IN THE CONSUMER DISPUTES REDRESSAL COMMISSION,
ALAPPUZHA
Monday the 13th day of August, 2021
Filed on 28.06.2019
Present
1. Sri.S.Santhosh Kumar, Bsc.LLB(President)
2. Smt. C.K.Lekhamma.BA, LLB(Member)
In
CC/No.160/2019
Between
Complainant:- Opposite parties:-
Smt. Vijayalakshmi 1. United India Insurance Co Ltd
Puthathayyil Divisional Office
Pathirapally.P.O Sarada Shopping Complex
Alappuzha-688521 2nd Floor, No.3, Mullackal
(Adv. Sri.Jayamohan) Road, Alappuzha-688011
(Adv. Sri. Thomson Pulthakidy)
O R D E R
SRI. S. SANTHOSH KUMAR (PRESIDENT)
Complaint filed under Sec.12 of the Consumer Protection Act, 1986.
1. Material averments briefly discussed are as follows:-
On 04.02.18 complainant purchased a jersey cow for Rs.60,000/- from one Thilakan. The cow was insured with the United India Insurance Co. Ltd. as per policy No.1015004718P106698731. Tag No.420022472900 was allotted to the cow. The policy is valid from 29.05.18 to 28.05.19. At the time of purchase the cow was yielding 12 liters of milk per day.
When the cow was not conceiving on 10.10.18 the matter was informed to Dr.Rachana.R, Veterinary Surgeon, Government Veterinary Dispensary, Mararikkulam. After examining the cow and treatment the doctor certified that the cow will not conceive.
On 08.02.2019 complainant filed a claim form before the opposite party but no amount was given. As per the policy conditions complainant is entitled for compensation for non concievement and it was rejected by the opposite party. There is deficiency of service from the part of opposite party and hence the complaint may be allowed and the opposite party may be directed to give the policy amount. Complainant is also seeking an amount of Rs.12,000/- as compensation along with cost.
2. Opposite party filed a version mainly contenting as follows:-
The complaint is not maintainable either in law or on facts. Complainant had insured the jersey cow from 29.05.2018 to 28.05.2019 for a sum of Rs.50,000/-. Ear tag with No.420022472900 was given to the cow.
On 08.02.2019 complainant filed application claiming insurance amount. The reason for claiming amount was shown as infertility of the cow insured under the policy. The opposite party had examined the animal through the panel veterinary surgeon Dr.James P.K. He reported that there was no ear tag and the animal could not be identified. Hence it was not examined and he recommended to reject the claim. At the time of proposing the animal for insurance coverage the government veterinary doctor after examine the proposed animal had taken photographs and uploaded beneficiary details along with photographs and identification (ear tag number) details of the animal in Animal Husbandry Departments Web Portal. The insurance company accesses these details using ID and password provided by the Animal Husbandry Department. With these details policy was issued.
At the time of submission of claim by the complainant panel veterinary doctor was deputed to identify the animal. The doctor could not identify the insured animal as there was no ear tag. Subsequently the insured had submitted photographs of the animal in which ear tag are clearly visible. On comparing the photographs submitted at the time of insurance and that with submitted by the insured it is found that the ear tag at the time of insurance was on the right ear of the animal and the photographs submitted for claiming insurance the ear tag is on the left ear of the animal. On further scrutiny of the photograph it was found that the photograph is a fabricated one. Hence it is evident that the insured is making a false claim and hence the opposite party repudiated the claim. One of the basis requirements for claiming insurance as per conditions of the policy is strict adherence of maintaining the ear tag on the animal. Since the animal was not identified by the ear tag, this opposite party could not entertain the claim and hence it was repudiated. The condition of no tag- no claim is applicable in this case. There is no deficiency of service from the part of opposite party and hence the complaint may be dismissed.
3. On the above pleadings following points were raised for consideration :-
- Whether the complainant is entitled to realize an amount of Rs.50,000/- which is the insurance amount as alleged?
- Whether the complainant is entitled to realize an amount of Rs.12,000/- as compensation?
- Reliefs and costs?
- Evidence in this case consists of the oral evidence of PW1 and PW2 Exts.A1 to A4 from the side of the complainant and the oral evidence of RW1 and RW2 and Ext.B1 to B4 from the side of the opposite parties.
- Point No.1 and 2
For the sake of convenience these points are considered together.PW1 is the power of attorney holder of the complainant.He filed an affidavit in tune with the complaint and marked Ext.A1 to A4.
