FA.No.1517/2007 AGAINST C.C.No.32/2006  DISTRICT FORUM-II, TIRUPATHI

Between:

Sri M.Lokanadham S/o.Sri Munaswamy

Hindu, aged 40 years, Agriculturist,

R/o.Tirumaliahpalli Village and Post,

Vedurukuppam Mandal, Chittoor District.                                                                Appellant/

                                                                                                                                      Complainant

                   A N D

The National Insurance Company Limited

Rep. by its Branch Manager,

D/o.157-1, Ist floor, P.K.Layout, Tirupathi

Chittoor District.                                                                                                           Respondent/

                                                                                                                                      Opposite party

Counsel for the Appellant: Mr.A.Rama Rao

Counsel for the Respondent:-Mr.Phalguna Rao

QUORUM:      SMT.M.SHREESHA,  MEMBER

&

SRI K.SATYANAND, MEMBER

FRIDAY, THE THIRTIETH DAY OF OCTOBER,

TWO THOUSAND NINE

Oral Order( Per Sri K.Satyanand,Hon’ble Member)
***

This is an appeal filed by the unsuccessful complainant assailing the order of the District Forum dismissing his insurance claim.

The facts of the case are briefly as follows:

The complainant purchased a jersey cow and took out an insurance policy on 18-3-2003 furnishing risk coverage to the said animal. The said cow was allotted tag number NIA 3739. The said tag was lost during the course of grazing by the animal.  In the said circumstances, the complainant claimed to have given a representation to the opposite party and with the knowledge of the opposite party a new tag was fixed on the animal bearing No.NIA 42430. To that effect, a certificate was also issued by the veterinary surgeon addressing the opposite party.  The opposite party acknowledged the said letter on 17-6-2005.   Later on 5-8-2005 the said cow suddenly died at about 5.00 p.m.  He claimed to have approached the veterinary surgeon on the early hours of         06-8-2005 and on his verification and conduct of post mortem on the dead animal, he issued a certificate to that effect.  Thereupon, the complainant claimed to have approached the opposite party with claim forms on 6-8-2005.  It seems the office remained closed according to the watchman and advised the complainant to present the claim on 8-8-2005.  It is further alleged that unfortunately the complainant became sick on the evening of 7-8-2005 and was not in a position to move about.  In these circumstances, the complainant sent the claim forms with a covering letter on 10-8-2005 to the office of the opposite party. The claim forms were received by the opposite party on 11-8-2005. On the very same day, the opposite party sent a letter to the complainant that he had violated the policy conditions 7 and 13 and therefore his claim was closed as ‘no claim’.  This according to the complainant was not justified, so he got issued a legal notice which evoked no response.  Consequently, he filed the complaint seeking an amount of Rs.12,500/- covered under the policy with interest at 24%p..a from the date of death of the animal as also damages to a tune of Rs.3,000/-.

This claim was resisted by the opposite party reiterating that the complainant violated the terms of the policy 7 and 13.  According to them condition No.7 clearly postulated that on the death of the animal, the insured shall within 12 hours give notice thereof by telegram to the company at the office which issued the policy etc. Like wise the condition No.13 also was allegedly violated as it required the insured to surrender the tag in respect of the animal as a condition precedent  to make a claim.

            In support of his case, the complainant filed his own affidavit and relied upon documents marked as Exs.A1 to A7.  The opposite party did not file any affidavit, however, it relied upon two documents marked as Ex.B1 and B2.

            On a consideration of the evidence adduced on either side, the District Forum dismissed the complaint holding that the complainant violated the express provision of condition No.7 as also condition No.13 and therefore his claim was rightly repudiated.

            Aggrieved by the said order, the complainant preferred the present appeal essentially on the grounds that the opposite party ought not to have pleaded about the discrepancy in the tag number as it had the knowledge about the veterinary doctor assigning a new tag number in as much as the same was informed to the opposite party.  The complainant also urged that the death of the cow was intimated to the veterinary doctor and that he approached the insurance office with the claim on 6-8-2005 and it was only due to the non availability of the access to the insurance company due to holidays and his sickness that he could not send the claim form till 10-8-2005.  So he reiterated that the District Forum ought not to have accepted the plea that the appellant violated policy conditions 7 and 13.  The District Forum failed to see that there was deficiency of service and unjustifiably upheld the repudiation.

