SACRED FARM PRODUCTS (INDIA) vs National Insurance Company Ltd.

THIS appeal is directed against the order dated 12.5.2003 by District Consumer Disputes Redressal Forum-II, U.T., Chandigarh (for short, hereinafter, to be referred as District Forum-II) in Complaint Case No. 226 of 2000. The factual matrix is as under :

THE appellant/complainant had insured his Honey Bees Farm run under the name and style of M/s. Sacred Farm Products (India), Quiet Office No. 4, First Floor, Cabin No. 4, Sector 35/A, Chandigarh with respondents/O.Ps. vide Insurance Policy No. 400100/9400/29/97 effective from 20.3.1997, valid for one year w.e.f. 20.3.1997 to 19.3.1998 for which the premium of Rs. 5,082/- was duly paid. As per the averments due to inclement weather conditions in the form of cyclonic circulation build up, thunder showers and heavy rain and fog in the 1st week of December, 1997 till January, 1998 the 90% of honey bees died till end of January, 1998. THE appellant on 13.1.1998 personally visited the office of respondent No. 2/O.P. No. 2 to inform the death of honey bees and conveyed it in writing as well, consequent to which Dr. Adarsh Gupta, the Technical Representative from the respondent No. 2/O.P. No. 2 was deputed to collect the sample of dead honey bees but no further inquiry was made from the appellant/complainant at any stage with regard to this. THE claim was filed on 22.4.1998 in reply to which the appellant/complainant was informed vide letter dated 9.6.1998 that the loss was not covered under the policy and was not maintainable under the Honey Bee Insurance Scheme. On 23.7.1998 respondent No. 1/O.P. No. 1 the Divisional Office was requested to reconsider the claim but the same was again turned down vide letter dated 28.8.1998 on the ground that loss was due to inclement weather which is not covered under the scope of the policy. THE appellant/complainant has alleged that cover note of the aforesaid policy was issued after one year and seven months though the policy was only for one year period of 20.3.1997 to 19.3.1998. Due to non-issuance of original policy documents he was kept in dark about the conditions governing the same. THE appellant/complainant has alleged that after his personal visits to the office of respondent No. 1/O.P. No. 1 the policy document was made at a much later stage and it was received by the complainant as late as on 15.10.1998 and thereupon he learnt that the policy in question had a condition that loss due to vagaries of weather/natural calamities is covered under the Honey Bee Policy. THE appellant has alleged that he had to make numerous visits to the office of the Insurance Company after which the Divisional Office sent the file to the Regional Office for review on 12.9.1998. THE appellant/complainant has also alleged that on his various visits he was informed verbally that his claim has been considered favourably and sent for review to Calcutta Office. However, on 16.9.1999 he was informed vide letter dated 23.12.1999 (Annexure C-11) that inclement weather conditions are not covered under the Honey Bee Insurance Policy as the policy specifically defines the perils to be covered. THE appellant/complainant has averred that his claim was unjustifiably repudiated by the Insurance Company as the loss occurred on account of atmospheric disturance due to building up of cyclonic circulation which resulted in the stormy conditions in the region during the relevant period. THE appellant has alleged that due to aforesaid deficient services of the Insurance Company he had incurred losses and in the prayer clause he has prayed for compensation Rs. 4,36,200/- under various heads. In the reply filed on behalf of the O.P. the factum of insurance and payment of requisite premium for an insurance cover of Rs. 88,000/- to the honey bee farm of the complainant stands admitted. The respondents/O.Ps. have stated that 90% of the honey bees of the complainant died due to inclement weather but it has been submitted that this condition was not covered by the policy in question the same being in the exclusionary clause as stated in Annexure C-3, hence, the claim was repudiated. The respondents/O.Ps. have denied the allegations of late issuance of the policy as alleged and have averred that if he was not supplied the cover note on the day he paid the premium to the agent, he should have represented earlier to the higher officials of respondents/O.Ps. Insurance Company. The respondents/O.Ps. have also denied that at any point of time his claim of Rs. 66,000/- was recommended. The claim was repudiated on the ground that loss does not fall under the ambit of the policy, hence he is not entitled to any compensation as there is no deficiency in service.

In evidence the complainant has brought on record his affidavit alongwith Annexures C-1 to C-22 while the O.P. filed affidavit of S. Gulzar Singh, Assistant Administrative Officer of respondent No. 1/O.P. No. 1.

