Punjab

Faridkot

CC/14/120

Nachhattar Singh - Complainant(s)

Versus

United India Insurance comp. - Opp.Party(s)

Iqbal Kaushal

06 Feb 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM FARIDKOT

 

Complaint No. :      120

Date of Institution: 12.09.2014

Date of Decision :   6.02.2015

 

 

Nachhattar Singh aged about 49 years, s/o Kartar Singh s/o Sh Hakam Singh s/o Joginder Singh, r/o village Dhai Pai, Jaitu District Faridkot.                                                                                ...Complainant

Versus

United India Insurance Co. Ltd, Divisional Office, SCO 72, Phase-9, SAS Nagar, Mohali-160062, through Divisional Manager.

United India Insurance Co. Ltd,  Branch Office, Jaitu Road, Near Battian Wala Chowk, Kotkapura through its Branch Manager.                                                                                                                 

                                                                        .....Opposite Parties(Ops)

 

 Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

 

Quorum: Sh. Ashwani Kumar Mehta, President,

               Smt Parampal Kaur, Member,

               Sh P L Singla, Member.

 

Present: Sh Iqbal Kaushal, Ld Counsel for complainant,

              Sh Ashok Monga, Ld Counsel for OPs.

 

(A K Mehta, President)

1                                            Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against United India Insurance Co. Ltd etc/OPs seeking directions to OPs to make payment of insurance policy claim worth Rs 50,000/- with interest at the rate of 18% per anum on account of death of cow insured with Ops and for further directing OPs to pay Rs 20,000/- as compensation for harassment and mental tension and Rs 15,000/- as litigation expenses.

2                                    Briefly stated, the case of the complainant is that complainant purchased one cow Breed HF Cross, colour black for domestic purpose and got insured the same with Ops for Rs 50,000/-vide token no. 69484 and paid the premium amount to Ops; that age of cow was six years and it was free from any disease, but suddenly, cow of complainant died on 6.01.2014 and post mortem of said cow was got conducted from Veterinary Officer, Civil Animal Hospital, Panj Garain Kalan vide no. 4 dt 6.01.2014 and after death of cow, complainant immediately informed OP-2 and submitted the claim case of death of cow alongwith other relevant documents to Ops, but even after more than five months, Ops have not released  payment of insurance claim and all this has caused harm and harassment to complainant without any reason; that complainant made many requests to Ops to make payment of insurance claim but they kept lingering on the matter on one pretext or the other; that complainant also served legal notice to Ops, but Ops failed to make payment of his genuine claim and flatly refused to admit the claim of complainant, which amounts to deficiency in service and has caused harassment and mental tension to him for which he has prayed for directing OPs to pay Rs20,000/-as compensation for harassment and mental tension and Rs 15000/- as litigation  expenses besides main relief. Hence, the complaint.

3                                    The counsel for complainant was heard with regard to admission of the complaint and vide order dated 18.09.2014, complaint was admitted and notice was ordered to be issued to the opposite party.

4                                 On receipt of the notice, the opposite party filed written statement taking legal objections that complaint is without cause of  action and is liable to be dismissed and it involves complex questions of law and facts, which require thorough inquiry and investigation that cannot be conducted in this Forum with limited jurisdiction and limited time span given in C P Act; that complainant is not consumer of Ops as he is engaged in commercial activities and is running a large scale dairy farm and is earning huge profits and complaint filed by complainant is vague and discloses no cause of action as no detail regarding amount of Rs 50,000/-, Rs 20,000/- and Rs 15,000/- is given and complaint is not maintainable as per terms and conditions of the insurance policy; that there is no deficiency in service on the part of answering Ops and therefore, complaint is not maintainable and is liable to be dismissed; that alleged loss took place on 6.01.2014 and after receipt of intimation, the independent surveyor/investigator Sh Balraj Singh Brar, Partap Nagar, Kotkapura was appointed, who inspected the spot on 6.01.2014 and submitted detailed report dt 5.02.2014 and after completion of formalities and after due application of mind and that also on merits, the claim was declined vide letter dt 26.09.2014 on the grounds that the insured animal was not healthy/fit at the time of insurance; that insured cow died within 20 days from the issuance of health certificate dt 17.12.2013 and it was observed by the said independent surveyor that the animal was weak at the time of death and thus, it is crystal clear that the complainant concealed the material facts regarding health of the animal in question at the time of insurance and thereby inducing the respondent insurance company to insure the animal with a view to  extract money from the answering Ops and hence, there is no deficiency in service as claim was processed on merits and was declined within shortest period and therefore, complaint is liable to be dismissed. However, on merits, OPs have denied all the allegations levelled by complainant being incorrect and wrong and reiterated that there is no deficiency in service or unfair trade practice on the part of answering opposite parties.The allegations with regard to relief sought too were refuted with a prayer that complaint deserves to be dismissed with costs.

5                            Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1, and documents Ex C-2 to C-6 and then, closed his evidence.

6                                   In order to rebut the evidence of the complainant, ld Counsel for OPs tendered in evidence, affidavit of Sh A K Kanojia Ex OP-1 and documents Ex OP-2 to OP-7 and then, closed the evidence.

