DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SAHIBZADA AJIT SINGH NAGAR (MOHALI)
Complaint No. 679 of 2015
Dated of institute 22.12.2015
Decided On 19.12.2017
Hem Raj aged about 48 years S/o Sh. Chand Ram R/O Prem Basti, Gali No.30, Sangrur, Punjab.
Complainant………
Vs
- United India Insurance Company Limited, Duri Road, Sangrur, Punjab through its Divisional Manager/Manager/Authorised Signatory.
- United India Insurance Company Limited, Divisional Office, SCO No. 72, Phase 9, Mohali Punjab its Divisional Manager/Manager/Authorized Signatory.
Opposite Parties…..
Complaint under Section 12 of
the Consumer Protection Act.
Quorum
Sh. G.K. Dhir, President,
Ms. Natasha Chopra, Member
Present:- Sh.Inderjit Singh, cl for the complainant.
Sh.Madan Lal Chaudhary, cl for the OPs.
Order by :- Sh. G.K. Dhir, President
Order
Complainant by believing the representation of the OPs and protecting his only source of income agreed to get his cow insured on 07.10.2011 for a sum of Rs. 40,000/- for a period of one year commencing from 07.10.2011 against the token no. 18906. Medical check up of the said cow of black and white HCF was conducted by Veterinary Officer, Sangrur. After finding the said cow in healthy and fit condition, the insurance cover was issued by allotting above numbered token, after acceptance of the premium amount. The complainant kept on waiting for the receipt of formal certificate of insurance but the same has not been received despite several visits to the office of OP No.1. On 07.12.2011 the insured cow died regarding which intimation was given to the OPs by submitting the Claim Form, Post Mortem Report, Health Certificate and other documents . Neither the claim of the complainant was processed nor any intimation given to him regarding the status of the said claim. Legal notice dated 23.07.2012 was served on the OPs but to no effect and thereafter consumer complaint no.363 dated 16.08.2012 was filed before the Ld. District Consumer Disputes Redressal Forum, Sangrur. That complaint was dismissed for want of territorial jurisdiction. An appeal preferred before the Hon’ble Punjab State Consumer Disputes Redressal Commission, Chandigarh, was withdrawn on 29.06.2015. In FAO/943/2013, Hon’ble State Commission granted liberty to the complainant to file a fresh complaint in the District Forum at Mohali. The period spent in prosecuting the complaint before the Ld. District Forum at Sangrur was ordered to be excluded while computing the period of limitation. As such, this complaint alleged to be within limitation. Sh. Ram Kumar, Surgeon Veterinarian, the investigator appointed by the OPs submitted the report confirming the death of the cattle on 07.12.2011 by opining that payment of the insured claim be made to the complainant. Despite that the same has not been done and as such by pleading deficiency in service on the part of the OPs, prayer made for directing the OPs to pay the claim amount of Rs. 40,000/- along with compensation for delay of Rs. 1 lac and cost of litigation of Rs. 25,000/- with interest 18% P.A w.e.f. 07.10.2011 till its realization even claimed.
2. In the joint reply filed by the OPs, it is pleaded inter-alia that the complaint is not maintainable because of the involvement of complicated questions of law and facts requiring elaborate evidence and that there is no deficiency in service. Besides, it is claimed that the complainant has suppressed the material facts and the complaint is bad for non-joinder and mis-joinder of the necessary parties. Admittedly the complainant insured two cows with the OPs vide policy no.112100/47/11/01/00000476 having validity for the period from 07.12.2011 to 06.12.2012. Fitness of the cows was checked and tag nos.18964 and 18906 were issued to the HFC cows on 07.10.2011. However, policy was issued w.e.f. 07.12.2011 on receipt of premium from the insured i.e. Punjab Live Stock Dev. Board, Sector 17, Chandigarh. Health certificate cannot be issued by the Insurance Company because it issues the insurance policy after completing all the formalities like taking photographs of the animal, issuing the tag , but after receipt of the premium. Merely on issuance of the health certificate, the insurance cover does not start. Rather the insurance cover starts from the date of issuance of the policy, which in this case started w.e.f. 07.12.2011 to 06.12.2012. As per exception no. 2, any claim arising out of disease or illness contracted by animal during the first 15 days from the date of commencement of the policy is not covered and as such the company is not liable to pay any claim amount. The complainant intimated about the death of his cow having tag no. 18906 on 07.12.2011 itself and thereafter Dr. Ram Kumar was appointed for spot verification and investigation. That doctor informed as if he found carcass of the cow lying with ear tag no.18906 with the owner. In the postmortem report the cause of death mentioned as Bebesiosis. There is no agreement or contract between the complainant and the OPs and as such the complainant has no cause of action, particularly when he has misrepresented the facts. All other averments of the complainant denied.
