Kerala

Idukki

CC/153/2018

Sijo Joseph - Complainant(s)

Versus

Secretary AppCos (no 198) - Opp.Party(s)

Adv.K M Sanu

29 Nov 2019

ORDER

DATE OF FILING :31/07/18

IN THE CONSUMER DISPUTES REDRESSAL FORUM, IDUKKI

Dated this the 29^th day of November 2019

Present :

SRI. S. GOPAKUMAR PRESIDENT

SMT.ASAMOL P. MEMBER

CC NO. 153/2018

Between

Complainant : Sijo Joseph,

Vellaringattu House,

Perumthotty P.O.,

Mannathara P.O., Idukki.

(By Adv: K.M.Sanu)

And

Opposite Party : 1 . The Secretary (APCOS No.198),

Ksheerolpathaka Sahakaran Sangam

Thopramkudy, Thopramkudy P.O.

(By Adv.Lissy M.M.)

2 . Diary Extension Officer,

Diary Development Office,

Vathykudy, Vathykudy P.O.

3 . The Deputy Director,

Diary Development, Idukki, Mini Civil Station,

Thodupuzha, Thodupuzha P.O., 685 584.

4 . The Manager,

New India Assurance Co.Ltd.,

Thrippunithura Branch,

Thrippunithura P.O. - 682 301.

(By Adv: Thomas Sebastian)

 

O R D E R

SRI. S. GOPAKUMAR (PRESIDENT)

 

The case of the complainant is that,

 

Complainant is a Diary farmer. The opposite parties launched an insurance scheme named as 'Ksheera Jyothi' in the year 2016, in order to insure the cattle and the diary farmers. In this scheme complainant remitted premium for insuring

(Cont....2)

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his three cows, and the three cows having tag Nos.420005/603337, 9197, 9198 were duly insured with the fourth opposite party. As per this policies the cattles are covered for their illness, permanent disability and death to the maximum extent of Rs.50,000/-. In addition to it, the policy covers mediclaim of the complainant and his wife. This policy was valid from 2016 March to 2017 March.

 

While so, one of the cow of the complainant having ear tag No.420005/603337 suffered with illness from 18/08/16, immediately after its delivery. The veterinary surgeon treated the cow from the date of its illness. At last due to the illness the cow died on 19/08/16. Immediately after the death of the cow complainant lodged claim application along with the treatment records, post mortem certificate and ear tag of the cow through the first and second opposite parties. On receiving the claim application the fourth opposite party verified it and repudiated the claim on the reason that, the cow having ear tag No.9076 was not insured with them.

 

The complainant further averred that, actually complainant lodged claim for the death of his cow having ear tag No.603337, but the fourth opposite party handed this matter carelessly even not to go through the claim application and rejected the claim on the ground that the cow having ear tag No.9076 is not insured with them. Complainant further averred that, even though the insurance broker of the fourth opposite party, 'The Videl Health', issued health card to the deceased cow, the claim repudiated by them without valid reason and without verifying the records is gross deficiency in their service and unfair trade practice. Hence the complainant filed this petition for allowing the relief such as to direct the opposite parties to pay the claim amount of Rs.50,000/- along with 18% interest from 19/08/16, further direct the opposite parties to pay compensation and cost.

 

Upon notice opposite parties entered appearance and filed detailed reply version.

 

In their version the first opposite party contented that they insured 46 cows and 133 diary farmers in the 'Ksheera Jyothi Insurance Scheme' and paid an amount of Rs.3,03,596/- as premium for this cows and persons. The amount is

(Cont....3)

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transferred from the SB account of the opposite parties of the Union Bank of India, Thopramkudy Branch, directly to the Ksheera Jyothi Co-Ordinater's account. The first opposite party further contented that they submitted insurance application and premium including the application of the complainant, and his premium amount. They submitted all the documents relating to the insurance of the complainant's cows to the third opposite party's office. The first opposite party complied all the formalities in this matter and there is no deficiency in service is happened on the part of the first opposite party.

