DATE OF FILING : 30.3.2017

IN THE CONSUMER DISPUTES  REDRESSAL FORUM, IDUKKI

Dated this the  30th  day of  May,   2018

Present :

SRI. S. GOPAKUMAR PRESIDENT

SRI. BENNY. K. MEMBER

CC NO.64/2017

Between

Complainants       :    Shinto Joseph,

Thadickal House,

Padmukham P.O.,

Idukki – 685 604. 

And

Opposite Parties                                          : 1.  Amex Insurance Brokers (India) 

Pvt. Ltd.,

     33-1885 B.(A) Frutomance Building,

     N.H. 47, Kochi Byepass Road,

     Vennala, Kochi – 682 028. 

          2. The Chairman and Managing Director,

  New India Insurance Company Ltd., 87,

  M.G. Road, Fort Mumbai – 400 001.

   (By Adv:  Thomas Sebastian) 

         3. The Deputy Director,

                                                                Dairy Development Department,

   Mini Civil Station, 

   Thodupuzha P.O.,  Idukki – 685 590.

4. The Secretary, 

    Padamukham Milk Producers 

Co-operative Society (APCOS),

    Padamukham P.O., Idukki – 685 604.

  (By Adv: Sibi Thomas)

O R D E R

 

SRI. S. GOPAKUMAR, PRESIDENT

 

Case of the complainant is that,

 

The complainant had insured his cow having ear tag No.3720819 through 1st opposite party, the insurance broker, with 2nd opposite party, the insurance company, as per the policy of Ksheera Jyothi Insurance scheme, on 7.3.2016. The insured amount was Rs.40000/- for the cow.  This scheme was introduced by the State Government through 3rd opposite 

            (cont....2)

-  2  -

party.  Through 4th opposite party, complainant submitted the insurance application and the 3rd opposite party collected all application and sent it to 2nd opposite party, along with premium amount.  Complainant received an insurance certificate having number K-053000 1000 2920 and put tag in the ear of the cow tag number is 3720819 by the 2nd opposite party company.  While so, when the insurance coverage is active, the cow was affected with eat obstruction and subsequent infection with califarm.  In spite of nugical correction and treatments, the left two quarters were completely fibrosed with no scope of production.  

 

Immediately the complainant informed the matter to the 2nd opposite party with relevant records through 4th opposite party, and intimated the matter to 1st opposite party also.  But the 1st and 2nd opposite party has not taken any effort for conducting an enquiry in this matter, eventhough the opposite parties 3 and 4 reminded the matter so many times.  At last, the complainant approached the veterinary doctor and informed the day to day worsening condition of the cow and decided to sell out the cow, on the fear that the disease will spread to other cows also.  The cow was sold out for an amount of Rs.4500/- whereas the cow was purchased for an amount of Rs.78000/-.  At the time of selling the cow, the complainant tried to loosen the ear tag, but he failed to get it, because he cannot loosen it without cutting the ear of the cow.  Hence the complainant sold the cow along with its ear tag.

 

The complainant  further stated that at the time of lodging the insurance claim before the 2nd opposite party, they have sufficient opportunity to enquire the matter and to convince the disease of the cow, having proper ear tag.  2nd opposite party denied the insurance claim of the complainant, on the reason that, alongwith the claim petition, the complainant failed to produce the ear tag for some other reasons.  

 

This act of the 2nd opposite party in denying the claim of the complainant, which is legally entitled to him, is a gross deficiency in service and unfair trade practice.  Against this complainant filed this petition for getting the reliefs such as to direct the 1st and 2nd opposite parties to pay Rs.30000/- as insurance claim and also direct them to pay Rs.10250/- as damages and Rs.2 lakhs as compensation.

   (cont....3)

-  3  -

Upon notice, opposite parties entered appearance and 2nd and 4th opposite parties filed reply version separately.  In their version, 2nd opposite party contended that, they have not received any application to insure the cow having ear tag No.3720819 and has not insured this cow.  It is admitted that 2nd opposite party has issued three policies bearing No.761002/47/15/04/00000015, 761002/47/16/04/00000001 and 761002/47/16/04/00000002.  No premium is collected for insure the cow having ear tag No.3720819 from the insured.  So the above said policies do not cover the complainant's cow.  The 2nd opposite party has not issued a policy having No.K/5300010002920 to cover the complainant's cow having ear tag No.3720819.  2nd opposite party further contended that, they has not received any intimation to examine the cow suffering from disease.  The complainant has not produced the ear tag along with the claim form.  At the same time, 2nd opposite party has received a claim form claiming permanent total disablement in respect of cow having ear tag No.3720819.  The ear tag is necessary for the settlement of claim.  The certificate from 3rd opposite party is not sufficient to settle the claim.  On scrutiny of the claim form, it is seen that, the cow mentioned above is not included in the list of cattles in the policy. Hence there is no deficiency in service on the part of the opposite party and complainant is not entitled to get any relief as prayed for.