PW2 was working as doctor attached to Mararikkulam south veterinary dispensary. On 10.10.18 she examined the cow and issued Ext.A2 certificate.Inspite of treatment and artificial insemination the cow was not conceiving.The tag number of the cow was 420022472900.Ext.A2 and A4 contains her signature.
RW1 is the divisional manager of the first opposite party.She filed an affidavit in tune with the version and marked Ext.B1 to B4.
RW2 had retired as deputy director from animal husbandry department.He is a panel member of the opposite party.Complainant filed a claim application before the opposite party and he was directed to examine the cow.Since there was no ear tag he could not examine the cow.He gave Ext.B4 report recommending that since there is no ear tag, complainant is not entitled for claim.
Complainant in this case purchased a Jersy Cow on 4/2/2018 for Rs.60,000/- and insured the same with the opposite party M/s United India Insurance Company Ltd. Tag No.420022472900 was allotted to the cow. The insurance policy is valid from 29/5/2018 till 28/5/2019. At the time of purchase the cow was yielding 12 litres of milk per day. When the cow was not conceiving on 10/10/2018 complainant contacted veterinary Surgeon attached to the Govt.Veterinary Dispensary, Mararikkulam. Inspite of hormone treatment and artificial insemination the cow was not conceiving and it was reported by the veterinary doctor. On 8/2/2019 complainant approached the opposite party with a claim petition. However the claim was rejected and hence the complaint. Opposite party filed a version admitting the policy and the sum assured was Rs.50,000/-. Their only contention is that the claim petition was filed with a reason “infertility”. However when the panel veterinary doctor of the opposite party went to the complainant’s house he could not identify the animal since there was no ear tag. According to them there condition is ‘no tag no clam.’ Hence the claim was rejected. The Power of Attorney holder of the complainant was examined as PW1 and Ext.A1 to A4 were marked.
The veterinary surgeon was examined as PW2. From the side of opposite parties, the Divisional Manager of the opposite party was examined as Rw1 and Ext.B1 to B4 were marked. The Veterinary Surgeon who was deputed to examine the cow was examined as RW2.
Here in this case insurance policy of the cow is admitted by the opposite party. It is valid from 29/5/2018 to 28/5/2019 and the sum assured was Rs.50,000/-. The only dispute in this case is that when RW2 who was deputed by the opposite party to examine the cow after getting the claim application could not identify the animal since the ear tag was not available. Ext.A1 is the claim form filed on 8/2/2019. The tag number is shown in Ext.A1. Ext.A2(Ext.B1) is the policy issued to the cow on 4/2/2019 which is valid from 29/5/2018 to 28/5/2019. From Ext.A2 it is seen that the complainant had insured 3 cows on that day. The cow in this case is a brown with white mark on face and the sum assured was Rs.50,000/-. From Ext.A1 it is revealed that the tag number allotted to the cow was 420022472900.
PW2 is the Veterinary Surgeon attached to the Veterinary Dispensary, Mararikulam . She deposed that on 10/10/2018 she examined the cow at the house of complainant and issued a certificate. Inspite of doing artificial insemination several times the cow was not conceiving and so she issued Ext.A4 certificate requesting for maximum compensatory allowance. In Ext.A4 it is stated that the complainant brought the cow assuming a production of 12 litres per day. But it is not economical to keep this animal in this condition and she recommended for compensation. However after getting the claim form RW2 was deputed by the insurance company and he issued Ext.B4 Veterinary enquiry report. On 19/2/2019 he visited the house of the complainant to examine the cow. However he could not find out a tag in the cow and so he recommended to reject the claim.
Admittedly complainant had taken a policy with the opposite party and it was valid at the time of filing the claim application. Along with the application she has produced the certificate of PW2 who is a veterinary surgeon attached to veterinary dispensary Govt. Veterinary Hospital, Mararikulam. Her report shows that inspite of hormone treatment and artificial insemination the cow is not conceiving and so it is not economical to keep the animal and so she requested for maximum compensation. So the fact that complainant is entitled for compensation on the basis of the report of PW2 is not in dispute. The only dispute is that at the time of examination by RW2 the cow was not having a tag in its ear.
