BEFORE THE PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHABAD.
Complaint No.246 of 2016.
Date of Instt.: 19.09.2016.
Date of Decision: 27.04.2017.
Suraj Mal son of Ujala Ram resident of village Nehla Tehsil Fatehabad & District Fatehabad.
Complainant
Versus
United India Insurance Company Limited through its Branch Manager Branch Office at 75 Anaj Mandi Fatehabad District Fatehabad.
Opposite party.
Complaint U/s 12 of the Consumer Protection Act, 1986
Before: Sh.Raghbir Singh, President.
Smt.Ansuya Bishnoi, Presiding Member.
Sh.R.S.Panghal, Member.
Argued by: Sh.Devi Lal, counsel for the complainant.
Sh.Kaushal Mehta, counsel for the OP.
ORDER:
1. The complainant has filed this complaint against the OP-Insurance Company with the averments that he had got insured his buffalo from OP for a sum of Rs.45,000/- vide insurance policy No.111903/47/14/01/ 00000530 on 18.02.2015. On 12.02.2016 said buffalo died, therefore, the complainant intimated about the death of the buffalo to the OP and Sh.Moti Lal, Veterinary Surgeon. Thereafter, post mortem on the dead body of buffalo was done but in the meantime surveyor Sh.Ajay Saini also visited the spot who inspected the dead buffalo and also took into possession the ear tag after removing the same from the ear of dead buffalo. Thereafter, the surveyor took the signatures of the complainant and persons present over there on some blank papers and also assured that the claim would be settled shortly but the OP- insurance Company repudiated the claim of the complainant without any reasonable cause and excuse. The complainant has visited the office of the OP many a times and requested for settling the claim but in vain. The act and conduct of the OP has not only caused mental agony and harassment to the complainant but also fall within the definition of deficiency in service on its part.
2. The OP appeared and filed its reply resisting the claim of the complainant on the various grounds. It has been contended that the complainant in order to harass and humiliate the OP has filed the present complaint by suppressing the material facts, therefore, neither the present complaint is maintainable nor he has any cause of action to file any complaint against the insurance company. It has been further submitted that on receiving of death claim of buffalo surveyor of the insurance company Sh.Ajay Saini, Advocate, Sirsa had visited the inhabitants of the village and got recorded their statements and also investigated the mater and during investigations it has come to the notice that there was no tag in the ear of the dead buffalo and the buffalo was getting treatment from a private person, which is clear cut violation of terms and conditions of the policy. It has been further submitted that in the policy there was specific term and condition that ‘No Tag No Claim’ because ear tag was basic identification of the insured animal and in the absence of tag it is not possible to ascertain whether the dead animal was insured or not. There is no deficiency in service on the part of the insurance company. Other allegations of the complainant have also been controverted and it has been prayed that the complaint of the complainant be dismissed with costs.
3. The parties have led their evidence in the form of affidavits and documents. The complainant has tendered in evidence his affidavit Ex.CW1/A, affidavit of Sh.Shamsher Singh as Ex.CW2/A and affidavit of Sh.Hari Chand as Ex.CW3/A and documents Annexure C1 to Annexure C8 whereas the OP has tendered affidavit of Sh.Parhlad Singh, Banch Manager as Ex.RW1/A, affidavit of Sh.Ajay Saini, Surveyor as Ex.RW2/A and documents Annexure R-1 to Annexure R8.
4. Heard. We have examined the pleadings and documents of the parties very carefully. From the material available on the case file it transpires that the complainant had purchased an insurance policy from the insurance company for a buffalo which was valid from 18.02.2015 to 17.02.2016 and the buffalo was affixed with tag ID No.185900 as is evident through Annexure R1. There is also no dispute that the buffalo of the complainant has died and this fact is even clear from a copy of the post mortem report Annexure C2. It is also not in dispute that the complainant had submitted his claim to the OP-insurance company. It is also not disputed that the buffalo had died during the subsistence of the policy. The complainant has however been aggrieved from the action of the OP-insurance company when it had repudiated the claim of the complainant on the report of the surveyor. Now the only point for determination by this forum is as to whether the OP- insurance company rightly and legally repudiated the claim of the complainant. The complainant in his duly sworn affidavit Ex.CW1/A has specifically stated that his buffalo having ear tag No.160002/185900 died during the subsistence of the policy but the OP has taken a plea that the dead buffalo was having no tag, therefore, the complainant was not entitled for any claim. This plea taken by the OP is not survived because in the Post mortem report Annexure C2 it has been clearly mentioned that the dead animal was having tag No.160002/185900 and the complainant has been shown as owner of the said buffalo. A certificate in this regard has also been given by the officer of Animal Husbandry Department who conducted the post mortem. The same is annexure C-4. The report of the doctor who is a Government Officer and who has no interest in the matter cannot be disbelieved or discarded. The act and conduct of the insurance company reveals that it bent upon to avoid the legal claim of the complainant on one pretext or the other because it has been clearly established on the case file that the dead buffalo was having tag No. 160002/185900 and the complainant was owner of the same and the animal has died during the subsistence of the policy. The insurance-company is relying upon the report of surveyor Annexure R2 wherein the surveyor had mentioned that the buffalo was taking treatment from a private person but the OP has not produced any evidence to show that the buffalo was taking treatment from any doctor. It is well settled principle of law that there is no provision under the law to appoint a Surveyor by the Insurance Company of its own when there is no legal sanctity to the report submitted by such a surveyor. Such an investigation can be got done by the Insurance Company for its own satisfaction but in order to prove the report, the Insurance Company shall have to produce independent evidence about the report. In that view of the things the OP-insurance has committed an error in not releasing the insurance amount of the dead buffalo in favour of the complainant. This approach is totally illegal and cannot be accepted. Thus we have no doubt in our mind in holding that the dead buffalo was the same which was insured with the respondent and there is negligence and deficiency in service on the part of the respondent in not releasing the insurance amount also in favour of the complainant.
5. For the reasons and findings recorded above, we hereby allow the complaint against respondent directing it to pay a sum of Rs.45,000/-, the insured amount of the dead buffalo, to the complainant with interest @ 6 % per annum from the date of institution of this complaint till actual payment. The respondent is further directed to pay Rs.2,000/- in lump sum for mental agony, harassment and litigation expenses to the complainant. The compliance of this order be made within a period of one month, failing which the complainant is at liberty to initiate the legal proceedings against the OP-insurance company. A copy of this order be supplied to the parties free of costs. File be consigned to record room after due compliance.
Announced in the open court:
Dated: 27.04.2017
(Raghbir Singh)
President
(Ansuya Bishnoi) Distt.Consumer Disputes
Member, Redressal Forum, Fatehabad.
(Ranbir Singh Panghal) Member
