 appeared and filed its written statement separately whereas OP No.3 given up vide order dated 11.07.2016.

4.                     OP No.1 filed its written statement by taking some preliminary objections such as complaint is not maintainable; no territorial jurisdiction to try and adjudicate the  present complaint; complaint is bad for non joinder and mis joinder of necessary parties; no locus standi to file the present complaint; the claim of the complainant was repudiated on legal and valid ground. On receiving the intimation regarding the alleged death of one buffalo of the complainant bearing tag No. UII 2504, the OP No. 1 immediately registered the claim and deputed Er. Sumeet Goel Mechanical Engineer, Surveyor and Loss Assessor, for verifying the facts of the case. The said surveyor had submitted his report dated 06.11.2012 with the OP No.1. As per the opinion of the said Surveyor, the dead buffalo was not wearing any ear tag, so as per rule “No tag No Claim”  The claim of the complainant was repudiated because there was an utter violation of the terms and conditions of the insurance and the State Bank of Patiala, Harnaul was informed about the fate of the claim vide registered AD letter dated 27.12.2012 and on merit controverted the plea taken in the complaint and reiterated the stand taken in the preliminary objections and lastly prayed for dismissal of complaint.

5.                     OP No.2 filed its written statement by taking some preliminary objections such as complaint is not maintainable; complainant has intentionally and deliberately dragged the OP No.2 bank in this litigation; no locus standi to file and maintain the present complaint and on merit it has been stated that the OP Bank insured the buffalo purchased by Shiva Self Help Group from the loan amount vide cover note No. 899810 issued by OP No.1 which was valid from 20.05.2011 to 19.05.2014.The OP No.2 admitted the fact that the complainant intimated to OP No.2 Bank regarding the death of buffalo and they immediately wrote a letter dated 28.09.2012 to the Op No.1 regarding the settlement of claim of deceased buffalo. The OP No.2 bank has each and every right to recover the loan amount from the complainant. If the Hon’ble Forum has awarded any claim to the complainant, in that case the OP No.1 may kindly be directed to prepare the voucher in the name of Op No.2 Bank. The OP No.2 bank has received a letter dated 27.12.2012 from the OpNo.1 Insurance Company regarding the closing of the claim on the ground that “ No Tag was found fitted in the ears of death animal.” Lastly prayed for dismissal of complaint against the OP No.2.

6.                     In support of his case, counsel for the complainant tendered into evidence affidavit of complainant as Annexure CW/A and documents such as Photo copy of Postmortem report as Annexure C-1, Photo copy of claim form as Annexure C-2, Photo copy of insurance policy as Annexure C-3 and closed the evidence on behalf of complainant.

7.                     On the other hand, counsel for the OP No.1 tendered into evidence affidavit of Ajay Sarin, Assistant Manager, UIIC as Annexure RW/A, affidavit of Er. Sumeet Goyal, Mechanical Engineer, Surveyor and Loss Assessor as Annexure RW/B and documents such as Photo copy of claim repudiation letter dated 27.12.2012 as Annexure R-1, Photo copy of insurance policy as Annexure R-2, Photo copy of surveyor report as Annexure R-3 and closed the evidence on behalf of OP No.1.  

8.                     Counsel for OP No.2 tendered into evidence affidavit of Kundan Bisht, Branch Manager SBOP Harnaul as Annexure RW2/A and documents such as Photo copy of letter dated 28.09.2012 as Annexure R2/1, Photo copy of letter dated 29.11.201 as Annexure R2/2, Photo copy of claim repudiation letter dated 27.12.2012 as Annexure R2/3 and Photo copy of insurance cover note as Annexure R2/4 and closed the evidence on behalf of OP No.2.

9.                         We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on file very carefully and minutely.  Counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for opposite parties reiterated the averments made in reply and prayed for its dismissal.

