Punjab

Ludhiana

CC/19/197

Shashi Kant - Complainant(s)

Versus

Oriental Insurance Co.Ltd. - Opp.Party(s)

G.Kapoor Adv.

04 Aug 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 197 dated 25.04.2019.                                                        Date of decision: 04.08.2022.

 

Shashi Kant S/o. Vijay, Resident of Pamali Road, Mansura, Ludhiana.                                                                                                       ..…Complainant 

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1. The Oriental Insurance Company Ltd., Branch Office, CBO-V, 146, Industrial Area-A, Opp. Allahabad Bank, Cheema Chowk, Ludhiana through its Manager.
2. The Oriental Insurance Company Ltd., Regional Office, SCO 109-110-111, Surendra Building, Sector-17-D, Chandigarh-160017 through its Manager.
3. The Oriental Insurance Company Ltd., Head Office Oriental House, A 25/27, Asaf Ali Road, New Delhi-110002 through its Manager.                                                                                           …..Opposite party 

Complaint under Section 12 of the Consumer Protection    Act.

QUORUM:

SH. K.K. KAREER, PRESIDENT

SH. JASWINDER SINGH, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         None.

For OPs                          :         Sh. Rajeev Abhi, Advocate.

 

ORDER

PER K.K. KAREER, PRESIDENT

1.                In brief, the case of the complainant is that he got three cattle i.e. one black and white cow, one black chedh white and white and brown insured from OP1 through its agent Sanjeev Kumar Softi vide policy No.889859 dated 14.06.2017. As per the policy, the sum assured under the policy was Rs.1,50,000/-. The complainant paid a premium of Rs.4275/-. On the asking of Sanjeev Kumar Softi, the complainant further got two more cattle insured which were in the name of his wife and daughter vide policy No.889860 and 889861 both dated 19.06.2017 and in the said policy the sum assured was Rs.50,000/- each. The complainant paid premium of Rs.1435/- and Rs.1475/- in respect of these policies. The cattle were inspected by Dr. P.S. Mann who also inserted a chip in the cattle.

2.                It is further alleged that in the month of August 2017, the cattle of the complainant died which was insured vide policy No.889860. The complainant immediately informed Mr. Sanjeev Kumar Softi who came to the dairy of the complainant accompanied by a surveyor. As per the instructions of Sanjeev Kumar Softi and the surveyor, the complainant collected photographs of the dead cattle as the surveyor forgot to bring his camera. They also received Rs.2000/- from the complainant as surveyor fee and took with them all the necessary documents in original from the complainant assuring him that the claim would be finalized soon.

3.                It is further alleged that in the month of September 2017 another cattle of the complainant died which was insured vide policy No.889859. Again, on intimation, Sanjeev Kumar Softy along with surveyor came to the dairy of the complainant. They again charged Rs.2000/- from the complainant as surveyor fee and also received necessary documents and went away assuring the complainant that the claim would be finalized and paid very soon. In the month of December 2017, Sanjeev Kumar Softi called the complainant that two cheques of the claim were ready and he would hand over the same to the complainant very soon but later on he kept postponing the matter on one pretext or the other. In the month of January2019, the complainant enquired about the claim from an employee of OP1 who also assured that the claim would be paid very soon. However, the claim was not paid. This amounts to deficiency of service on the part of the OPs. Even a legal notice dated 16.03.2019 served through Sh. Gagandeep Kapoor, Advocate failed to evoke a positive response from the OPs. Hence the complaint whereby it has been requested that the OPs be directed to pay the insurance claim of Rs.1,00,000/- to the complainant along with a compensation of Rs.1,00,000/- and litigation expenses of Rs.50,000/-.

