By Sri.Ananthakrishnan. P. S, President:

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

2.   The Complainant’s case in brief is as follows:-

The Complainant is a milk vendor and is depending upon the income derived from it. He is the owner of the cow bearing tag No.7984. He insured the cow on 30.12.2016 for Rs.80,000/- as per policy No.76130447160400000431 through the second Opposite Party. The cow did not get pregnant. Thus, he started treatment for the cow from 02.04.2017 and the cow is found to be infertile.  Therefore, the Complainant presented a claim on 18.09.2017 through the second Opposite Party. But, the first Opposite Party after waiting a long period closed the claim as no claim and sent a letter to the complainant. The first Opposite Party without any reason closed the claim of the Complainant. Hence this complaint to get the insurance amount of Rs.80,000/-and Rs.10,000/- as compensation.

3. The first Opposite Party filed version which is in short as follows:- 

He admitted that the Complainant had insured his cow bearing ear tag No. 7984 for the period starting from 06.01.2017 to 05.01.2020 as per Pasumithra Scheme based on Memorandum of Undertaking (MOU) with Malabar Regional Co-operative Milk Producers Union Limited, Kunnamangalam, Kozhikode. Since the pre existing decease PTD claims are also submitted by the Societies, the average claim ratio including the pending claims under process exceeds 150 percentages.  Hence the enrolment of cattle has to be increased to compensate the claim ratio.  As per the decision taken in the meeting held at MRCMPU Limited on 14.11.2016 in order to avoid pre-existing decease PTD claims, the PTD claims will be considered only after 3 months from the date of issue of insurance Policy. Thus Milma had issued a circular No. 511/2016 containing this decision to all milk societies. The terms and conditions of policy and MOU are applicable in the case of complainant. He insured the cow only on 6.1.2017 and he started the treatment of his cow on 2.4.2017 which is within the waiting period of 3 months.  Hence the complainant is not entitled to get the claim.

4. The second Opposite Party filed version which in brief is as follows:-

              They admitted the presentation of the insurance claim by the Complainant. This Opposite Party is the mediator to get proposal form and claim form from the parties and transfer those to first Opposite Party. They have no role to allow or reject the claim of the parties.

5. The third Opposite Party filed version which is in short as follows:

This Opposite Party is an unnecessary party.  This Opposite Party had issued a circular explaining all the eligibility criteria for enrolment in the scheme as well as the entitlement of the benefits of the scheme and accordingly the members are enrolled in the scheme. This Opposite Party has no role in allowing or rejecting the claim.

6. On the above contentions, the points raised for consideration are:-

1.  Whether there is any deficiency in service from the part of

     Opposite Parties?

2.  Reliefs and Cost.

7.  The evidence in this case consists of oral testimonies of PW1, OPW1, Ext. B1 to Ext.B4 and Ext.X1 series. Heard both sides.

8. Point No.1:- The case of the complainant is that he insured his cow bearing tag No.7984 and his cow was found to be infertile. He alleged that though, he presented the claim form through second Opposite Party, the first Opposite Party rejected his claim without any valid reason.  Complainant has given evidence as PW1 who supported his case.  It is an admitted fact that PW1 insured his cow bearing tag No.7984 and though he presented the claim form through second Opposite Party, the first Opposite Party, insurance company rejected the claim as no claim.  Ext.X1 series are the file containing the claim form, treatment records and other related documents.  OPW1 has given evidence to substantiate the reason for the rejection of the claim of the Complainant.  Ext.B1 is the policy certificate.  The main point assailed by the first Opposite Party is that in order to avoid pre existing disease PTD claims, the third Opposite Party issued a circular which contained that the PTD claims will be considered only after 3 months from the date of issue of insurance Policy.  Ext.B2 is the decision and Ext.B3 is the Circular of third Opposite Party which contains this condition.  Ext.B4 is the rejection letter of the claim of the complainant. In Ext.B4, first Opposite Party specifically stated that the claim of the Complainant is rejected for the reason that the treatment of the insured cattle had started on 2.4.2017 and subsequent dates which is within the waiting period 3 months for PTD claims. It is evident as per Ext. B1 policy, the Complainant had insured this cow on 6.1.2017. His case is that since, he found his cow as infertile, he started the treatment of the cow from 02.04.2017 which is within 3 months from the inception of the insurance policy.  So, as per Ext.B3 circular, the Complainant is not entitled to get the claim. Hence we held that there is no deficiency in service on the first opposite party. So the point is found against the Complainant.

9. Point No.2: Since Point No.1 is found against the Complainant, he is not entitled to get any relief as prayed for.

In the result, the complaint is dismissed without costs

Dictated to the Confidential Assistant, transcribed by him and corrected by me and pronounced in the Open Commission on this the 29^th day of June 2022.

Date of Filing:-15.03.2018.

PRESIDENT   :Sd/-

MEMBER       :Sd/-

APPENDIX.

Witness for the complainant:-

PW1.              Abraham. K. V.                               Ksheera Karshakan.

Witness for the Opposite Parties:-

OPW1.          K. Somanathan.                              Divisional Manager.         

Exhibits for the complainant:

X1(a).             Copy of Memorandum of Understanding.

X1(b).                        Letter.                                                                        Dt:19.09.2017.

X1(c)              Claim form.                                                              Dt:18.09.2017.

X1(d).                        Veterinary Certificate.                                          Dt:18.09.2017.

X1(e)              Photograph.

X1(f).             Ear tag.

X1(g).             Copy of Identity Card.

X1(h).                        Copy of Aadhar Card.

X1(i).              Copy of Ration Card.

X1(j).              Letter.                                                                        Dt:07.11.2017.

X1(k).             Copy of Voucher.                                                   Dt:10.11.2017.

X1(l).              Copy of Cattle Insurance Policy.

X1(m).           Detail Treatment Certificate.                              Dt:18.09.2017.

X1(n).                        Certificate issued by Dr. Pradeep Kumar.

Exhibits for the opposite parties:-

B1.                  Copy of Cattle Insurance Policy for the period of 06.01.2017 to

            05.01.2020.

B2.                  Copy of the Minutes of the meeting held at MRCMPU Limited.

                        Dt:14.11.2016.

B3.                  Copy of Circular No.511/2016.                         Dt:16.11.2016.

B4.                  Letter.                                                                        Dt:28.02.2018.

PRESIDENT   :Sd/-

MEMBER       :Sd/-

/True Copy/

                                                                                                               Sd/-

                                                                                              ASSISTANT REGISTRAR

                                                                                                  CDRC, WAYANAD.