By. Smt. Bindu. R, President:
This complaint is filed by Smt. K. Sini against United India Insurance Company represented by the Divisional Manager, Divisional Office, Aluva alleging deficiency of service and unfair trade practice from the side of the Opposite Party.
2. The Complainant states that she had purchased a milking cow from one Mr. Gopi on payment of Rs.80,000/-. On 28.06.2021 the cow showed some physical complaints and had taken to the Medical Officer, Veterinary Centre, Irulam. The cow died on the same date at 12.30 pm. The doctor told the Complainant that the cow was having septicemia and postmortem was conducted by the Surgeon at Irulam Centre.
3. The cow was insured with the Opposite Party and was having a live policy coverage on the day of death of the cow. The insurance policy was taken under “ksheeravasantham” with enrolment No.CDIS 2122-120410/M/601574 (Tag No.420045769752). The Complainant further states that she had applied for the claim on proper form after completing all the formalities prescribed by the Company along with all necessary documents.
4. The claim was repudiated by the Opposite Party stating that the cow was not given proper treatment but the Complainant states that every possible treatments were given to the cow soon on detecting the physical discomfort. The Complainant states that the act from the side of the Opposite Party amounts of deficiency of service and unfair trade practice and therefore prays to issue direction to the Opposite Party to release the amount of Rs.60,000/- being the insured amount of the cow along with a compensation of Rs.50,000/- and others.
5. Even though notice was sent to the Opposite Party they didn’t file version in time. Hence set ex-parte.
6. Complainant filed proof affidavit and produced Ext.A1 to A6 documents.
7. Ext.A1 is a Cattle insurance policy certificate valid from 23.03.2021 to 22.03.2022. Ext.A2 is a Veterinary Certificate issued by the Veterinary Surgeon. Ext.A3 is the Post mortem Report dated 28.06.2021 and Ext.A4 is a Lawyer notice with postal receipt and acknowledgment card. Ext.A5 is the Claim form preferred by the Complainant and Ext.A6 is the Repudiation Letter.
8. Since Opposite Party is ex-parte the Commission had to rely on the documents submitted by the Complainant to verify the facts stated in the complaint and affidavit.
9. The following are the important aspects to be decided in this case.
- Whether the Complainant had proved deficiency of service or unfair trade practice from the side of the Opposite Party?
- If so, compensation and costs to be awarded in this case.
10. Heard the Complainant and perused the records in detail.
11. The Complainant is an ordinary woman and the purpose of feeding the cow is for getting milk. Soon on detection of the discomfort of the cow she had taken the cow to the nearby Veterinary Hospital. One ordinary person can never foresee the disease of an animal well in advance and it can be noticed only when some external symptoms or likewise instances are developed or shown by the cow. In the instant case soon on when septicemia was noticed, the cow was immediately taken to the nearby Veterinary Hospital at Irulam where the Veterinary Surgeon Dr. Amalraj. K. V had treated the cow. At this stage it is pertinent to state that the cow was insured with the Opposite Party from 23.03.2021 to 22.03.2022 for an amount of Rs.60,000/- and the death of the cow took place on 28.06.2021 the day on which there was a valid insurance coverage for the cow. As per Ext.A6 issued by the Opposite Party it can be seen that the repudiation of the claim is due to “no proper treatment taken which is violation of policy condition No.7”. The Opposite Party had not considered the vital fact that the Complainant had no medical background to detect and ascertain decease like septicemia except under circumstances when the cow behaves unnaturally or shows some discomfort or bodily disorders or under developments of systems. The action of the Opposite Party is a clear case of deficiency of service and unfair trade practice and therefore this Commission finds that the Complainant had proved Point No.1 on merit. Therefore the following Orders are passed:-
- The Opposite Party shall release the insured sum of Rs.60,000/- (Rupees Sixty Thousand Only) to the Complainant along with interest @ 12% from the date claim till the date of realization.
- The Opposite Party shall also pay an amount of Rs.50,000/- (Rupees Fifty Thousand Only) to the Complainant as compensation for the mental agony and hardship caused to the Complainant.
- The Opposite Party shall pay an amount of Rs.10,000/- (Rupees Ten Thousand Only) to the Complainant towards cost of the proceedings.
Needless to say that the Order is to be complied with by the Opposite Party within one month from the date of receipt of the copy of this Order otherwise the Complainant will be eligible for 12% interest for the amounts awarded except cost of the proceedings, from the date of Order till date of realization.
Complaint is allowed accordingly.
Dictated to the Confidential Assistant, transcribed by him and corrected by me and pronounced in the Open Commission on this the 15th day of November 2023.
Date of Filing:-01.12.2022.
PRESIDENT :Sd/-
MEMBER :Sd/-
MEMBER :Sd/-
APPENDIX.
Witness for the Complainant:-
PW1. Sini.
Witness for the Opposite Party:-
Nil.
Exhibits for the Complainant:-
A1. Copy of Micro-Insurance product-cattle insurance policy for the
period of 23.03.2021 to 22.03.2022.
A2. Copy of Livestock Claim. Dt:28.06.2021.
A3. Copy of Post-mortem Report. Dt:28.06.2021.
A4. Lawyer Notice.
A5. Copy of Claim Application. Dt:28.06.2021.
A6. Copy of Claim Repudiation Letter. Dt:12.01.2022
Exhibits for the Opposite Party:-
Nil.
PRESIDENT :Sd/-
MEMBER :Sd/-
MEMBER :Sd/-
/True Copy/
Sd/-
ASSISTANT REGISTRAR
CDRC, WAYANAD.
Kv/-
