SMT. RAVI SUSHA: PRESIDENT

Complainant filed this complaint U/s 12 of Consumer Protection Act 1986, seeking to get an order directing the opposite party to pay Rs.70,000/- towards insured amount with 12% interest from 01/08/2018 together with cost of the proceedings of this case.

In nutshell, the facts of the case are that the complainant a member of the Cherupuzha Ksheerolspadaka co-operative Society Ltd.(milma) purchased a cattle and got the same insured with the Insurance company.  The Insurance company provided a cattleand got the same insured with the Insurance company.  The insurance company provided on ear tag for the purpose of identification of the cattle at the time of issuing policy.  The policy number was 76130047170400004226 and ear tag number was 42001/ 5062472.  Later on, the said cattle died and claim was preferred by the complainant before OP with the P/M certificate of veterinary Doctor Dr. Viswalakshmi, treatment details and other details, for the sum assured, which was repudiated by the Insurance company on the basis that as per the proposal and policy records, there is no coverage for the cattle bearing Tag No.42001/5062472 as per the certificate issued by the veterinary surgeon wit h post mortem report.  Further stated that the policy records for one cattle bearing Tag No.42001/506472 which is legibly seen in the proposal submitted by the insured.  Hence repudiated that claim as per policy clause “No tag No claim”.  Complainant submitted that there was a clerical error happened from the side of veterinary surgeon, during filling the proposal form in the ear tag number of the insured cow.  She had missed the number ‘2’ in noting the ear tag  in the proposal form while submitting before the insurance company and for that she had given correction letter also to the OP company for getting the claim amount to the complainant.  According to complainant, he could not get the claim amount due no fault from his side.  Hence filed this complaint.

            After receiving notice, OP entered appearance through counsel and filed their version.  It is stated that this OP admits the issuance of a cattle insurance policy vide No.76130047170400004226 in the name of Cherupuzha Ksheeropadaka Sahakarana Sangam Ltd.  But this OP specifically deny the insurance of the cattle with tag No.42001/5062472 as per above said policy.  It is also admitted that the complainant has submitted a claim form before this OP, along with the ear tag of the deceased cow, claiming for the insurance amount towards the death of the cattle with Tag No.42001/5062472.  But on scrutiny of the claim form, the certificate from the veterinary doctor and the ear Tag of the dead cow surrendered by the complainant, it is the cow with ear tag 42001/5062472 which died.   Whereas according the proposal form, the insurance policy and the tag number it is found that such a cattle with the said tag number was not cow insured with them, because as per the proposal form for insuring the cattle the insured has given the ear tag number of the cow as 42001/506472.  Hence the insurance coverage was issued to the cattle with the Tag No.42001/506472.  Therefore this OP is not liable to pay the insurance amount towards the death of the cattle of which the Tag No is 5062472.  Therefore after processing the claim the OP has rightly treated the claim as “No Tag No claim” as per the specific terms and conditions of the insurance policy.  The repudiation of an unlawful claim as per the terms and conditions of the insurance policy may not be treated as deficiency of service of unfair trade practice on the part of the insurer.  Hence prayed for the dismissal of the complaint.

            Complainant has filed his chief affidavit with documents.  He has been examined as Pw1 and marked Ext.A1 to A4.  Ext.A1 is the Insurance policy, Ext.A2 treatment details, Ext.A3 post mortem report and Ext.A4 repudiation of death claim.  From the side of OP.  Ext.B1 the ear tag, Ext.B2 proposal cum veterinary certificate, Ext.B3 cattle Insurance policy, Ext.B4 proposal from Ksheerolpadaka society, Ext.B5 is the death claim submitted by the complainant with veterinary certificate, treatment details of surgeon and photo of the died cattle.  Ext.B6 is the repudiation letter of the claim.  After that both parties argued the matter.

            The main contention of learned counsel for the Insurance Company is that as per the proposal form submitted by the veterinary surgeon, veterinary dispensary, Cherupuzha, for insuring the cattle, the insured has given the ear tag number of the cow as 42001/506472.  Hence the insurance coverage was issued to the cattle with the tag No.42001/506472.  The death claim submitted by the insured, belongs to the cow with the ear Tag                           No. 42001/5062472.  According to OP, the cattle with ear Tag No.42001/562472 was not insured with OP and hence the claim application was rejected as per the terms and conditions of the Insurance policy.

            On perusal of the available documents before us, maintain the proposal form, insurance certificate and certificate of veterinary surgeon Dr. Viswalekshmi. L, there is a discrepancy in the ear tag of the insured cow.  It is clearly revealed that all other factors, and features, ie insurance policy number 76130047170400004226, category – CBHF, cattle type mlch cours, sex – female Breed/colour/other marks, Black and white, TE, Ht. 12.6cm Age and months 3 year, sum Insured, Name of owner –Mathew K M are the same in the proposal  form, Insurance certificate, claim form, as well as in the P/M certificate and treatment details of veterinary surgeon.  Only difference is missing of digit ‘2’ in the ear tag submitted by the veterinary surgeon.  The proposal form noting the ear tag of the cattle was submitted before insurance company by the veterinary surgeon of the dispensary is evident that the veterinary surgeon  Dr. Viswalekshmy a responsible employee of the state government had given an excuse letter in the treatment details to the Insurance Company along with the death claim of the disputed cattle, ie “NB:  The tag number of animal is 42001/5062472”.  Further stated that during the insurance procedure time, I was written the tag No. in proposal form in which the digit ‘2’ was missing.  It was a human error and please consider this claim”.  In her certificate it has been mentioned by the surgeon that the insured cow with the OP was died and it was under the treatment of the veterinary surgeon.  In her report, it has further been explained by her that there was human error in missing one digital ‘2’ in noting the ear tag of the insured cattle while submitting the proposal form.  As a responsible officer there is no need to disbelieve the statement of the veterinary surgeon about the missing of one digital ‘2’ in the ear tag of the cow in question in the proposal form who had treated the cattle and done the post mortem.  More over except ear tag number, all other factors in the proposal form and insurance certificate are seen same.

            Therefore, we are of the opinion that due to the clerical mistake happened from the side of veterinary surgeon, denial of claim benefit to the farmer complainant is not a justifiable action on the part of Insurance company, even after, receiving the explanation of the veterinary surgeon, who had given the proposal form to them. Hence there is deficiency in service on the part of OP Insurance company.  So the complainant is entitled to get insured claim from OP.

            In the result complaint is allowed in part. Opposite party is directed to give Rs.70,000/- the insured amount of the cattle in question to the complainant. Opposite party is also directed to give Rs.10,000/- as compensation for the mental agony to the complainant. The opposite party shall comply the order within one month from the date of receipt of the order, failing which the amount Rs.70,000/- carries interest @ 7% from the date of complaint till the date of realization of the amount.  Complainant is at liberty to execute the order by filing application against the opposite party as per the provision of Consumer   Protection Act 2019.

Exts.

A1-Insurance policy(photo copy)

A2-Treatment details (photo copy)

A3-Post mortem report (photo copy)

A4-Repudiation of death claim (photo copy)

B1-Tag

B2- proposal cum veterinary certificate

B3-Cattle Insurance policy B1-Tag

B4- Proposal from Ksheerolpadaka society

B5- Death claim

B6- Repudiation letter

Pw1- Complainant

      Sd/                                                                          Sd/                                                     Sd/

PRESIDENT                                                                   MEMBER                                                   MEMBER

Ravi Susha                                                               Molykutty Mathew                                     Sajeesh K.P

(mnp)

/Forward by order/

Assistant Registrar