KESHAV PRASAD SHUKLA vs United India Insurance Co. Ltd.

THIS appeal under Section 15 of the Consumer Protection Act, 1986 is directed against the order dated 22.4.2002 in Complaint No. 383/2000 by District Consumer Disputes Redressal Forum, Bilaspur, (hereinafter called ''District Forum'' for short) dismissing the complaint of the complainant/appellant.

UNDISPUTABLY the complainant/appellant had purchased two she-buffaloes on 24.9.1998. He had obtained finance for the same from the respondent No. 2 Bank. It is also not in dispute that the said she buffaloes were insured by the complainant with the respondent No. 1 United India Insurance Co. Ltd., and an amount of Rs. 20,000/- was payable on the death of the each of the she-buffaloes. The policy of insurance covered the risk from 12.10.1998 to 11.10.2001. The averments of the complainant are that one of the she-buffaloes died suddenly on 27.2.1999. The intimation of the death was given by the complainant to the respondent No. 1 immediately. Similarly, the other she-buffalo died on 3.7.1999 and an intimation was also given to the respondent No. 1 by letter dated 6.7.1999. Though the claims were registered by the respondent No. 1 regarding the said she-buffaloes, yet the amount of claim was not paid by the respondent No. 1 to the complainant. Hence the complainant sent registered notice to the respondent No. 1 and, thereafter, filed the complaint claiming compensation of Rs. 40,000/- with interest thereon.

The complaint was resisted by the insurer/respondent No. 1. It was averred in its written version that though the she-buffalo which died on 27.2.1999 suffered from the disease ''Tripansoniasis'', yet it was not properly treated by the complainant/insured. It was alleged that on the report of Surveyor Dr. T.J.R. Naidu the claim was repudiated. It was also averred that the tag of the said she-buffalo was in two parts and thus false claim regarding death of the said she-buffalo was submitted by the complainant. Regarding the repudiation of the claim of the other she-buffalo which died on 3.7.1999, it was averred that the ear tag of the said she-buffalo was not produced by the complainant. It was also stated that the alleged post-mortem by Dr. O.P. Tiwari about the second she-buffalo which allegedly died on 3.7.1999, was also suspicious. It was, therefore, averred that the complainant was not entitled to claim of the amount of insurance, from the respondent No. 1/insurer.

THE respondent No. 2 Bank also filed its separate written version and resisted the complaint. The District Forum held that the death of the insured she-buffaloes was not properly proved and, therefore, the complainant was not entitled to any amount under the policy of insurance issued by the respondent No. 1. The complaint was accordingly dismissed.

THE learned Counsel for the parties were heard and the record was perused. As noticed above the complaint was regarding the death of two she-buffaloes purchased by the complainant on 24.9.1998. It is not in dispute that the said she-buffaloes were insured by the respondent No. 1 as per insurance policy issued by them. Copy of the said policy has been marked as Annexure P-1 by the District Forum. It would appear from the said policy Annexure P-1, that the insurance was for the period from 12.10.1998 to 11.10.2001. The sum assured was Rs. 40,000/- for both the she-buffaloes. It may also be noticed that according to the complainant one of the she-buffaloes died on 27.2.1999. From the record it would appear that the claim regarding the death of the said she-buffalo was registered by the respondent No. 1 insurer, as Claim No. 8/99, while the other she-buffalo allegedly died on 3.7.1999 and the claim about its death was registered by the respondent No. 1 as Claim No. 24/99. It may also be noticed that regarding the she-buffalo that died on 27.2.1999 Tag No. 10598 was issued while regarding the other she-buffalo Tag No. 10597 was issued. Firstly, we shall consider the case of the she-buffaloo bearing Tag No. 10598 regarding which Claim No. 8/99 was registered by the respondent No. 1/insurer. It may be noticed that the said she-buffalo according to the complainant died on 27.2.1999. Claim from ''Annexure P/2 B'' was submitted by the complainant on 16.3.1999. In the said Claim Forum Tag No. has been clearly mentioned. The Veterinary Assistant Surgeon, Mungeli has also certified at the back of the claim form that the she-buffalo died on account of ''Acutetrys'' on 27.2.1999 at 4.00 p.m. It was also stated that the death occurred suddenly and, therefore, she could not be treated. Tag number of the said she-buffalo as 10598 has also been mentioned in the said certificate.