 

In their version the second opposite party contented that he is not aware of the averment in the complaint, because he took charge recently and he forwarded the file to the then officer now he is working as the Diary Development officer in Mukkathala block, Kollam district.

 

In their version the opposite party further contented that he took charge as Diary Development officer in Vathikudy Block on 16/07/2018. At that time he holds additional charge of Diary Development Officer Idukki Block. At that time there was no sufficient staff in this office to conduct data entry of the details of the members of Ksheera Jyothi insurance Scheme. Due to the lack of expert staff, the opposite party engaged the work of conducting data entry to one Edwina Computers, Thopramkudy, with the consent of Deputy Director. He directed all the Secretaries of 28 Ksheera Sangam to approach the computer center with the details of cattles and persons who joined this insurance scheme. The third opposite party further contented that, the complainant also submitted his enrollment form for joining in this Ksheera Jyhothi Scheme. At the time of entering data or after thereafter nobody raised any objection and it is seen that all the details regarding the members of the scheme is entered in the data entry. When the details of members joined in the scheme along with their premium was transferred to the 4^th opposite party, it is their duty to verify the list of members. If the 4^th opposite party raised any objection regarding the number of application and the premium amount at the time of receiving it from the 3^rd opposite party. The 3rd opposite party will rectify the defect if any, caused in submitting the application along with the corresponding premium.

 

(Cont....4)

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The third opposite party in their reply version contented that they handed over all the insurance details to the 4^th opposite party on 12/07/17 along with a letter having No.716/17. More over, the cattle claim received from the 4^th opposite party insurance company having the name of the complainant also. As per this list the reason for withholding the claim was stated that 'the person not covered in the policy'. This opposite party intimated the matter to the Diary Development officer, Vathikudy on 15/08/18. In addition to it the 3^rd opposite party send a E-Mail to the Diary Development officer, Vathikudy on 23/05/18.

 

The opposite party further contented that, when they received the intimation from the 4^th opposite party, regarding the non- inclusion of the complainant name in the policy list, intimated the matter to the second opposite party, for verification and report. In this matter no deficiency is caused from the office of this opposite party. Then opposite party submitted all the relevant records of the 3^rd opposite party to the insurance company.

 

In their version the 4^th opposite party contented that the complainant's cow tag No.603337 was not insured with this opposite party. The cows bearing ear tag Nos.9197 and 9198 were insured with the 4^th opposite party as per the above said policy and premium for policy for those cows were paid. No premium is paid by other opposite parties to insure the cow having ear tag No.603337 from the insured. So the above said policy does not cover the complainant's above said cows.

 

The fourth opposite party further contented that on perusal of documents it is revealed that the above said cow is not insured with the 4^th opposite party and hence the claim is repudiated, the repudiation of claim was properly interacted to the insured by letter. Hence the complainant is not entitled to get insurance claim from this opposite party.

 

Evidence adduced by the complainant by way of documents. Complainant produced 5 documents which is marked as Ext.P1 to Ext.P5. Ext.P1 is the repudiation letter, Ext.P2 is the insurance enrollment form copy, Ext.P3 is the claim application,. Ext.P4 is the copy of post mortem report, Ext.P5 is he copy of post mortem certificate.

(Cont....5)

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From the opposite parties side the first opposite party was examined as DW1 and Ext.R1 to Ext.R3 produced and marked. Ext.R1 is the copy of comprehensive diary insurance enrollment form of the complainant, Ext.R2 is the copy of pass book of the opposite party's society, Ext.R3 is the enrollment list of cattle and diary farmers. From the side of 4^th opposite party total list of insured cattles and diary farmers were produced and marked as Ext.R4.

 

Heard,

 

The point that arose for consideration is whether there is any deficiency in service from the part of opposite parties, and if so, for what relief the complainant is entitled to ?