7                        We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

8                                   The Ld Counsel for complainant contended that complainant purchased the cow in question for his domestic use and got the same insured with OP Insurance Company for Rs 50,000/- on 17.12.2013 and filed the Health Certificate Ex C-5 with the OP/insurance company. He further contended that OP/Insurance Company insured the cow of the complainant for Rs 50,000/- and token no. 69484 was issued to the cow in question. He contended that during the operation of insurance policy, the cow in question died on 6.01.2014 and complainant gave intimation to the OP Insurance Company vide letter Ex OP-2 and post mortem of the cow in question was also got performed from Veterinary Civil Hospital, Panj Grahin Kalan and post mortem report was proved on file as Ex C-6. He contended that instead of giving claim to the complainant, the OP/Insurance Company illegally repudiated the claim of the complainant vide letter dt 26.09.2014 Ex OP-6 simply on the ground that cow in question was not well at the time of insurance but no evidence or record has been produced or proved by the OPs to show that cow in question was not well at the time of insurance. He contended that the act and conduct of the OP/Insurance Company has caused unnecessary harassment and mental agony to the complainant for which complainant is also entitled for compensation and as such, complaint is required to be allowed and complainant is entitled to claim amount along with compensation and litigation expenses mentioned in the complaint.

9                               The ld Counsel for OP contended that complainant has concealed material facts from OPs and due to this reason, OP/Insurance Company has declined the claim of complainant vide letter dt 26.09.2014 on the ground that cow in question was not healthy at the time of insurance. He contended that cow in question was not well at the time of insurance but complainant concealed this fact and obtained the Insurance Policy. He contended that post mortem  report of the cow shows that cow in question died due to respiratory failure caused by cyst and cyst cannot develop in few days because cow in question died within 20 days from the date of insurance and it clearly shows that cow in question was not well at the time of insurance and this fact was concealed by the complainant and due to this reason, claim of the complainant has been rightly repudiated by the OP/Insurance Company and complaint is also liable to be dismissed.

10                              It is admitted fact in this complaint that complainant is the owner of the cow in question. It is also admitted fact that OP/Insurance Company insured the cow in question for Rs 50,000/- vide Insurance Policy Ex OP-7 and the period of insurance was from 19.12.2013 to 18.12.2014. Cow in question died on 6.01.2014 i.e within operation of Insurance Policy. The only dispute between the parties is that whether cow in question was not well at the time of insurance and whether this fact was known to complainant and he intentionally concealed this fact from the Insurance Company. However, after going through record of the case, evidence and documents produced on file by the parties, this Forum is of the considered opinion that OP/Insurance Company have not brought any evidence or documents on file to show that cow in question was not well at the time of insurance or this fact was in the knowledge of complainant. Complainant has proved Health Certificate Ex C-5 and it shows that cow in question was allotted token no. 69484 and it was insured for Rs 50,000/-. There is also a certificate from Veterinary Officer that the cow in question is healthy and is free from any injury or disease and is fully fit for insurance at the insured price. It is correct that this certificate does not bear the signatures of any Doctor but this Health Certificate shows that cow in question was fit for insurance and was not sick at the time of insurance. Even for the sake of arguments, if it is presumed that no Veterinary Officer have given this certificate, but even then, it was the duty of the Insurance Company to get the cow in question examined from the Veterinary Officer and get the fitness certificate before the offer of insurance by the complainant is to be accepted by the  OPs and it is the sweet will of Insurance Company to get the cow in question examined and further it is the sweet will of the Insurance Company to insure the cow in question after getting Health Certificate from the Veterinary Officer or without getting the Health Certificate from the Veterinary Officer. Moreover, it is only mentioned in the post mortem report that cow in question has died due to respiratory failure caused by the cyst. Otherwise, cyst is generally not visible with naked eye and there is no other evidence on the file brought by the OPs that complainant was aware of this cyst or was aware about this cyst and as such, repudiation of the claim by the OP Insurance Company is illegal and not in accordance with the law and as such, complainant is entitled to the claim amount and is also entitled to compensation and litigation expenses as OP/Insurance Company repudiated the claim of complainant without any ground and without any evidence and the conduct of OP must have caused harassment and mental agony to the complainant and complainant was compelled to file the complaint in hand.

11                                            In the light of above discussion, complaint succeeds and the same is hereby allowed with costs in favour of complainant and against OPs and complainant is held entitled to claim amount of Rs 50,000/- and OP/Insurance Company is burdened with compensation of Rs 5000/- on account of harassment and mental agony to the complainant and Rs 2000/-as litigation expenses. Ops are directed to comply with the order within one month from the date of receipt of the copy of the order failing which, complainant is entitled to interest at the rate of 9% per anum on the claim amount from the date of filing the complaint till realization of the claim amount. Copy of the order be supplied to the parties free of costs as per rules. File be consigned to record room.

Announced in Open Forum

Dated : 6.02.2015

                               Member            Member                  President

 (P Singla)          (Parampal Kaur)     (A K Mehta)