BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.64 of 2015

Date of Instt. 25.02.2015

Date of Decision :13.08.2015

Balwinder Kaur aged about 59 years wife of Jarnail Singh R/o Village and Post Office Bal, District Jalandhar-144001.

..........Complainant Versus

1. ICICI Lombard, General Insurance Company Ltd, Cattle Claims Team, PlotNo.12, Financial District, Nanakaramguda, Gachibowli, Hyderabad-500032.

2. Winner Pal Singh, Customer Service Manager (Cattle Claims) ICICI Lombard, General Insurance Company Ltd, Space No.1-5, 3rd Floor, Kunal Tower, 88, Mall Road, Ludhiana-141001.

.........Opposite parties

Complaint Under the Consumer Protection Act,1986.

Before: S. Jaspal Singh Bhatia (President)

Ms. Jyotsna Thatai (Member)

Sh.Parminder Sharma (Member)

Present: Sh.AK Sharma Adv., counsel for complainant.

Sh.Raman Sharma Adv., counsel for opposite parties.

Order

J.S.Bhatia (President)

1. The complainant has filed the present complaint under the Consumer Protection Act, 1986, against the opposite parties on the averments that the complainant got insured her cow having black and white colour under Cattle Insurance Policy with the opposite parties under policy No.K9JAL10026610674 against Tag No.100017751 and the period of the insurance was between the period of 29.9.2012 to 28.9.2015 and the insurance coverage amount of the cow is Rs.36,000/-. The complainant has deposited the insurance premium of Rs.4045/- with the opposite parties. The insured cattle of the complainant fell sick and the complainant got treated the insured animal with veterinary doctor of Veterinary Hospital, Naugajja, Jalandhar but on 6.9.2014 at about 4.00 PM, the insured cattle died due to sickness. The complainant had also got postmortem certificate of the cattle from the veterinary doctor of Veterinary Hospital, Naugajja, Jalandhar and deposited the same with the insurance claim form alongwith other requisite documents with the opposite parties. The postmortem report of the insured cattle clearly specifies the reason of death due to Babesiosis, loss of blood and dehydration. The complainant has filed a claim with the opposite parties alongwith requisite documents as per the Cattle Insurance Claim Document Checklist, but the opposite parties declined the valid claim of the complainant vide letter dated 27.11.2014 without any reasonable cause. On such like averments, the complainant has prayed for directing the opposite parties to pay her the claim amount of Rs.36,000/- alongwith interest. She has also claimed compensation and litigation expenses.

2. Upon notice, opposite parties appeared and filed a written reply, inter-alia, pleading that the complainant can not take advantage of her own wrongs. The liability of the opposite party No.1 is only subject to terms and conditions of the insurance policy. The insured cow was sick for more than one month and died on 6.9.2014 where as the insured cattle was treated only from 21.8.2014. The insured cow was suffering from Pyrexia, Downer Cow Syndrome. Downer Cow Syndrome is a disease which occurs immediately after parturition. In the present case, the insured cow delivered a calf about two and a half month prior to death of cow, but the treatment is only with effect from 21.8.2014 till death. As per insurance policy, the claim falls under the exclusion death due to Mismanagement of Farm or Stable, if the insured cattle is not treated if the sickness in more than three days as in the present case. All calving related diseases are also excluded from the scope of the cattle insurance policy. As the treatment record shows that the insured cow was suffering from Pyrexia, Downer Cow Syndrome not covered under the scope of the insurance policy, as such the claim of the complainant was repudiated as per terms and conditions of the insurance policy vide letter of repudiation dated 27.11.2014 and the complainant was informed accordingly. They denied other material averments of the complainant.

3. In support of her complaint, learned counsel for the complainant has tendered into evidence affidavit Ex.CA alongwith copies of documents Ex.C1 to Ex.C13 and closed evidence.

4. On the other hand, learned counsel for the opposite parties has tendered affidavit Ex.OA alongwith copies of documents Ex.OP1 to Ex.OP7 and evidence of opposite parties was closed by order.

5. We have carefully gone through the record and also heard the learned counsels for the parties.

6. The facts involved in the present complaint are not much disputed. Ex.C1 is certificate of the insurance in respect of cow of the complainant. The sum assured was Rs.36,000/- and period of insurance was from 29.9.2012 to 28.9.2015. It is not disputed that during the validity of the insurance policy, the insured cow died due to some illness. The complainant preferred the claim with the opposite party insurance company but the opposite party insurance company repudiated her claim vide letter dated 27.11.2014 Ex.C9 mentioning as under:-

"This is with reference to the cattle insurance claim No.GEN000132341 filed with us under policy No.4057/72283306/00/ 000 against Tag No.100017751. We have perused the documents submitted by you and regret to inform that your claim can not be settled for the following reason(s):-

7. The opposite party insurance company has repudiated the claim of the complainant on the ground of mismanagement of farm (no regular treatment given) and on account of calving related disease. The opposite parties have not lead any reliable evidence to prove that the insured cow died due to calving related disease or that no regular treatment was given to it. Ex.C2 is treatment certificate in respect of the insured cow and from perusal of the same, it is evident that firstly the cow was got treated from 21.8.2014 to 23.8.2014 and then 24.8.2014 to 31.8.2014 and then 4.9.2014 to 6.9.2014. The insured cow died on 6.9.2014. So, from the treatment certificate, it is evident that before death, the cow was being treated regularly. Ex.C3 is postmortem certificate in respect of the insured cow and cause of death is mentioned as Babesiosis, loss of blood and dehydration. Babesiosis is fever due to some parasite. So the insured cow died due to fever, loss of blood and dehydration. The loss of blood and dehydration might have occurred due to above said fever. In the survey report Ex.O3 produced by the opposite parties, the reason of death is also mentioned that the insured cow died due to weakness as result of fever. The date of last calving in survey report is mentioned 2-1/2 months. In survey report, it is also mentioned that as per owner, cattle got fever about one month back and it was treated by Dr.Parshotam Singh and the cattle i.e cow died due to weakness. So from the treatment certificate Ex.C3 it is evident that the insured cow was being treated by Veterinary Officer of Veterinary Hospital regularly from 21.8.2014 to 6.9.2014 i.e till death. Moreover, as per survey report Ex.O3, the surveyor has also concluded that the claim is payable. So in the above circumstances, we are of the opinion that opposite party insurance company has repudiated the claim without any valid justification.

8. In view of above discussion, the present complaint is accepted and opposite party insurance company is directed to pay Rs.36,000/- to the complainant alongwith interest @ 9% per annum from the date of repudiation of claim till the date of payment. It is clarified that interest amount is being granted by way of compensation. The complainant is also awarded Rs.3000/- on account of litigation expenses. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.

Dated Parminder Sharma Jyotsna Thatai Jaspal Singh Bhatia

13.08.2015 Member Member President