THE post-mortem examination report ''Annexure P/2 E'' dated 27.2.1999 is also appended along with the said certificate ''Annexure P-2 D'' which is captioned as ''valuation-cum-treatment certificate'', which also mentions the Tag number of the she-buffalo, signed by the Veterinary Asstt. Surgeon bearing his official seal also.

THE complainant has also sent a letter which is marked as Annexure P-7 which states that the said she-buffalo died of ailment known as ''Bhanwari''. It was also stated therein that before it could be treated she succumbad to the disease. It was further stated in the said letter that the relevant documents, broken tag, etc. were sent to the respondent No. 1 and that Claim No. 8/99 was also registered, however, the claim has been repudiated by the respondent No. 1. Thus, it appears that after a long lapse of time after the death of the she-buffalo and after the complainant protested that his case has not been settled and processed properly, upon which a letter dated 16.5.2000 was issued by the respondent No. 1 intimating the complainant about the closure of the said Claim No. 8/99 on 29.4.1999, and that Claim No. 24/99 regarding the death of other she-buffalo was under consideration and decision shall be communicated to the complainant. It however does not appear from the material placed on record, that the complainant was intimated about the closure of Claim No. 8/99 regarding the death of the she-buffalo which died on 27.2.1999, prior to 16.5.2000. Inordinate delay in communicating the complainant/appellant about the closure of the case regarding the death of the she-buffalo which died on 27.2.1999, itself amounts to deficiency in service by respondent No. 1 insurer.

Now we will take up the case regarding the death of other she-buffalo which according to the complainant died on 3.7.1999 regarding which Claim No. 24/99 was registered. It may be noticed that the claim from submitted by the complainant. It was duly forwarded by the respondent No. 2 Bank on 9.7.1999, under the seal and signature of its manager, which is marked as Annexure P-4 by the District Forum. There is also a ''valuation-cum-treatment certificate'' dated 8.7.1999 signed by the Veterinary Asstt. Surgeon who also mentioned therein the Tag number as 10597. The report states that the she-buffalo died due to ''Pericarditis'' resulting in cardiact arrest.

IT may be mentioned that the said post-mortem report has been termed as suspicious by the respondent No. 1 on the strength of the report of investigator Dr. T.J.R. Naidu. IT appears from the documents placed on record that the respondent No. 1 made certain inquiries as to whether Dr. Tiwari who had conducted the post-mortem was authorised and had obtained permission to go to Mungeli, for conducting the post-mortem, from the department. However, the report of Dr. Naidu is not supported by his affidavit. Moreover, even if, Dr. Tiwari has conducted the post-mortem, without properly obtaining permission from his department that would merely be an irregularity and would not render the report of post-mortem, as worthless. It is, therefore, clear that the respondent No. 1 had not performed its duty of repudiating the claim in time regarding the death of the she-buffalo which died on 27.2.1999. So far as the other she-buffalo is concerned, the claim was again kept pending for a long time as would be clear from the letter of the respondent No. 1 which is marked as Annexure P-8. There appears to be no justification for the respondent No. 1 insurer to have kept the matter pending for a long period, as above. It appears that the claim form was duly submitted along with post-mortem report, through the respondent No. 2 Bank. The respondent No. 1 should have pointed out deficiency if any, in the claim lodged by the complainant without delay. But, it failed to do so. Respondent No. 1 cannot be permitted to take advantage of belatedly informing the complainant that its claim is not accepted, because of certain deficiencies found in the said claims. In the circumstances, we find that there was no justification and proper ground for repudiation of the claim by the complainant.

THEREFORE, the complaint deserves to be allowed, and the complainant is entitled to assured amount under the policy. We accordingly allow this appeal and the complaint, and set aside the impugned order. We direct that the respondent No. 1 shall pay to the complainant a sum of Rs. 40,000/-, the assured amount for the death of the two she-buffaloes under the policy with interest @ 9% per annum thereon, from the date of complaint. Appeal allowed.