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Dinesh Gautam v/s The New India Assurance Co. Limited

    Appeal No. 16 of 2021

    Decided On, 25 November 2021

    At, Union Territory Consumer Disputes Redressal Commission UT Chandigarh

    By, THE HONOURABLE MR. JUSTICE RAJ SHEKHAR ATTRI
    By, PRESIDENT
    By, THE HONOURABLE MRS. PADMA PANDEY
    By, MEMBER & THE HONOURABLE MR. RAJESH K. ARYA
    By, MEMBER

    For the Appellant: Dinesh Gautam, Advocate. For the Respondent: Vinod Gupta, Advocate.



Judgment Text

Padma Pandey, Member

This appeal is directed against an order dated 17.10.2018, rendered by District Consumer Disputes Redressal Forum-I, UT, Chandigarh now District Commission-I (hereinafter to be called as the District Commission only), vide which, it dismissed the complaint, with no order as to cost, filed by the complainant (now appellant).

In brief, the facts of the case are that the complainant purchased 15 buffaloes for earning his livelihood, through Bank of Baroda which were insured with the Opposite Party, covering permanent total disability, for the period from 01.04.2016 to 31.03.2017 vide policy No.35010047160400000001 (Annexure C-1). It was stated one buffalo bearing Micro Chip No.956000003679821 had contracted MASTITIS disease and was rendered totally disabled to produce milk, due information regarding which was also given to the Opposite Party, who in turn appointed one Dr. Chohan, but the said Dr. Chohan neither visited the farm of the Complainant nor inspected the disabled buffalo. It was further stated that the complainant also gave representation vide Annexure C-4 to the Opposite Party, for early processing of the claim/case and also showed his intention to dispose of the said buffalo to avoid further financial burden, but nothing positive could come out. It was further stated that in the meantime, the said

Dr. Chohan expired, but before his demise he gave an adverse report dated 06.06.2017, which was taken into account by the Opposite Party and after the death of

Dr. Chohan, one Mr. Sandeep Datta visited the Farm of Complainant on 29.06.2016 and inspected every buffalo, read microchips and everything was found in order, but still the Opposite Party repudiated his claim vide Annexure C-5. It was further stated that the aforesaid act of the Opposite Party, amounted to deficiency in service and unfair trade practice. When the grievance of the complainant, was not redressed, left with no alternative, a complaint was filed.

The Opposite Party filed its reply and admitted, the factual matrix of the case, stated that, upon receipt of intimation from Bank of Baroda, Mullanpur Garibdass Branch regarding PTD claim of Buffalo of the Complainant, an Investigator was deputed who visited the premises of the complainant and enquired the line of treatment given to the said Buffalo, but the complainant neither gave proper reply nor supplied any documents nor gave an opportunity to the investigator of inspect the disabled animal to confirm PTD before settlement of claim as the complainant sold out the said Buffalo which is clear violation of the terms & conditions of the insurance policy. It was further stated that the claim was processed by the competent authority and concluded that the claim of the complainant was not maintainable as there was clear violation of the terms & conditions of the Policy and repudiated the claim of the Complainant vide letter dated 15.07.2016 (Annexure C-5). It was further stated that there was no deficiency, in rendering service, and remaining averments, were denied, being wrong, on the part of the Opposite Party.

In the rejoinder, filed by the complainant, he reiterated all the averments, contained in the complaint.

The Parties led evidence, in support of their case.

After hearing the Counsel for the Parties, and, on going through the evidence, and record of the case, the District Commission, dismissed the complaint, as stated above.

Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant.

We have heard the appellant and Counsel for the respondent, and have gone through the evidence, and record of the case, carefully.

After giving our thoughtful consideration, to the rival contentions, raised by the Parties and the evidence, on record, we are of the considered opinion, that the appeal be partly allowed, for the reasons to be recorded hereinafter.

On going through the records of the case, we find that the learned District Commission had observed following in paragraph No.7 of the impugned order:-

“The main grievance of the Complainant is that Permanent Total Disablement Claim under the Policy was repudiated by the Opposite Party on the basis of the report of the Investigating Officer appointed by them. Having considering the rival contentions, we have minutely perused the Cattle Insurance Policy alongwith Cattle Insurance Clause attached thereto (Annexure R-1). There is a specified claim procedure provided in the terms & conditions of the Policy for PTD Claims. The said claim procedure for PTD Claim reads as under:-

A certificate from the qualified Veterinarian to be obtained.

The Animal should be inspected by our Vet. Officer also.

Admissibility of claim to be considered after two months of issue of receipt of Vet.

In case of draught animals indemnity is limited to 70%.

In case of milch cattle indemnity is limited to 50%.”

It is observed from the record that the appellant/complainant did not conceal anything with regard to the sale of the cattle in his complaint. The insurer could have examined the cattle by the expert even after the sale of the cattle. Further, there is no bar on the sale of the insured animal by the insurer’s company, as per the terms of the insurance company. This Commission finds from the records that there is an underlying reason as to why the appellant sold the insured animal. The appellant is a poor man and is earning his livelihood by selling the buffalo milk. The buffalo in question had contacted Mastitis Disease and was rendered totally disable to produce milk. The said animal was incurring expenses without giving any milk and was therefore, being a burden upon the appellant. The appellant had duly intimated the insurance company and doctor’s certificate was also given and he had also written to the insurance company to inspect the said animal urgently as he wanted to sell the same. The insurance company did not take action at the proper time and repudiated the claim on flimsy grounds. After analyzing all the above facts, this Commission feels as a gesture of rendering natural justice to a poor appellant, the appeal deserves to be partly allowed and the respondent i.e. New India Assurance Co. Ltd. is directed as under:-

To pay 75% of sum insured to Rs.1,50,000/- of buffalo under PTD claim i.e. Rs.1,12,500/- alongwith interest @ 9% from the date of loss i.e. 04.03.2016.

To pay Rs.10,000/- as litigation expenses.

The above order be complied within 45 days from the date of receipt of the certified copy of the order failing which, the said amount could attract interest @12% instead of 9%

Since M.A. No.188 of 2021 has been filed by the appellant for condonation of delay of 815 days (822 days as p

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er office report), this Commission on examination of the facts and circumstances of the case, is of the opinion that in the interest of justice, the said delay is condoned. No other point was urged, by the Counsel for the parties. In view of the above discussion, it is held that the order passed by the District Commission, being not based on the correct appreciation of evidence, and law, on the point, warrants the interference of this Commission. For the reasons recorded above, the appeal, is partly allowed, with no order as to costs. The order of the District Commission is set aside. Certified copies of this order, be sent to the parties, free of charge. The file be consigned to Record Room, after completion.
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