DATE OF DISPOSAL: 24.06.2022
Sri P.Surya Rao, President:
The case of the complainant in brief is that the complainant Dandapani sahu purchased five number of cows from Sri Gopal krushna sahu of Kukudakhandi for his livelihood on payment of Rs. 1,78,000/- (Rupees One Lakh Seventy Eight Thousand) on 26.03.2013. The complainant insured these five cows under cattle insurance policy with The New India Assurance Co. Ltd., The complainant paid the consideration amount of Rs. 20,399/- towards the policy at State Bank of India of chatrapur Bazaar Branch chatrapur. The policy number bearing no. 20400000035 was valid from 30.03.2013 to 29.03.2016. The o.p. no. 3 has issued collection receipt-cum-adjustment voucher dt. 30.03.2013 with regard to receipt of the insurance amount. The complainant also furnished the copy of report of the Addl. Veterinary Asst. Surgeon, Chatrapur for health certificate of the cattle after proper examination on 26.03.2013. During phailin on 12.10.2013 the Government of Odisha through the special relief commission issued a circular to all the collectors of Ganjam, Gajapati, Puri, Nayagarh etc. (Vide Letter No. 1935, dt. 11.10.2013). The Annexure – 5 interalia speech that the live stock and domesticated animals should also be evacuated to safer places no cattle should be left tied in the kutcha house. The complainant untied the ropes in cow shed. After devastating cyclone, phailin the complainant could not trace out his cattles though he searched in near by places.
The complainant informed the same to the State Bank of India authorities, chatrapur, Ganjam. Further he also submitted petition to the district veterinary department. The o.p. no. 3 communicated to the complainant that “the missing of animals due to cyclone is not covered under the policy in respect of (1) tag no – 40180, 40146, 40150, 40143 and 40145. The complainant also approached before the insurance ombudsman vide complaint no. BHD-G. 049-1516-0063 but the ombudsman refuted the claim. Hence this complaint case.
Written version of o.p.(s) - The o.p.(s) denied the most of the averments of this complaint. They stated that the purchase receipt of the cows is created for the purpose of this case. The examination by the V.A.S is not true. That the complainant untied the cattles in accordance with circular and announcement of the District Administration, is not true. The o.p(s) admitted that the complainant after repudiation of claim by them approached the insurance ombudsman which was also rejected.
There is no cause of action to file this complaint case. The complaint is barred by limitation and this case is not maintainable. The Branch Manager S.B.I Chatrapur vide Letter dt. 18.10.2013 forwarded the application of Dandapani Sahu, (Complainant) about missing cows to the Branch Manager. It is ascertain that the cows tag no. 40180, 40146, 40150, 40143 and 40145 are under policy number 55060147120400000035. The missing cows insured under policy is not covered as per the conditions of the policy. Accordingly the o.p.(s) repudiated the claim of the complainant. The complainant approached before the insurance ombudsman who rejected the complaint stating as devoid of merit. The complaint case is not maintainable under C.P. Act, 1986. Hence the complaint case should be dismissed.
Issue to be decided –
- Issue No – 1. Whether the complaint petition is maintainable.
- Issue No – 2 – Whether there is any deficiency of service on the part of the opposite parties in refusing the claim of the complainant.
- Issue No – 3. Whether the complainant is entitled to reliefs claim for.
Issue No. 2 –
This issue is most vital one. In this issue it has be discussed whether there is any deficiency of service on the part of opposite parties in refusing the claim of the complainant under the contract of insurance. According to the complainant he had purchased five milch cows and also got them insured with the New India Assurance Company Ltd. There was cyclone named phailin on 12.10.2013. The Government of Odisha issued through special relief commissioner circular to all the Collectors including Collector of Ganjam district. The Ganjam district authorities made circulations stating that live stock domesticated animals should be evacuated to safer places. No cattles should be left tide in the kutch house. After the devastating cyclone phailin, in the morning the complainant could not trace out the cattles inspite of search in nearby places. The complaint informed the SBI authority and submitted petition to the District Veterinary Department. The complainant was communicated by the opposite party No. 3 that missing animals is not covered in respect of Tag No. 40180, 40146, 40150, 40143 and 40145.
In this regard the opposite party submitted that there is no cause of action for filing the complaint against the responded. After of the scrutiny of the policy No. 55060147120400000035 it is ascertained that the cows relating to the tag No. 40180, 40146, 40150, 40143 and 40145 are covered under the policy. However on perusal of the conditions it is ascertained that the missing cows is not covered under the policy. Accordingly the claim of the complainant was repudiated. The death of the cows due to cyclone is covered but missing of cows is not covered under the policy as such there is no illegality by the opposite party in repudiating the claim of the complainant. We perused the record, documents, evidence and the materials on the record.
