By Smt.  Beena. M, Member:

This  is a complaint filed under section 12 of the Consumer Protection Act 1986.

2. Brief facts of the case are as follows:-  The case of the Complainant is that he is a dairy farmer and his only source of income is derived from it.   On 22.03.2017, he took an insurance policy from the First Opposite Party through the Second Opposite Party for his cow, cross breed, Black & white colour, aged four and half years vide insurance policy No.76130247160400000110 for a sum of Rs.60,000/-.  Before taking the insurance policy, a Tag No.4073339 was issued by the Doctor, Thariyod Veterinary Hospital.  The Complainant used to take care of the cow but later, after several treatments he was convinced that the cow could not conceive.  Thereafter, on 21-07-2018, the Complainant applied to get the insurance claim amount from the First Opposite Party.   

          3.  Afterwards, the Complainant approached the First Opposite Party on several occasions, but they did not take any action on the Complainant's application for a year and finally the claim was rejected on the grounds that the cow did not have a tag.  As the First Opposite Party repudiated his claim the Complainant had caused many troubles and difficulties.  The act of the First Opposite Party is unfair trade practice.  Hence the Complainant filed the complaint for getting the claim amount of Rs. 60,000/- with interest, Rs.1,09,500/- as wages for rearing  of the cow and compensation of rupees 10,000/- from the First Opposite Party and cost of the complaint. 

          4.  The First Opposite Parties entered appearance   and filed Version wherein the preliminary objection raised by the Opposite Party as to the maintainability of the Complaint and violation of the terms and conditions of the policy.  The First Opposite Party admitted the existence of the policy and denied all other allegations.  The First Opposite Party averred that the Complainant is liable to produce the ear tag of the cow for its identification along with the claim application to process the claim but the Complainant failed   to produce the ear tag.  In Version,   the First Opposite Party alleged that in the absence of the ear tag, they could not process the claim.  The Complainant did not take any steps to retag the cow.  The First Opposite Party further alleged that the Complainant filed the complaint in collusion with the veterinary surgeon, Dr. Muhammedkutty. No deficiency in service / unfair trade practice and any type of negligent attitude from the side of the Opposite Party.  So, the First Opposite Party prayed for dismissal of the complaint with compensatory costs.  The Second Opposite Party did not file Version and on 15-02-2020 they were declared ex- parte.

          5.  On perusal of complaint, version, and documents, the Commission raised the following points for consideration:-

1. Whether the Complainant is entitled to get insurance claim from the

     Opposite Parties?

2.  Whether there is any deficiency in service / Unfair trade Practice from

     the First Opposite Party?.

3.  Whether the Complainant is entitled to get any Compensation as prayed

     for?

4.  Whether the Complainant is entitled to get   cost of the Complaint..?

6.  Point No. 1 to 4 :-  For the sake of convenience and brevity all the points are considered and answered together.

          7. The Complainant was examined as PW1 and the documents produced were marked as Ext. A1 to A3 and documents called for marked as X1 Series.  No oral evidence from the side of Opposite Parties.   

          8. On perusal of the X1 series documents, it is seen that the  Opposite Party had  rejected the claim  as the Complainant did not produce the ear tag.  Even if there was no ear tag, there was no hindrance to the Opposite Party in considering the claim based on the investigation report of the doctor and the report of the insurance surveyor.   As the Opposite Party did not give any oral statement, their contention  that the Complainant colluded with the doctor and preferred a fraudulent claim should not sustain and could not be accepted by the Commission.   No information was given to the Complainant to produce the ear tag before the claim was rejected. 

           9. The Complainant has produced the judgment of the Hon’ble Supreme Court of India has reported in 2022 Live Law (SC) 506 in Gurmel Singh v Branch Manager, National Insurance Co.Ltd, held that “Insurance companies refusing claim on flimsy grounds and/or technical grounds- While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control”.

10. Considering all these aspects the Complainant's claim should not have been rejected on technical grounds.  Hence, in the instant case, the repudiation of the claim by the First Opposite Party was illegal and not in accordance with law. Consequently the Complainant is entitled to be indemnified under the policy.  In the view of the aforesaid discussion, we hold that the Complainant is entitled to get insurance benefit, compensation and cost. It is seen that there is no deficiency in service on the part of the Second Opposite Party.

          In the result, the complaint is partly allowed in the following terms.

1. The First Opposite Party is directed to pay Rs. 60,000 (Rupees Sixty Thousand only) within a period of one month from the date of receipt of the copy of the order with interest at the rate of 8% per annum from the date of filing of the Complaint till realization.
2. The First Opposite Party is directed to pay Rs.5,000/- (Rupees Five Thousand only) towards compensation.
3. The First Opposite Party is directed to pay Rs.50,000 (Rupees Fifty Thousand only) towards expenses for looking  after of the cow till date and
4. The First Opposite Party is also directed to pay Rs.5,000 (Rupees Five Thousand only) towards cost of this Complaint.

The First Opposite Party must comply the above orders within one month,

failing which it will carry 9% interest from the date of order.   

          Dictated to the Confidential Assistant, transcribed by him and corrected by me and  pronounced  in the Open Commission on this the 30^th day of August 2022.

Date of filing: 25.09.2019

                                                                   PRESIDENT:  Sd/-

                                                                   MEMBER   :   Sd/-

                                                                   MEMBER  :    Sd/-

APPENDIX.

Witness for the complainant:

PW1.           Raju. K.T.                      Complainant.

Witness for the Opposite Party:

Nil.

Exhibits for the complainant:

A1.       Copy of Policy Schedule.     

A2.       Copy  of Claim form.                     dt: 21.07.2018.

A3.         Copy of   Letter.                            dt:05.08.2019.

X1(a)           Copy of Policy Schedule.                 

X1(b)          Letter.                                      dt:05.08.2019.     

X1©            Letter.                                       dt:15.05.2019.

X1(d)          Cattle Claim Work Sheet.                  

X1(e)          Address Cover.

X1(f)           Letter.                                       dt:18.08.2018.

X1(g)          Claim Form.                                      dt:21.07.2018.

X1(h)          Claim Form.                                      dt:21.07.2018.

X1(i)           Investigation Fees Bill.             dt:22.03.2019.

X1(j)           Photos.

X1(k)          Photos.

X1(l)           Photos.

X1(m)         Letter.                                       dt:01.01.2019.

X1(n)          Treatment Chart.                      dt:21.07.2018.

X1(o).         A.I. Details.                              dt:21.07.2018.

X1(p)          Valuation Certificate.               

X1(q)          Copy of   Identity Card.

X1®            Copy of  Aadhaar Card.          

Exhibits for the Opposite Party:

Nil.