DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

PATIALA.

                                      Complaint No.CC/15/146 of 14.7.2015

                                      Decided on:        26.11.2015

Baldev Singh son of Harban Singh, resident of House No.19, Village Paror, Tehsil & District Patiala.

                                                                   …………...Complainant

                                      Versus

1.      ICICI Lombard Insurance Co.Ltd.,Branch SCO 12,Chhoti Baradari, Patiala through its Branch Manager.

2.      ICICI Bank Ltd., Branch Ajit Nagar,Near Leela Bhawan, Patiala, through its Branch Manager.

                                                                   …………….Ops

                                      Complaint under Section 12 of the

                                      Consumer Protection Act.

                                      QUORUM

                                      Sh.D.R.Arora, President

                                      Smt.Neelam Gupta, Member

                                      Smt.Sonia Bansal,Member

Present:

For the complainant:      Sh.Baldev Singh, in person.

For Op No.1:                   Sh.Amit Gupta,Advocate           

                                         ORDER

D.R.ARORA, PRESIDENT

1. It is alleged by the complainant that he got his four cows insured with Op no.1 vide certificate of insurance No.IL100019497 for the period 28.10.2012 to 27.10.2015 having made the payment of the premium of Rs.22472/- . Before the insurance was effected by Op no.1, it had got the cows medically examined and the Op installed the tags. Tag No.19497 was provided to the cow, in respect of which the complainant has brought this complaint.
2. One of the insured cows bearing tag No.19497 died on 1.10.2014 at about 1.30AM, the intimation in respect of which was given by the complainant to the Ops. The Ops had appointed the surveyor who conducted the investigation. Dr.Rajiv Kumar Verma, Veterinary Officer, CVH, Uppli, District Patiala had also conducted the postmortem examination. After the investigation , the complainant was assured that the Ops will pay the insured amount as the complainant had lodged the claim with the Ops after  the postmortem examination of the insured cow alongwith the relevant documents. However, the complainant received the letter dated 27.11.2014 from the Ops having repudiated his claim on the frivolous ground that the death had occurred due to the mis-management of the farm/stable of the complainant.
3. It is further averred by the complainant that he approached the Ops many a times with a request to release the insured amount but the Ops dilly dallied the matter and only two days before the filing of the complaint made a refusal to pay the same. Accordingly the complainant has brought this complaint against the Ops under Section 12 of the Consumer Protection Act,1986 ( for short the Act) for a direction to the Ops to pay him Rs.50,000/-, the insured amount of the dead cow; topay him Rs.40,000/- by way of compensation on account of the harassment and mental agony experienced by him and further to pay him Rs.7500/-towards the costs of the complaint.
4. The cognizance of the complaint was taken against Op no.1 only. It is admitted by the Op that the complainant had purchased Insurance policy No.1000194197 for the period 28.10.2012 to 27.10.2015 also including the cow covered with tag No.100019497 for the sum insured of Rs.50,000/-. On receipt of the intimation, the competent authority of the Op had deputed Sh.Lovejeet Singh, surveyor to assess the loss. The complainant had submitted the claim form alongwith the postmortem certificate. The surveyor submitted his report. As per the claim form, the animal had been treated by Iqbal Khan, Veterinary Inspector and in that way the cow was not treated by the authorized veterinary doctor. Under the exclusion clause of the terms and conditions of the policy the claim is not covered for the reasons : “Death due to mis management of farm or stable”. Accordingly the claim of the complainant was repudiated vide letter dated 27.11.2014. After controverting the other averments of the complaint, going against the Op, it was prayed to dismiss the complaint.
5. In support of his complaint, the complainant produced in evidence Ex.CA, his sworn affidavit alongwith documents Exs.C1 to C9 and his counsel closed the evidence.
6. On the other hand, on behalf of the Op, it’s counsel tendered in evidence Ex.OPA, the sworn affidavit of Smt.Meenu Sharma, Legal Manager ,Ex.OPB, the sworn affidavit of Sh.Lovejeet Singh, Surveyor, alongwith the documents Exs.OP1 to OP7 and closed the evidence.
7. The parties failed to file the written arguments. We have heard the complainant in person, the learned counsel for the Op and gone through the evidence on record.
8. Ex.C4 is the letter dated 27^th November,2014 written by the Op to the complainant on the subject: Claim Status Notification and informed him: “This is with reference to the Cattle Insurance claim No.GEN000134858 filed with us under Policy No.4057/72283306/00/000 against Tag No.100019497. We have perused the documents submitted by you and regret to  inform that your claim cannot be settled for the following reasons:

