Order by:

Smt.Priti Malhotra, President

1.           The complainant has filed the instant complaint under section 35 of the Consumer Protection Act, 2019 on the allegations that the complainant got insured his milch cow with Opposite Party for a sum of Rs.95,000/- w.e.f 30.11.2021 to 29.11.2022 vide Tag no.A124095. The said cow breed HF colour black and white died on 07.08.2022 and post mortem examination was conducted by Veterinary Doctor, Civil Veterinary Hospital, Kot Ise Khan, District Moga on 08.08.2022. Due intimation was given to Opposite Party. The complainant lodged the claim with Opposite Party and all the formalities were completed, but despite that the opposite party did not pay any amount to complainant regarding the claim. Opposite Party was asked many time to pay the amount of the claim, but they refused to do so. Hence this complaint. Vide instant complaint, the complainant has sought the following reliefs:-

a)       Opposite party may be directed to make the payment of Rs.1,00,000/- on account of death of insured cow alongwith interest @ 12 % p.a. from the date of claim till it realization.

b)      To pay an amount of R.50,000/- as compensation on account of mental tension, harassment and agony.

c)       To pay an amount of Rs.20,000/- as litigation expenses.

d)      And any other relief which this Commission may deem fit and proper be granted to the complainant in the interest of justice and equity.

2.       Opposite Party appeared through counsel and contested the complaint by filing written reply taking preliminary objections therein inter alia that intricate questions of law and facts are involved in the present complaint which require voluminous documents and evidence for determination which is not possible in the summary procedure under Consumer Protection Act and appropriate remedy, if any, lies only in the Civil Court. The complainant has concealed the material facts and documents from this Commission as well as from the Opposite Party, thereof, the complainant is not entitled to any relief. The complainant has concealed the fact that on receipt of intimation dated 07.08.2022 regarding death of cow bearing tag no.124095, the Opposite Party got the claim investigated through M/s Secure Risk Management and Insurance Service Investigator and on receipt of investigation report it was observed that reported cattle was died on 07.08.2022 while intimation was given as 08.08.2022 after disposal for carcass. Thus, no opportunity was provided to Opposite Party to verify “carcass of the animal with its tag”. Since no opportunity for verification of cattle’s carcass with its “Tag” has been provided so, identity and coverage of deceased cattle in policy has not been established. Further alleged that on receipt of investigation report confirming that during investigation it has been observed that the subject case of cattle bearing tag no.124095 has been manipulated because photos of carcass of the animal provided by the complainant are not matching with the animal in the pre-inspection photographs and body & head patches are totally different and tagging position is different. Therefore, the photos of the dead cattle provided by the complainant are not matching with the animal in the PI photographs and tagging position is different. Therefore, the claim falls under ambit of the policy conditions no.5 and 12 of the policy. Hence, the claim of the complainant was declined vide letter dated 08.09.2022. Further raised objections that complainant is not the consumer of Opposite Party; the complainant has no locus standi or cause of action to file the present complaint against Opposite Party. On merits, all other allegations made in the complaint are denied and a prayer for dismissal of the complaint is made.

3.       In order to prove his case, complainant tendered in evidence his affidavit Ex.C1 alongwith copies of documents Ex.C2 to Ex.C10 and photographs Ex.C11 to Ex.C15

4.       To rebut the evidence of the complainant, Opposite Party tendered in evidence affidavit of Sh.Rohit Ranjan, Assistant Manager Legal and Authorized Signatory, SBI General Insurance Company Ltd. Ex.OP/1 along with copies of documents Ex.OP/2 to Ex.OP/5 and affidavit of Sh.Amandeep Singh, Authorized Signatory, M/s Secure Risk Management and Insurance Ex.OP/6 and letter dated 08.09.2022 Ex.OP/7.

5.       During the course of arguments, ld. counsel for the Opposite party has made a statement that written reply on behalf of Opposite party be read as written arguments on its behalf.  We have heard the counsel for the complainant and gone through the documents placed on record.

6.       There is no dispute with regard to availing of cattle insurance policy by the complainant for his cow for the period 30.11.2021 to 29.11.2022 for sum assured of Rs.95,000/-. The dispute in the present complaint pertains to the repudiation of the claim lodged by the complainant qua the death of the insured cow on 07.08.2022. The relevant part of the repudiation letter dated 08.09.2022 Ex.OP/7 is reproduced as under:-

“We are now in receipt of investigation report confirming that during investigation it has been observed that the subject case of the cattle bearing tag number 124095 has been manipulated because photos of carcass of the animal provided by you are not matching with the animal in the pre-inspection (PI) photographs and body and head patches are totally different. Therefore, the photos of the dead cattle provided by you are not of the cattle which is insured. Further it is observed that the photos of carcass of the animal provided by you are not matching with the animal in the PI photographs and tagging position is different.”

7.       We have given thoughtful consideration to the rival contentions of ld. counsel for the parties and evidence on record. After verifying the record available, we inclined to allow the present complaint of the complainant for the reasons below:-

          It is well proved on record that the claim for the dead insured cattle has thoroughly been verified by the investigator appointed by the Opposite party, who after thorough verification has concluded in his report Ex.OP/5 as under:-

“As per our investigation and finding above, we believe that death of insured’s cattle having ear tag no.SBI General 124095 during our visit insured provided us written statement which clearly mention that the date of loss is 07.08.2022. As per PMR Animal died due to Theileriosis.

In remarks it is mentioned that the above said died cattle Tag no.124095 died on 07.08.2022 which is covered under policy SBI General Insurance Co.”

8.       It is gathered from the record that the investigator duly appointed by the Opposite party has meticulously gone through the ‘post mortem report’ of the dead insured cattle; which has also thoroughly been conducted by Dr.Paramjeet Kaur, Veterinary Officer, Civil Veterinary Hospital, Kot Ise Khan who in its report Ex.C5 opined that “death of animal caused by Theilariases”.

The abovesaid investigation report Ex.OP/5 reveals that no where the identity of the dead cattle has been disputed by giving any comparative chart highlighting the discrepancies in photographs as alleged in the repudiation letter Ex.OP/7 of the Opposite party. There is no whisper in the investigation report qua the positioning of the tag in question as has wrongly been alleged in the repudiation letter. Thus, for the reasons stated above there is no iota of doubt to disbelieve the death of the insured cow during the coverage period. So, the repudiation of the genuine claim of the complainant by the Opposite party is unjustified.

9.       In view of the discussion above, we are of the view that the complainant is fully entitled for the claim of the dead insured cow. Hence, the present complaint stands partly allowed and opposite party are directed to pay Rs.95,000/- (Rupees Ninety Five Thousand only) as sum insured of the dead insured cow to the complainant. Opposite party are further directed to pay a compository amount of Rs.10,000/- (Rupees Ten Thousand only) towards compensation and litigation costs to the complainant for rendering deficient services. The compliance of this order be made by the Opposite Party within 30 days from the date of receipt of copy of this order, failing which, the Opposite Party is burdened with additional amount of Rs.20,000/- (Rupees Twenty Thousand only) to be paid to the complainant. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.

Announced on Open Commission