10.                   It is not disputed that the OP No.2-Bank obtained an Insurance policy bearing no.110101/47/11/01/00000036 covering the risk of 20 buffalo of different persons for Rs.24500/- each valid from 20.05.2011 to 19.05.2014 from the OP No.1-Insurance company.  It is also not disputed that OP No.2-bank intimated the OP No.1-Insurance Company in respect of death of one buffalo belonging to the complainant Smt. Bhago Devi w/o Sh.Rameshwar Dass which is duly evident from the letter dated 28.07.2012 (Annexure R2/1) issued by the State Bank of Patiala to the OP NO.1-Insurance Company.  It is also not disputed that alleged buffalo died on 27.09.2012 which is duly evident from the copy of postmortem report (Annexure C-1).  Learned counsel for complainant argued at length that genuine claim of the complainant has wrongly been repudiated by the United India Insurance Company on the flimsy ground that the dead buffalo was not wearing any tag in the ear at the time of death i.e  No Tag No Claim, whereas the claim of the complainant was duly supported with the post mortem report Annexure C-1.  Learned counsel for the complainant argued that Veterinary Doctor has duly mentioned the tag number bearing no.UII-2504 in the postmortem report (Annexure C-1) and lastly prayed for acceptance of complaint.

11.                   On the other hand, counsel for the OP No.1 Insurance Company hotly argued at length that the claim of the complainant has been rightly repudiated vide its letter dated 27.12.2012 (Annexure R-1) as there was violation of terms and conditions of the Insurance Policy on the part of the complainant. The dead buffalo was not wearing any tag in the ear at the time of spot survey done by the Investigator Er. Sumit Goyal, Mechanical Engineer, Surveyor & Loss Assessor, which is evident from Investigator Report (Annexure R3). Learned counsel for the OP No.1 further argued that as per terms and conditions of the insurance policy no claim is payable if the dead buffalo does not wear the tag as the specific condition has been mentioned in the policy that “No Tag No Claim” and draw our attention towards the insurance policy/cover note Annexure R2/C-3. Learned counsel for the OP No.1 Insurance Company further argued that the claim of the complainant has been rightly repudiated vide its letter dated 27.12.2012 (Annexure R1). Hence, there is no deficiency in service or unfair trade practice on the part of Op Insurance Company and lastly prayed for dismissal of complaint.

12.                   After hearing the parties at length, we are of the considered view that there is deficiency in service on the part of OP No.1 Insurance Company and the claim of the complainant has been wrongly repudiated by the O P No.1 Insurance Company. Further arguments advanced by the learned counsel for the OP No.1 that there was no tag tagged in the ear of the dead buffalo is not tenable as the Veterinary Surgeon has duly mentioned the tag number in the post mortem report as UII-2504 which is duly evident from the post mortem report (Annexure C-1).  Further, OP-Insurance Company has totally failed to place on file the health certificate to prove that the particulars of the buffalo were tallied or not but in the absence of any health certificate it can not be said that died buffalo not tallied with the insured buffalo. It is pertinent to mention here that OP-Insurance Company has deputed Sh.Sumit Goel, Mechanical Engineer as Surveyor and Loss Assessor whereas in such type of cases Veterinary Doctor or other qualified person in this particular field can be appointed as Investigator not Mechanical Engineer, on this angle also repudiation done by the OP-Insurance Company is also not justified.   Thus, the repudiation letter dated 27.12.2012 (Annexure R-1) is liable to be set aside and the act of the OP No.1 in repudiating the claim of the complainant amounts to deficiency in service and the complaint of complainant deserve acceptance.

13.                   Resultantly, we partly allow the complaint of complainant and direct the OP No.1 Insurance Company to pay a sum of Rs. 24,500/- as insured amount on account of deceased buffalo bearing tag No. UII-2504 to the complainant through OP No.2 Bank alongwith interest at the rate of 7% per annum from the date of filing of complaint till its realization and also to pay Rs. 2000/- as litigation expenses within 30 days failing which the complainant is at liberty to initiate the legal proceedings against the OP Insurance Company as per law. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced in open court. 14.12.2016.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER