BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL COMMISSION, JALANDHAR.
Complaint No.361 of 2020
Date of Instt. 19.10.2020
Date of Decision: 31.01.2024
Meena Rani W/o Satpal Singh r/o Village and Post Office Ladhran, District Jalandhar.
..........Complainant
Versus
1. Universal Sompo General Insurance Co. Ltd., SCO 4, 2nd Floor, PUDA Complex, Ladowali Road, Jalandhar through its Branch Manager.
2. The Managing Director, Universal Sompo General Insurance Co. Ltd., Unit No.401, 4th Floor, Sangam Complex, 127, Andheri Kurla Road, Anderi East, Mumbai.
….….. Opposite Parties
Complaint Under the Consumer Protection Act.
Before: Dr. Harveen Bhardwaj (President)
Smt. Jyotsna (Member) Sh. Jaswant Singh Dhillon (Member)
Present: Sh. R. K. Sharma, Adv. Counsel for Complainant.
Sh. Vikas Gupta, Adv. Counsel for OPs.
Order
Dr. Harveen Bhardwaj (President)
1. The instant complaint has been filed by the complainant, wherein it is alleged that the complainant purchased a Cattle and Live Stock Policy bearing No.3016/56753234/00/000 from OP for the period 19-11-2016 to 18-11-2019 insuring ten buffaloes with sum insured of Rs.60,000/- for each buffalo and respective Ear Tag Nos were given by the company to each buffalo. During the currency of the aforesaid insurance policy on 07-09-2019, one of the insured buffaloes bearing Tag No.913327 died. Immediate intimation of the death of the insured buffalo was given to the OP No.1 and the Post Mortem was conducted on the buffalo bearing Tag No.913327 on 07-09-2019. The complainant completed all the requirement of lodging the claim such as furnishing of claim form, Post Mortem Report etc. as required by the insurance company. Surveyor appointed by the OPs also photographed the dead animal and took away its Tag and also got some blank forms signed from his client. The complainant visited number of times, the office of OP No.1 and Allahabad Bank, Maqsudan (wherefrom the complainant had availed Loan and insurance premium was also paid from Loan account) for release of the claim amount. The complainant was assured every time that the claim shall be passed shortly, but till date the claim has not been paid despite repeated requests, reminders and visits. When despite repeated visits the claim was not paid, the complainant made a written request for making the payment of her claim vide letter dated 02-12-2019. The said letter was duly received by the OP No.1 and Allahabad Bank. The complainant also served Legal Notice dated 06.03.2020 upon the OPs. Despite receipt of Legal Notice, the OPs did not respond and did not pay the genuine claim of the complainant. More than a year has elapsed, but the complainant has not been paid her genuine claim which amounts to gross negligence, deficiency in service and unfair trade practice on the part of the OPs and as such, necessity arose to file the present complaint with the prayer that the complaint of the complainant may be accepted and OPs be directed to make payment of Rs.60,000/- being the sum insured of buffalo bearing Ear Tag No.913327 on account loss of cattle due to death on 07-09-2019 during the subsistence of insurance policy along with interest @12% p.a. from the date of loss till the date of payment. Further, the OPs be directed to Rs.50,000/- for causing mental tension and harassment to the complainant and Rs.22,000/- as litigation expenses.
2. Notice of the complaint was sent to the OPs, who filed reply and contested the complaint by taking preliminary objections that the present complaint is frivolous, vexatious and devoid of merits and hence, the same is liable to be dismissed with heavy cost. It is further averred that there is no negligence and unfair trade practice on the part of the OP which brings the present complaint ad judicable by this Forum. Hence the present complaint is liable to be dismissed. It is further averred that the complainant has not approached this Forum with clean hands. The complainant has suppressed various material facts in the present complaint and has stated totally wrong facts before this Commission. It is further averred that the complainant has not filed any claim with respect to buffalo mentioned in the complaint with answering party. In case any such claim is filed by the complainant with the required documents, then the answering OP undertakes to process the same as per terms and conditions of the insurance policy. It is further averred that the present complaint filed by the complainant with the malafide intention and has not come before this Commission with the clean hands, being litigation for the sake of litigations is liable to be dismissed with exemplary costs. On merits, the factum with regard to purchase of cattle and livestock insurance policy by the complainant from OPs, which was valid from 19.11.2016 to 18.11.2019 insuring 10 buffaloes with sum insured of Rs.60,000/- is admitted, but the other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merits, the same may be dismissed.
3. Rejoinder to the written statement filed by the complainant, whereby reasserted the entire facts as narrated in the complaint and denied the allegations raised in the written statement.
4. In order to prove their respective versions, both the parties have produced on the file their respective evidence.
5. We have heard the learned counsel for the respective parties and have also gone through the case file very minutely.
6. It is not disputed that the complainant purchased a Cattle and Live Stock Policy bearing No.3016/56753234/00/000 from OP for 19-11-2016 to 18-11-2019 insuring ten buffaloes with sum insured of Rs.60,000/- for each buffalo. This is evident from Ex.C-1. Ex.C-1 clearly shows the detailed particulars of each buffalo with the Ear Tag Number and Color. It has been alleged by the complainant that on 07.09.2019, one of the buffalo died. The Ear Tag number mentioned in the complaint shows that this buffalo was insured at Serial no.6 and postmortem report Ex.C-2 also shows that the buffalo died on 07.09.2019 at 07:30 AM. Thereafter, the complainant lodged the claim and he has alleged that the Surveyor was appointed and he has also clicked the photographs of the dead animal and took away its tag, but they have not paid any claim to the complainant and in reply to the letter, the complainant was informed that they have made request vide Ex.C-3. The complainant has made request to decide the claim.
7. The OP in the written statement has alleged in Para No.2 that the complainant has not filed any claim with respect to buffalo mentioned in the complaint with the OP and the request has been made in the written statement that the complainant should file claim, but perusal of Ex.C-3 shows that the copy of the letter dated 02.12.2019 was received by the OP at 11:43 AM. This letter is duly stamped by the OPs. This clearly shows that the letter was received by the OP, but the OP never intimated or never contacted the complainant that they have not received any claim nor the claim has been paid or settled by the OP. In view of the letter received by the OP, this seems that the claim was filed by the complainant, which has not been settled by the Ps as yet. In such circumstances, the OP is directed to settle the claim of the complainant within 30 days from the date of receipt the copy of order, failing which the OPs will be liable to pay compensation of Rs.20,000/- to the complainant. It is further ordered that if the OP demands any document from complainant for settlement of claim, then the complainant will provide the same to the OP, if these are available with him. It is further ordered that if the complainant is not satisfied with the settlement of the claim made by the OPs, then he is at liberty to file a fresh complaint. Thus, this complaint is disposed of. This complaint could not be decided within stipulated time frame due to rush of work.
8. Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.
Dated Jaswant Singh Dhillon Jyotsna Dr. Harveen Bhardwaj
31.01.2024 Member Member President