Ext.B2 is the photograph of the cow from which it is seen that the cow is having a tag on the right ear, having number 420022472900 which is allotted to the cow in question. However along with Ext.B3 another photograph is available from which it is seen that there is a tag on the left ear. From Ext.A1 (Ext.B3) it is seen that the colour of the cow was brown with white mark on face. In both of photo graphs the colour of the cow is brown with white mark on face. It is true that as per Ext.B4 report of RW2 at the time of examination the cow was not having an ear tag and so he recommended for rejecting the claim. However the oral evidence of PW2 coupled with certificate issued by her shows that at the time of examination the cow was having ear tag number 420022472900. As stated earlier PW2, is a Veterinary Surgeon attached to the Govt. Veterinary Dispensary, Mararikulam. The learned counsel appearing for the opposite party had no case that she had issued a false certificate supporting the complainant.
Now the only question to be decided is whether the opposite party can reject the claim of the complainant on a contention that at the time of examination by their panel veterinary doctor it was not having an ear tag. The purpose of ear tag is only to identify the animal. If it is identifiable by other means opposite party has no right to reject a genuine claim. Here in this case PW2 the Veterinary doctor certified that the cow is not conceiving inspite of treatment and so she recommended for compensation. Such a matter was considered by the State Consumer Disputes Redressal Commission , Uttarakand in The Oriental Insurance Company Ltd. vs. Prem Ram in First Appeal No. 258/2011 on 8/12/2014. It was held
“ The tag is only for the identity of the animal and if the identity of the animal which had died, is established by the other reliable evidence on record, it cannot be said that the animal which had died, was not the insured one. As is stated above, the Veterinary Officer has certified that the animal which had died was the insured one and that he had also medically examined the said animal at the time of insurance and has also mentioned the tag number of the animal in the postmortem report.”
Here in this case as stated earlier PW2 the Veterinary Surgeon had examined the animal and certified that it is not conceiving inspite of treatment. She has stated the tag number when examined before court as PW2. There is no reason to disbelieve the evidence of PW2 who is a veterinary surgeon working in the government department.
It was held by the Hon’ble Supreme Court in Om Prakash Vs. Reliance General Insurance in Civil Appeal No. 15611 of 2017decided on 4/10/2017.
“ Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy –holders in the insurance industry. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act.”
To summaries it can be seen that the oral evidence of PW2 coupled with certificate issued by her shows that it is not economical to keep the animal and so she recommended for maximum compensatory allowance. She had examined the cow and identified the ear tag and it is mentioned in the veterinary certificate. Hence applying the principles laid down by decisions read above, we are of the opinion that opposite party has no right to reject the claim only on the basis of the report of RW2 that there was no ear tag at the time of examination.
It is seen that the claim was rejected without any valid reason. The policy was admitted and only contention taken was that at the time of examination by RW2 there was no ear tag. Opposite party has no case that complainant had another cow. From Ext.B1 it is revealed that the other two cows insured on the very same day was having different colour. In said circumstances complainant is entitled for compensation for deficiency of service. These points are found accordingly.
6. Point No.3:-
In the result complaint is allowed in part.
A) Complainant is allowed to realize an amount of Rs.50,000/- being the sum assured along with interest at the rate of 9% from the date of complaint ie, on 26/6/2019 till realization from the opposite party.
B) Complainant is allowed to realize an amount of Rs.10,000/- as compensation for deficiency in service.
C) Complainant is allowed to realize an amount of Rs.3000/- as cost.
The order shall be complied within one month from the date of the receipt of this order.
Dictated to the Confidential Assistant, transcribed by him corrected by me and pronounced in open Commission on this the 13 th day of August, 2021.
Sd/-Sri.S.Santhosh Kumar(President)
Sd/-Smt. Sholy.P.R(Member)
Appendix:-Evidence of the complainant:-
PW1 - P.K.Balan(Power of Attorney Holder)
PW2 - Dr. Rachana.R(witness)
Ext.A1 - Copy of Claim Form
Ext.A2 - Copy of Policy
Ext.A3 - Description of Animal
Ext.A4 - Veterinary Certificate.
Evidence of the opposite parties:-
RW1 - Nija Vijayakumar(Witness)
RW2 - P.K.James(Witness)
Ext.B1 - Copy of Policy
Ext.B2 - Photograph
Ext.B3 - Claim Form
Ext.B4 - Veterinary Enquiry Report
// True Copy //
To
Complainant/Oppo. party/S.F.
By Order
Senior Superintendent
Typed by:- Br/-
Compared by:-