THE District Forum dismissed the complaint on the ground that there is no material on record to suggest that the order of the repudiation of claim was not passed in good faith, hence O.Ps. could not be held liable for deficiency or unfair trade practice against the O.Ps. Aggrieved against the order of the District Forum the present appeal has been filed pleading, inter alia, that the impugned order suffers from infirmities and illegalities and the District Forum has not appreciated the facts of the case, in view of undisputed fact that unprecedented environment which prevailed in the region from first week of December, 1997 to end of January, 1998 due to which 90% of the honey bees died and also inspite of facts and circumstances in which honey bees died has been admitted by A.A.O. Mr. Gulzar Singh of respondents/O.Ps. in Para 5 of his affidavit. The District Forum ignored this document and did not give any weightage to the same. Further the District Forum failed to note the contradictions in the act and conduct of the respondents/O.Ps. Insurance Company. The appellant has stated that on one hand the Regional Manager vide letter dated 6.5.1998 to the Calcutta Head Office inquired whether loss under inclement weather condition was covered under the basic cover of the policy and on the other hand vide letter dated 9.6.1998 the appellant was informed about the loss being not covered. The appellant has alleged that the District Forum failed to take note of this inconsistency in the stand of the O.Ps. and the impugned order is liable to be set aside on this ground. The order of the District Forum has further been assailed on the ground that repudiation letter dated 9.6.1998 does not state any ground for the rejection of the claim but the District Forum has failed to take note of the same. Further the impugned order is erroneous as it has gone beyond the pleadings of the parties as neither the cover note nor the policy was issued by the Divisional Office till 13.10.1998 and the ante dated policy was received by the appellant/complainant on 15.10.1998. The District Forum in Para 13 of the impugned order have observed two minor omissions on the part of the respondents/O.Ps., namely, that affidavit of Sh. Kapoor has not been filed and the allegations of complaint contained in Annexure C-8 have not been denied. The appellant has alleged that the District Forum wrongly interpreted the Para-11 of the complaint. The appellant has urged that Annexure A-1 stating clearly that the claim was repudiated on the ground of honey bees having died due to inclement weather and foggy, rainy and extremely cold weather conditions. A perusal of the policy cover makes it clear that claim was covered under the policy. The appellant has prayed for setting aside the impugned order.

DURING the arguments in this appeal, Mr. Gopal Mittal, Advocate for the appellant vehemently contended that the District Forum has failed to take note of the deficiency on the part of the O.Ps. which is patently established on the basis of letters dated 6.5.1998 and 9.6.1998. The case cited in support was ignored by the District Forum. Mr. Pardeep Bedi, Advocate appearing for the respondents/O.Ps. vehemently defended the judgment as the loss occurred admittedly due to extreme cold, foggy and other weather conditions and which are not covered. Since, these weather conditions in the month of December-January are not unknown in this part of the country the same can neither be termed nor covered under the clause of either the natural calamity or accident. After examining the rival contentions of both the sides, we proceed to examine the merit of the appeal. The contention of the appellant that the order of the District Forum is beyond the pleadings of the parties and that he was not aware of the terms and conditions of the policy as it was not received by him till 15.10.1998, though, the policy was for the period 20.3.1997 to 19.3.1998 cannot be upheld as it is not substantiated by any evidence in the form of any communication or protest to the office of respondents/O.Ps. informing them about the non-receipt of the policy document. This contention is merely an allegation and a bald averment and hence is rejected. Another contention of the appellant that District Forum failed to take note of Para 5 of affidavit of Sh. Gulzar Singh, A.A.O. of respondents/O.Ps. wherein he had admitted the death of honey bees due to aforesaid weather conditions, is also rejected as the A.A.O. in the above para has stated the loss as per the statement of appellant. Coming to the moot point whether the repudiation of the claim on the ground of complainant''s loss not covered in the ambit of policy in question was justified in the facts and circumstances of the case. A perusal of the policy document Annexure C-3 wherein it is clearly mentioned that the policy in question was to cover any accident or Fire, Flood, Inundation, Storm, Tempest, Cyclone, Hurricane and Tornado ''Bee Hives and Colony stated in the Scheduled below against total loss or damage subject to the terms, conditions and exclusions'' brings us to the conclusion that appellant has nowhere been able to establish that the death of his honey bees was attributable to any of the above perils. The honey bees died due to inclement weather in the form of extreme cold, foggy and such harsh winter conditions which cannot be stated to be covered either accident or natural calamity as stated in the policy. In support of his contentions in Para 4 of complaint the appellant/complainant has averred that during the relevant period ''stormy conditions prevailed on account of cyclonic circulation build up, the sky remained overcast accompanied by thunder shower/heavy rain, cold winds and foggy conditions''. The appellant/complainant has used different phraseology to bring the loss under the cover of terms of the policy but it is evidently clear that during the relevant period the weather conditions might have been harsh winter but were not covered under the terms of policy. The various words like cyclonic build up, thunder showers, heavy rains etc. show the vagaries of the weather at that point of time but clearly they were not of such occurrence as were covered under the policy. Taking note of the cause of the loss and the perils covered under the policy in question brings us to the conclusion that the death of honey bees resulting in losses to the complainant since was not covered under the policy no deficiency can be attributed to the respondents/O.Ps. for repudiating his claim. It is a settled law that if a claim has been processed within reasonable time and it is rejected on the ground of not being covered, after due consideration, no deficiency can be attributed. In the instant case, the various communications brought on record such as Annexures C-9, C-11 and A-2 clearly demonstrate that the claim of the appellant was duly considered by the Regional Office as well as Divisional Office and rejected on the ground of being not covered under the policy, no deficiency can be held against the Insurance Company. Due to aforesaid reasoning, we find no infirmity in the order of the District Forum and the same is upheld. In the peculiar circumstances of the case, the parties will bear their own costs. The appeal is dismissed. The order of the District Forum is affirmed. Copies of this order be sent to the parties free of charges. Appeal dismissed.