3.                The complaint has been resisted by the OPs. In the joint written statement filed on behalf of the OPs, it has been, inter alia, pleaded that the complaint is not maintainable and is bad for non-joinder of Sanjiv Kumar Sobti, Development officer, CVO-V, Ludhiana who allegedly mis-appropriated the premium received from the complainant and never deposited the same with the OPs. Moreover, there are allegations of fraud, cheating, bribe and harassment which can only be tried in a competent civil court. The complainant has not lodged any claim with the OPs. In addition to this, there has been no contract of insurance between the complainant and the OPs as the OPs never received any premium against any alleged cover note nor any policy was issued by the OPs in favour of the complainant till date. As per the provisions of Section 64-VB of the Insurance Act, no risk n India will commence unless the premium is paid in advance Thus, the complainant is neither a consumer nor this Commission has any jurisdiction to entertain and try the complaint. The OPs have further pleaded that no claim was reported by the complainant with the OPs in respect of the alleged insurance cover notice No.889860 or 889859. Moreover, the complainant never  brought the matter to the notice of the competent authorities of the OP company before 06.02.2018. Had he done so, the OPs would have acted promptly. Rather the complainant relied upon his past good relations with Sh. Sanjeev Kumar Sobti and never informed the OPs regarding the acts of Sanjeev Sobti. After the receipt of the complaint from the complainant vide email dated 06.02.2018, the OPs initiated action and started investigation and on receipt of investigation report dated 19.02.2018, Sanjeev Sobti  was placed under suspension vide order dated 13.03.2018. A departmental enquiry was conducted against Sanjeev Sobti on account of indiscipline and misconduct under the rules  and the disciplinary authority vide its order dated 28.05.2018 dismissed Sanjeev Kumar Sobti from service. Thus, there has been no deficiency of service on the part of the OPs. The other allegations made in the complaint have been denied as wrong and a prayer for dismissal of the complaint has also been made.

4.                In evidence, the complainant submitted his affidavit as Ex. CA along with documents Ex- C1 to Ex- C13 and closed the evidence.

5.                On the other hand, learned counsel for the OPs tendered affidavit Ex. RA of Sh. Sukhwinder Singh, Senior Divisional Manager of OPs along with documents Ex. R1 to Ex. R4 and closed the evidence.

6.                None has been appearing in this case on behalf of the complainant since 15.07.2022. We have, however, heard the counsel for the parties and gone through the record. We proceed to decide the case on merits.

7.                It is the case of the complainant that he got insured three cattle from the OPs through Sanjeev Kumar Sobti, Development Officer vide policy No.889859 dated 04.06.2017 for an assured sum of Rs.1,50,000/- on payment of premium of Rs.4275/-. It has further been claimed by the complainant that he got two more cattle insured from Sanjeev Kumar Sobti in the name of his wife and daughter vide policy No.889860 dated 19.06.2017 and 889861 dated 19.06.2017 for an assured sum of Rs.50,000/- each and paid a premium of Rs.1435/- and Rs.1475/- respectively. Admittedly, the policy No.889860 and 889861 were obtained in the name of the wife and daughter of the complainant. The cover note of these policies are Ex. C2 and Ex. C3 on the record which  are in the name of Minakhi Gupta and Miss Megha respectively. In this case, neither Minakshi Gupta nor Miss Megha has been impleaded as party nor the present complaint has been filed by the complainant being attorney of Minakshi Gupta or Miss Megha. So far as policy Ex. C2 and Ex. C3 are concerned there cannot be any privity of contract between the complainant and the OPs. Therefore, the complainant cannot claim anything under the policy over notes bearing No.889860 and 889861 which are not in his name and are in fact in the names of Manakshi Gupta and Megha respectively. 

8.                The policy Ex. C1 bearing No.889859 is in the name of the complainant whereby the complainant got insured three cows owned by him for a sum assured of Rs.1,50,000/- on payment of premium of Rs4275/-. As per the case of the complainant, one of the cattle insured vide this policy died and in this regard, the complainant informed Sanjeev Kumar Sobti who came to the dairy of the complainant accompanied by a surveyor and clicked the photographs of the dead cattle and further  assured the complainant that the claim would be paid to the complainant. Mr. Sanjeev Kumar Sobti further took the signature of the complainant on various documents for the purpose of claim but no such claim was reimbursed. In this regard, the stand taken by the OPs that Sanjeev Kumar Sobti, Development Officer misappropriated the premium received from the complainant and never deposited the same with the OPs. The OPs have further claimed that no case of deficiency of service is made out on the part of the OPs as no contract of insurance came into between the complainant and the OPs as no amount of premium was received by the OPs from the complainant. Moreover, no loss was every reported by the complainant with the OPs nor any claim was lodged in respect of any loss covered under the cover note No.889859. The first communication was received from the complainant through email only on 06.02.2018 upon which the investigation process was initiated and after the receipt of the investigation report dated 19.02.2018, Sanjeev Kumar Sobti was placed under suspension vide order date 13.03.2018. A departmental inquiry was conducted by the disciplinary authorities of the OPs who dismissed Sanjeev Kumar Sobti from the services vide order dated 28.05.2018. The Ops have further placed on record the investigation report wherein it is clearly stated that Sanjeev Kumar Sobti misappropriated the premium of Rs.5600/- in respect of cover note No.889859, 889860 and 889861and vide order Ex. R3 dated 28.05.2018, Sanjeev Kumar Sobti was dismissed from the service on the charges of misconduct and embezzlement.