            Heard both sides.

            The point that arises for consideration is whether there are any good grounds to interfere with the order of the District Forum?

            As could be seen from the letter of repudiation marked as Ex.A4, the claim was repudiated on the ground that the complainant failed to adhere to conditions No.7 and 13 which form part of the insurance policy. Ex.B2 is the copy of the conditions on the cattle policy filed by the opposite party.  Condition No.7 reads as follows:

‘On the death of animal hereby insured, the insured shall within

twelve hours give notice thereof by telegram to the company

at the office which has issued the Policy and shall give the company,

all opportunity of inspecting the carcass by not removing cutting

or parting with it until atleast the expiration of twenty four hours

after such notice shall have been received by the Company.  The

insured shall also within fourteen days furnish to the Company

such information accompanied by such veterinary certificate and

satisfactory proof as to the death identity and value of the animal

as the company may require’.

            It is amply clear from the language of condition No.7 that in case of death of the insured animal, the complainant has to follow a certain procedure of which the immediate intimation of the death of the animal within 12 hours to the company by a telegram figures prominently.  Moreover, after such intimation the complainant should not remove the carcass giving time of 14 days for the insurance company to conduct relevant investigations.  Instead of the said procedure, the complainant followed Altogether a different procedure of his own with the active assistance of the veterinary surgeon and as to what he did in the wake of death of the animal is found in paragraph 4 of the complaint as under:

‘The complainant further submits that all of a sudden on 5-8-2005

at about 5.00 p.m. the complainant’s cow covered under the above

policy was died.  As it was in the evening hours, the complainant

approached the Veterinary Assistant Surgeon on the early hours

of 6-8-2005 and on his verification and conducting the Post Mortem

on the dead animal, he issued a certificate to that effect.  After

arranging all the claim forms, the complainant had personally

approached the opposite party office on 6-8-2005, but the

watchman, who was present at that time intimated to the

complainant that the office was closed on that day due to holiday

and advised the complainant to present the claim on the next

working day i.e., 8-8-2005,   Unfortunately on 7-8-2005 evening

itself the complainant seriously fell ill and unable to move from

his bed to handover the claim forms in the office of the opposite

party within time.  As the opposite party office personal delayed

in receiving the complainant’s claim forms over the above said

policy and in the said circumstance, the complainant had sent his claim

forms with a covering letter on 10-8-2005 to the office of the opposite

party.  The said claim forms was received by the opposite party on

11-8-2005’.

That means he did not follow even a word of condition No.7 and what he did was quite contrary to the said term and the procedure he adopted was destructive of all the evidence regarding investigation as to the death depriving opportunity to the opposite party which had definitely a financial strake in the matter.  The other ground on which the claim was repudiated was that he also failed to surrender the tag.  There is absolutely no evidence to show that he surrendered any tag on the other hand, the complainant pleaded that the insurance company was in the know of the new tag but  his own documents give a lie to his assertions.  The veterinary surgeon by his letter dated 7-6-2003 informed to the insurance company that he himself issued a new tag with a new number as the old tag was lost and the said letter marked as Ex.A2 did not leave affirmative action on the part of the insurance company in token of having accepted the assignment of new tag.  On the other hand, it kept the issue of confirming the assignment of new tag pending as is evident from its letter Ex.B1 dated 24-6-2995. Thus Ex.B1 clearly shows that the assignment of new tag number was not recognized by the insurance company and remained inconclusive.  Apart from that it is no where the case of the complainant that he surrendered the new tag but the tag number is a very important input as the term 13 of the policy clearly postulates ‘no tag no claim’ principle which also means that the tag must be the one that was authentically assigned to the cow in question.  Thus the claim suffered from two infirmities which the opposite party took advantage naturally rightly.  Thus we see no merits in the appeal and the appeal is accordingly dismissed but without costs.

                                                                   Sd/

                                                                                                                                                MEMBER.

                                                                                                                                                  Sd/-

                                                                                                                                                MEMBER

JM                                                                                                                                                                               Dt.30-10-2009