Haryana

Karnal

CC/442/2021

Tushar - Complainant(s)

Versus

The New India Assurance Company Limited - Opp.Party(s)

Isham Munjal

20 Oct 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 442 of 2021

                                                        Date of instt.03.09.2021

                                                        Date of Decision:20.10.2022

 

Tushar aged about 20 years son of Shri Satish, resident of Taraori, District Karnal.

                                               …….Complainant.

                                              Versus

 

1.     The New India Assurance Company Ltd.,  Regional Office: Old G.T. Road, near Bus Stand, Karnal-132001, through General Manager.

2.     The New India Assurance Co. Ltd. Head Office: 87, MG Road, Fort Mumbai-400 001, through General Manager/Authorized Signatory.

 

                                                                      …..Opposite Parties.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri Isham Munjal, counsel for the complainant.

                    Shri Manjul Mishra, counsel for the OPs.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is having cows and buffalos at his house for the purpose of fulfilling requirement of milk in his family. The complainant had got insured his cow bearing batch no.160038797827 (black and white colour) from the OPs, vide policy no.233311, valid from 02.03.2020 to 01.03.2021, the insured value is Rs.75,000/-. It is further averred that prior to getting the insurance, the complainant had got medical check-up of said cow, vide health certificate bearing no.233311 dated 09.01.2019 conducted by Dr. Naresh Kumar, Veterinary Surgeon, Government Veterinary Hospital, Taraori, District Karnal. The cow of the complainant was suddenly expired on 08.07.2020 and thereafter complainant brought body of dead cow at Government Veterinary Hospital, Taraori, where the concerned Veterinary Surgeon, Taraori, District Karnal had conducted post mortem examination, vide PMR bearing sr. no.88008 dated 09.07.2020. Complainant also intimated the OPs about the death of insured cow on the same day of death. At the time of lodging claim the company of OPs had assured that the insurance claim amount will be disbursed as soon as possible, but in the last week of October, 2020, OPs repudiated the claim of complainant on the ground that no treatment given to animal. However, complainant was not aware about any disease to his animal, because in normal course of life the cow of complainant was leading a healthy life and was giving 15 liter milk during these days and his death was occurred all of sudden. On 03.11.2020, complainant moved a written representation before the Veterinary Surgeon, Veterinary Hospital Taraori, District Karnal with a request to provide the insurance claim from OPs, but no fruitful purpose has been served. In this way there is deficiency in service on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that as per the post mortem report the animal was seriously ill and died due to the serious illness, but no intimation regarding illness of the deceased cow has been given by the complainant and complainant has also failed to produce the medical record of the deceased cow. The company has rightly repudiated the claim of the complainant which is violation of clause 4,6,7 and 9 of the terms and condition of cattle insurance policy. There is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for complainant has tendered into evidence affidavit of complainant Ex.CW1/A, affidavit of Dr. Naresh Kumar, Veterinary Surgeon Ex.CW1/B, copy of Livestock claim form Ex.C1, copy of heath certificate Ex.C2, copy of post mortem report Ex.C3, copy of application to Government Veterinary Surgeon Taraori Ex.C4, copy of legal notice Ex.C5, postal receipts Ex.C6 and Ex.C7 and closed the evidence on 25.04.2022 by suffering separate statement.

5.             On the other hand, learned counsel for OPs has tendered into evidence affidavit of Kamal Sachdeva, Senior Divisional Manager Ex.OP1, copy of repudiation letter dated 25.10.2020 Ex.OP2 (Faridabad), copy of repudiation letter dated 08.10.2020 Ex.OP3, copy of postmortem report Ex.OP4, detail of dead animal Ex.OP5, copy of terms and conditions of the insurance policy Ex.OP6 and closed the evidence on 22.08.2022 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant is having cows and buffalos at his house for the purpose of fulfilling requirement of milk in his family. The complainant had got insured his cow with the OPs and the insured value was Rs.75,000/-. He further argued that prior to getting the insurance, the complainant had got medical check-up of said cow. The complainant also intimated the OPs about the death of insured cow on the same day of death and completed all the formalities. Thereafter, complainant requested the OPs several times to settle the claim but OP did not pay the claim and repudiated the same, vide letter dated  on the ground that no treatment given to animal and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that as per the post mortem report the animal was seriously ill and died due to the serious illness, but no intimation regarding illness of the deceased cow has been given by the complainant and complainant has also failed to produce the medical record of the deceased cow. The company has rightly repudiated the claim of the complainant which is violation of clause 4,6,7 and 9 of the terms and condition of cattle insurance policy and prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the complainant had got insured his cow with OPs for the sum insured of Rs.75,000/- and she had died during the subsistence of the insurance policy.

11.           The claim of the complainant has been repudiated by the OPs, vide letter Ex.OP3 dated 10.2021 on the ground that as per the post mortem report the animal was seriously ill and no treatment was given to animal and complainant has also failed to produce the medical record of the deceased cow.

12.           The OPs have taken a plea that as per the post mortem report the animal was seriously ill. The onus to prove its version lies upon the OPs but OPs miserably failed to prove the same by leading any cogent and convincing evidence. Rather, it is evident from the health certificate Ex.C2, the insured cow was hale and healthy at the time of commencement of the insurance policy. OPs have also taken a plea that the no treatment was given to animal. In this regard, we are of the opinion that the person whose animal is sick then as to why he will not get treated his animal. Further, OPs have also taken a plea that complainant has failed to produce the medical record of the deceased cow. As per health certificate Ex.C2, the insured cow was hale and healthy at the time of insurance  and complainant also did not get treated his cow at any time prior to the commencement of the insurance policy then question for bringing the treatment records does not arise at all. Hence, we found no substance in the contentions of the OPs.

12.           Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

                It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy.

13.           Keeping in view that the ratio of the law laid down in the aforesaid judgment and the facts and circumstances of the present complaint, we are of the considered view that the act of the OPs while repudiating the claim of the complainant amounts to deficiency in service and unfair trade practice, which is otherwise proved genuine one.

14.           As per Cattle Insurance Detail Ex.OP5, the sum insured of the cow is Rs.75,000/-. Hence, complainant is entitled for the said amount alongwith compensation for harassment and litigation expenses.

15.           Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OPs to pay Rs.75,000/- as insured amount to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization. We further direct the OPs to pay Rs.15,000/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expense. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 20.10.2022

                                                                President,

                                                      District Consumer Disputes

                                                      Redressal Commission, Karnal.

 

 

                        (Vineet Kaushik)       (Rekha Chaudhary)

                              Member                       Member