9.                From the facts and circumstances of this case and the evidence available on record, it is evident that the complainant got three cattle insured vide cover note Ex. C1 on payment of Rs.4275/-. The premium amount was received by Sanjeev Kumar Sobti, a Development Officer of the OPs. If Sanjeev Kumar Sobti did not deposit the premium with the OPs and embezzled the same, the complainant cannot be held responsible and it would be unfair to put the complainant at loss. Sanjeev Kumar Sobti admittedly was a Development Officer of the OPs and it is evident from the investigation report Ex. R4 and dismissal order Ex. R3 that Sanjeev Kumar Sobti had a very chequered and dubious record as in the past also, he has been misappropriating the premiums received from the people. Once the premium was received by Sanjeev Kumar Sobti from the complainant against issuance of a cover note, in our considered view, a contract of insurance came into being with the complainant and the OPs. The OPs are supposed to be bound by the act and conduct of its officer as the company acts through its officials only.

10.              As regards plea raised by the OPs that no claim was lodged with them and, therefore, there cannot be any deficiency of service on the part of the OPs. In this regard, it is pertinent to point out that it is the definite case of the complainant that the loss of the cattle was reported to Sanjeev Kumar Sobti in the month of September 2017 and the said official visited the dairy of the complainant accompanied by a surveyor and went away after taking the photographs etc. of the cattle. Again on this ground also, no fault can be found with the complainant. As a matter of fact, Mr. Sanjeev Kumar Sobti, Development Officer of the OPs has been dealing fraudulently with the complainant. Therefore, if the claim was not lodged by the complainant, it was due to mis-deeds of Sanjiv Kumar Sobti, an official of the OPs. Since it is a case of insured cattle dying during the currency of the policy, it may not be possible at this stage for the complainant to lodge a fresh claim as the OPs would not be in possession to verify the loss as the dead cattle might have been cremated or disposed of by now. Under the circumstances, in our considered view, it would be just and appropriate if the OPs are directed to refund the premium of Rs.4275/- to the complainant and are also directed to pay composite compensation of Rs.25,000/- to the complainant within a period of 30 days from the date of receipt of copy of order. The OPs will, however, be entitled to recover these amounts from Sanjeev Kumar Sobti either by forfeiting his service benefits, if not already paid to him or by resorting to civil or criminal proceedings against him.

11.              As a result of above discussion, the complaint is partly allowed with  direction to OPs to refund the premium of Rs.4275/- to the complainant and are also directed to pay composite compensation of Rs.25,000/- to the complainant within a period of 30 days from the date of receipt of copy of order. The OPs will, however, be entitled to recover these amounts from Sanjeev Kumar Sobti either by forfeiting his service benefits, if not already paid to him or by resorting to civil or criminal proceedings against him. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

12.              Due to rush of work and spread of COVID-19, the case could not be decided within statutory period.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

Announced in Open Commission.

Dated:04.08.2022.

Gobind Ram.

Shashi Kant Vs Oriental Insurance Co. Ltd.                             CC/19/197 

Present:       None for the complainant.

                   Sh. Rajeev Abhi, Advocate for OPs.

 

                   None turned up for the complainant today also. None has been appearing on behalf of the complainant since 15.07.2022.

                   Arguments on behalf of the counsel for the OPs heard. Vide separate detailed order of today, the complaint is partly allowed the complaint is partly allowed with  direction to OPs to refund the premium of Rs.4275/- to the complainant and are also directed to pay composite compensation of Rs.25,000/- to the complainant within a period of 30 days from the date of receipt of copy of order. The OPs will, however, be entitled to recover these amounts from Sanjeev Kumar Sobti either by forfeiting his service benefits, if not already paid to him or by resorting to civil or criminal proceedings against him. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:04.08.2022.

Gobind Ram.