The said cause of death is excluded from cover under clause 8 of the policy wordings. The said clause is reproduced hereunder:-

8. The company shall not be liable under this policy for compensating the insured for any loss or damage in the following events”

9. It was submitted by Sh.Amit Gupta, the learned counsel for the Op that the claim of the complainant was repudiated by the Op on account of the mismanagement of the farm in that in the claim survey report Ex.OP6 under the findings , it has been recorded on the basis of the interactions made with the complainant that the cattle had got ill five days before death and who was treated by Dr.Iqbal Khan(VI) but the animal could not recover and due to weakness had died. It was submitted by Sh.Gupta that the sick cow of the complainant had been treated by the Veterinary Inspector  and not by a qualified veterinary doctor and for that reason the cattle died.
10. Apparently the submissions made by Mr.Gupta, the learned counsel for the Op appear to be hypothetical because it is categorically recorded in the findings recorded by the surveyor with the help of the interactions  made with the complainant that the sick cow was treated by Dr.Iqbal Khan and in a bracket the status of the doctor has been recorded as Veterinary Inspector. It was for the Op to have lead the evidence that the Veterinary Inspector is not a qualified Veterinary Doctor. It is a matter of common knowledge and experience that in the specialized field only the qualified persons are employed as inspectors as earlier under the Prevention of Food Adulteration Act now substituted with Food Safety & Standards Act,2006, a qualified medical officer is designated as Food Inspector. When in the survey report Ex.OP5, it is categorically recorded that the treatment was imparted by Dr.Iqbal Khan, it was for the Op to have lead the evidence that Dr.Iqbal Khan is not the Veterinary Doctor and was not qualified to treat the sick cow and onus could not be shifted upon the complainant. Survey report is prepared by the surveyor  of the Op. Simply because the survey report was got signed by the surveyor from the owner of the cow would not mean that the onus had to be discharged by the insured. It appears that the Op has just innovated a ground to repudiate the claim of the complainant without caring to see with what disease the sick cow had suffered and what treatment was imparted to it by Dr.Iqbal Khan.  After all one or the other record must have been maintained by Dr.Iqbal Khan in the Civil Veterinary Hospital from where the complainant got the treatment for his sick cow and the same would have gone to explain the things as to who was the official who imparted the treatment to the sick cow but no such evidence has been lead by the Op.
11. Here, it is also important to note that as per the postmortem certificate Ex.OP4, in the opinion of the veterinary officer/Inspector CVH Uppli, Patiala the animal had died due to excessive blood loss due to entritis. It is also noted in the postmortem certificate under the heading Uterus: “Dead foetus about 4-5 months was noticed in the pelvic cavity”. Thus, it would appear that the animal had a problem with regard to the development of the foetus and there is no evidence to have been lead by the Op that the sick cow could not be treated properly by the concerned doctor. Consequently we are of the considered view that the Op had no cogent basis to repudiate the claim of the complainant and the claim of the complainant has been repudiated on baseless and flimsy ground. We therefore, accept the complaint and direct the Op to make the payment of the insured amount of Rs.50,000/- in the light of the certificate of insurance Ex.C1 with interest @9%  per annum from the date of the repudiation i.e. 27.11.2014. In view of the facts and circumstances of the complaint, the same is accepted with costs assessed at Rs.5000/-. The order be complied by the Op within one month on receipt of the certified copy of the order.

Pronounced

Dated: 26.11.2015

                   Sonia Bansal                Neelam Gupta                        D.R.Arora

          Member                        Member                                  President