 

The Point:- We have heard the counsels for both sides and had gone through the records. It is an admitted fact that the complainant had remitted his insurance premium and along with the insurance premium of his cattles and comprehensive Diary Insurance Enrollment Form. Opposite parties 1 and 2 prepared a detailed list (Ext.R3) and forwarded the list contains 133 members and 46 cattle and 8 staffs along with the total premium of Rs.3,03,596/- to the third opposite party the Ksheera Jyhothy Insurance Co-Ordinater. On perusing Ext.R3 list, it is seen that the list contains the proposal of the complainant and his wife and his three cattles. As per records this whole list and whole insurance premium was transferred to the third opposite party. The amount is transferred from the bank account of opposite parties 1 and 2 to the account of third opposite party.

 

Then it is the bounden duty of the third opposite party to convince the Forum that whether they handed over the entire list along with the premium amount forwarded by the opposite parties 1 and 2, to the 4^th opposite party, the insurance company. On verifying Ext.R4 list of members, in the Kshhera Jyothi Scheme, it is seen that except the cow in question having ear tag no 603337, other two cows having ear tag nos.9197 and 9198 are duly insured with the 4^th opposite party. Hence the 4^th opposite party repudiated the claim of the complainant on the reason that, the cow having ear tag No.603337 in the claim is not insured with them.

 

(Cont....6)

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When the 4^th opposite party repudiated this claim, the liability shifted to the 3^rd opposite party, who is the co-ordinator of this insurance scheme. Hence the 3^rd opposite party is bound to convince the Forum that they transferred the enrollment list and premium amount, which they received from the opposite parties 1 and 2 are handed over to the 4^th opposite party, as such. Here the 3^rd opposite party miserably failed to convince the Forum that they transferred the premium amount and enrollment list to the 4^th opposite party, and the 4^th opposite party is omitted to enroll the tag number of the cow in question.

 

Under the above circumstances, Forum is not in a position to accept the contention of the 3^rd opposite party due to the absence of such an evidence. On the basis of above discussion Forum is of a considered view that the 3^rd opposite party had committed error in forwarding the list of members to the 4^th opposite

party, as such they received it from the first and second opposite party. Hence liability of paying insured amount to be vested opposite party them.

 

Hence the Forum found that the deficiency in service has committed in this case is by the 3^rd opposite party alone and the 3^rd opposite party is bound to compensate the complainant.

 

Hence complaint allowed. The 3^rd opposite party is directed to pay Rs.50,000/- to the complainant being the insurance amount along with Rs.2000/- as litigation cost within 30 days from the date of receipt of the copy of this order, failing which the insurance amount shall carry 12% interest from the date of default till its realization.

 

Pronounced in the Open Forum on this the 29^th day of November, 2019.

 

Sd/-

SRI. S. GOPAKUMAR (PRESIDENT)

Sd/-

SMT. ASAMOL P. (MEMBER)

 

 

(Cont....7)

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APPENDIX

 

Depositions :

On the side of the Complainant :

Nil

On the side of the Opposite Party :

DW1 - Shaji Varghese

Exhibits :

On the side of the Complainant :

Ext.P1 - The repudiation letter

Ext.P2 - The insurance enrollment form copy

Ext.P3 - The claim application

Ext.P4 - The copy of post mortem report

Ext.P5 - The copy of post mortem certificate.

On the side of the Opposite Party :

Ext.R1 -The copy of comprehensive diary insurance enrollment form of the

complainant

Ext.R2 -The copy of pass book of the opposite party's society

Ext.R3 -The enrollment list of cattle and diary farmers.

Ext.R4- Total list of insured cattle and diary farmers

 

 

Forwarded by Order,

 

SENIOR SUPERINTENDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(When the 4^th opposite party repudiated the claim of the complainant, the liability shifted to the 3^rd opposite party, who is the co-ordinator of this insurance scheme, and opposite parties 1 and 2 are transferred the enrollment list and premium to the 3^rd opposite party. Hence the liability of the 3^rd opposite party is to convince the Forum with relevant records, substantially their version that they forwarded the list of the members of the scheme received from opposite parties 1 and 2 had transfers to the 4^th opposite party as such along with the respective premium amount. Hence the 3^rd opposite party miserably failed to produce any evidence to show that thy forwarded Ext.R3 list of member and the premium amount to the 4^th opposite party and the 4^th opposite party is omitted to enroll the subject matter cow having tag No.603337).