In this case the complainant had purchased five milch cows and got them insured with the New India Assurance Company. The terms of insurance contract inter-alia includes special conditions. They are as follows:
- Death due to diseases contracted prior to and within 15 days of commencement of risk are not payable for Non-scheme Cattle.
- Tag should be surrendered at the time of claim otherwise it will be treated as no claim. In the event of death of Cattle covered under the policy claim/s shall not be entertained unless the ear tag/s are surrendered to the Company.
In the event of loss of ear tag/s, it is the responsibility of the insured to give immediate notice to the Company and get the Cattle retagged.
The terms of insurance contract as filed by the opposite parties in relation to the present contract is perused. It contains many conditions which include common exclusion and specific exclusion and special conditions. The common exclusions speaks that accident occurring and / or disease contracted prior to the commencement of risk is excluded. Similarly consequential loss of whatsoever nature is excluded. Similarly there are certain specific exclusions. All claims of insurance received without ear tag will not be considered. The provision of No Tag No Claim should be included as policy condition No. 9. The wording may be as under.
“In the event of death of animals covered under the policy. Claim/s shall not be entertained unless the ear tag/s are surrendered to the Company. In the event of loss of ear tag/s, it is the responsibility of the Insured to give immediate notice to the Company and get the animal retagged.”
The terms of insurance contract also says that the examination fees for veterinary examination of the dead animals or for post mortem will be payable by the insurer. If qualified Veterinarians are not available in the area concerned for certifying cause of death, the insurer may make suitable alternate arrangements at their discretion.
In this case the complainant has not submitted the death certificates of the cows from the veterinary department. Similarly the complainant has not submitted the ear tag/s of the dead cows. It only goes to show that the cows which are insured are not dead. Infact the complainant has not used the word dead in his complaint petition. He only says that milch cows are missing due to cyclone and it not traceable. This is outside the preview of contract of insurance. In order to prove that the cows are dead the complainant has to show the ear tag/s of the cows and also produce the death certificate of cows from the veterinary doctor. The complainant has failed to produce the cow ear tag/s and also failed to produce the death certificate of cows. As such the treatment of the insurance company as no claim by the complainant is justified.
Further more the complainant has approached the insurance ombudsman of odisha with his grievances. The insurance ombudsman has given a detailed order. The proceeding before the insurance ombudsman is filed by the o.p. as Annexure – E. The conclusion of the ombudsman report is as follows
“Conclusion: The complaint’s cows went missing on 12.10.2013, on the date of sever cyclone Phylin, after they were freed from the cow shed by the owner, as per the Govt’s pre-cyclone announcement, before the landfall of the cyclone. Since the animals could not be traced out subsequently, he lodged the claims with the OP which were made no claim as the policy does not cover the missing of animals. The controversy here, therefore, centers round the policy coverage which has been looked into by me so as to reach a definite conclusion in the matter of admissibility of the claim of the complainant. Copy of the Cattle insurance (Market Agreement), as filed by the OP, is available in the file and 6th para of the same has clearly stated the coverage of the policy. An analysis of the same by any means does not cover the cause of loss of animals of the complainant. In such circumstances, the case of the complainant for settlement of his claim to save him from the loan burden is not maintainable as the cause of loss is not coming under the purview of the policy coverage. Hence it is felt that there is no need to interfere with the decision of the OP.”
Thus from the evidences of the complainant and the o.p. and the document filed by the both the parties clearly shows that the complainant failed to prove that the cows are dead due to cyclone he also failed to produce the ear tag/s of the dead cows and also failed to produce the death certificate of cows. Hence the terms of the contract of the insurance are not fulfilled by the complainant. Thus it is found that there is no deficiency of service on the part of the opposite parties. As such the complaint petition is not maintainable and liable to be dismissed.
Issue No. 1 & 3 –
In view of the discussion above we conclude that the complaint petition is not maintainable. It is also concluded that the complainant is not entitled for any reliefs claimed, because the complainant has failed to prove that the insured cows are dead and he failed to produce the tag/s of the cows in accordance with terms of the contract of the insurance. Hence both the issues are answered in negative. Hence ordered.
The present complaint case is dismissed without any cost.
Certified copy of this order be communicated to the parties free of cost.
A copy of this order be also sent to the Secretary, State Consumer Distputes Redressal Commission, Odisha, Cuttack for information and a copy of same be sent to the server of www.confonet.nic.in for posting in internet. After compliance the case record be consigned to record room.
This order is pronounced on 24th June 2022 in open commission.