3. The complainant to prove his case tendered in evidence his affidavit Ex CW1/1 along with documents Ex C-1 to Ex C-10 and Marks A and B and thereafter closed the evidence.
4. Counsel for the OPs has tendered in evidence affidavit of Ms. Hemali Batra, Dy. Manager of the OPs Ex OP1/1 along with documents Ex OP/1 to OP/4 and thereafter closed the evidence.
5. Written arguments filed by the parties. Oral arguments heard and records gone through.
6. Perusal of the order dated 29.06.2015, Mark-B passed in FAO No. 943 of 2013 by the Punjab State Consumer Disputes Redressal Commission, Chandigarh reveals that the complainant was given liberty to file a fresh complaint against the OPs in this Forum at Mohali because cause of action has accrued within the territorial jurisdiction of this Forum. Period spent by the complainant in prosecuting the complaint before the Ld. District Consumer Disputes Redressal Forum, Sangrur was ordered to be excluded while computing the period of limitation for filing this fresh complaint. In view of that, this complaint is within limitation, particularly when as discussed hereinafter the complainant has recurring cause of action available with him in view of non repudiation of the claim in writing or conveyance of the same to the complainant.
7. Undisputedly, the insured cow expired on 07.12.2011 in respect of which policy cover note Ex OP/1 was issued. Description of the dead insured animal is specifically given in Ex OP/2. Dr. Ram Kumar was appointed as investigator by the OPs for spot verification and he submitted his report Ex OP/3 by finding as if the claim should be paid as per the insurance policy. So virtually through this report Ex OP/3, the investigator appointed by the OPs confirmed about the death of the insured cow on 07.12.2011. Date of death of cow even mentioned in certificate Ex OP/4 equal to Ex C-3. Intimation cum claim form Ex C-2 along with health certificate Ex C-1 also has been produced on record. Ex OP/3 is the same thing as is Ex C-4.When asked during the course of arguments as to whether the repudiation of the claim took place by passing any order or issuance of the letter to the complainant, then counsel for the OPs admitted as if repudiation of the insurance claim in writing has not taken place. Even if cow may have been got insured by the complainant through Punjab Live Stock Dev. Board, Sector 17, Chandigarh, but despite that beneficiary of the insurance claim is the complainant and none else. If that be the position, then certainly the complainant has right to know the reasons for repudiation of his claim. However, reasons have not been conveyed and nor any order for repudiation of the claim passed. So much so, the information sought under the RTI Act through application C-7 sent through postal receipt Ex C-10 was not given to the complainant, but in para no. 5 of the written reply alone it is claimed as if the company was not liable to pay the claim in view of the exception no.2 of the terms and conditions of the policy note Ex OP/1. The complainant despite the recommendation for claim payment through Ex OP/3 equal to Ex C-4 is kept in dark, because of not passing any order by the OPs. That conduct of the OPs certainly is an act of highhandedness amounting to deficiency in service as well as adoption of unfair trade practice. However, to ensure that complainant gets his due, the ends of justice warrants that the OPs must be directed to pass appropriate order regarding admissibility or repudiation of the claim with intimation of the same being given to the complainant within specified time. Compensation for harassment and mental agony as well as litigation expenses should also be allowed in favour of the complainant and against the OPs. Keeping in view the highhandedness of the OPs referred above, the end of justice warrants that for ensuring the payment of the awarded compensation amount and litigation expenses, direction should be issued to the OPs to pay the amounts by the specified date, failing which to pay interest @ 6% P.A, which is normally payable nowadays by the Nationalized Banks to its customers on FDRs of one year or less period.
8. As a sequel of the above discussion, the complaint is allowed with the direction to the OPs to pass appropriate orders regarding repudiation or admissibility of claim in question within 30 days from the date of receipt of certified copy of the order and then convey the same to the complainant in writing at the address given in the complaint. Compensation for harassment and agony of Rs. 5,000/- and litigation expenses of Rs. 5,000/- more allowed in favour of the complainant and against the OPs. Payment of these amounts be made within 30 days from the date of receipt of certified copy of the order, failing which the complainant will be entitled to interest @ 6% P.A on these amounts of compensation and litigation expenses after expiry of 30 days period from the date of receipt of certified copy of the order till payment. Certified copies of the order be supplied to the parties free of cost and thereafter the file be consigned to the record room.
Announced
December 19, 2017
(G.K. Dhir)
President
(Ms. Natasha Chopra)
Member