 

First and 3rd opposite parties set exparte.

 

4th opposite party in their version, contended that they insured the cow of the complainant and complainant is entitled to get the insurance claim.

 

Complainant was examined as PW1 produced three documents and marked as Exts.P1 to P3.  Ext.P1 is the copy of Comprehensive Dairy Insurance along with proforma for enrolment of the mild producers in Comprehensive Dairy Insurance Scheme.  Ext.P2 is the copy of vidal health card issued by 1st opposite party.  Ext.P3 is the copy of claim form, PTD claim certificate, treatment certificate.  From the complainant's side Dr.Binod P.G was examined as PW2.

 

 

   (cont....4)

-  4  -

From the defence side, 2nd opposite party produced document which is marked as Ext.R1.  Ext.R1 is the copy of premium remitting details of Ksheerajyothi 2016-17.  Ext.R3 is the copy of details of insured and details of remittance of insurance premium.  Ext.R2 is the copy of customer acknowledgement.  Ext.R4 is the advance premium deposit receipts.

 

Heard both sides.

 

The point for consideration is whether there is any deficiency in service from the part of opposite parties and if so, for what relief the complainant is entitled to ?

 

The POINT :-   We have heard the learned counsels for the complainant and opposite parties and gone through the evidence on records in detail.  On perusing Exts.P1 to P3, the Forum convinced that the cow alleged in the complaint is duly insured with 2nd opposite party, insurance company through their broker 1st opposite party, by 3rd opposite party.  The premium collected from 4th opposite party Ksheera sangham was transferred to 2nd opposite party.  As per their version, through a master policy, they insuring cattles and milk producers and the family members as a group.  No practice of insuring any individual policy.

 

In this case, the disease of the cow having tag No.3720819, duly insured with 2nd opposite party is an admitted fact and it is strengthen through Ext.P1 treatment records and Medical certificate and the deposition of PW2, the veterinary doctor who treated the cow at the time of incident.

 

At the same time, the learned counsel for 2nd opposite party vehemently argued that, the claim is rejected due to the reason that non-production of ear tag alongwith the claim application.  The reason for non-production of ear tag is specifically stated by the complainant in his complaint as well as the proof affidavit that at the time of forcible selling of the cow, he fried to dismantle it from its ears, but he failed, as the reason that, it cannot be loosened, except by cutting the ear of the cow.  As a cattle rearer, his conscious cannot allow him to go to such an extent.  This reason for the non-production of ear tag cannot be brushed off, and it quite 

   (cont....5)

-  5  -

believable.  At this juncture, the version of the complainant, that eventhough the 1st and 2nd opposite parties get sufficient chances, to enquire this matter, they cannot turned up and never tried to visit the cow, at least, is acceptable.

 

Moreover, the 2nd opposite party has sufficient opportunity to conduct an enquiry in this matter evenafter the lodgong of this complaint, or they can call the person, to whom the complainant sold the cow, and examine him as a witness to clarify the version of the complainant.  Moreover, the insurance company can settle the claim, by receiving the affidavit from the complainant for non-production of the ear tag of the cow which is the subject matter.  Without conducting sufficient and material enquiries in this matter, insurance company straight away repudiated the claim of the complainant on some lame excuses or some baseless technical issues.  This act of the 2nd opposite party, warranting gross deficiency in their service.

 

On the basis of the above discussion, the Forum is of a considered view that, version of the complainant is genuine and versatile and hence the complaint partly allowed.  2nd opposite party is directed to pay an amount of Rs.30,000/- to the complainant as insurance claim along with 12% interest from the date of receipt of a copy of this order and also directed to pay Rs.2000/-, as litigation cost.  Other reliefs of the complainant are dismissed due to want of evidence.

 

    Pronounced in the Open Forum on this the  22nd  day of June, 2018

 

 

Sd/-

SRI. S. GOPAKUMAR, PRESIDENT

 

 

Sd/-

SRI. BENNY. K., MEMBER

 

 

 

 

 

    (cont....6)

 -  6  -

 

APPENDIX

Depositions :

On the side of the Complainant :

PW1              -   Shinto Joseph

PW2              -  Dr. Binod P.G.

On the side of the Opposite Party :

Nil.

Exhibits :

On the side of the Complainant :

Ext.P1            -   Ext.P1 is the copy of Comprehensive Dairy Insurance along with

      proforma for enrolment of the milk producers in Comprehensive 

      Dairy Insurance Scheme.  

Ext.P2           -  copy of vidal health card issued by 1st opposite party.  

Ext.P3           -  copy of claim form, treatment certificate.

Ext.P4           -   PTD claim certificate.

Ext.P5           -   cash voucher.

On the side of the Opposite Party :

Ext.R1           -  copy of premium remitting details of Ksheerajyothi 2016-17. 

 

 

             Forwarded by Order,

 

 

 

 

               SENIOR SUPERINTENDENT