By Smt.  Bindu.  R,  President:

          This Consumer Complaint is  filed alleging that the Branch Manager  the Oriental Insurance Co. Ltd.,  Branch Office  Kasargod  had committed  deficiency of service and unfair trade practice to the Complainant and therefore prayed to issue direction to the Opposite Party to pay an amount of Rs.70,000/-  towards insurance claim to the Complainant within a stipulated time from the date of filing of claim application of insurance till realisation among other reliefs. 

          2. The Complainant states that the Complainant is a diary farmer by avocation having  a farm house and maintaining  milch cows in his possession  and Complainant had insured his 11 cows with the Opposite Party under Live stock Insurance Scheme with effective insurance period between 31.05.2019 to 30.05.2020 for which the Opposite Party issued a policy certificate  dated 31.05.2019.  The Complainant further stated that all the insured cows were having ear tags which were specifically incorporated in the description of such  policy specifically marked as risk information column.   As per the policy each cows are insured for an amount of Rs.70,000/-  with required permission given by the Complainant and as per the terms of the said policy.   Complainant is entitled for claims of  insured value  on account of death of cows which is covered in the insurance policy issued to him.  It is stated by the Complainant that on 07.03.2020, team of the Veterinary  Dispensary Padinjarathara   came  to the Complainant’s diary farm and given vaccination to the cows as part of project under the scheme of Animal Disease Control  Programme for FMD 8 Brucellosis.  Complainant  further states  that at the time of vaccination the cows were retagged with new ear tags stating that 12 digit number ear  tag is necessary for further departmental and insurance proceedings and they retagged all cows and entrusted the removed ear  tag to the Complainant.  The Complainant states that  on the next day ie on 08.03.2020 morning  one of the cow shown as No.1  in the policy in  Livestock  Insurance Policy Risk information column with ear tag description  3544832  with tan colour which was retagged with new ear tag No.420045688477 found  dead in the cattle shed.  Immediately the Complainant contacted Dr. Sharmila, Veterinary Surgeon,  District Veterinary Centre,  Wayanad, Kalpetta and the surgeon  and department team conducted  post-mortem  and found  that the death of  cow was due to Asphyxia resulted from Acute Pulmonary Edema  due to Anophylous Sequel to  vaccination reaction.  After post mortem, Veterinary Surgeon removed the ear tag after  complying formalities and Dr. Sharmila  undertook  to forward the claim form with post mortem report and necessary certificates for which the Complainant entrusted  old ear tag and new ear tag which were removed from  the deceased  cow.  It is also stated by the Complainant that the  incident of   death of the cow is intimated to the Insurance  Broker Officer Babitha  over phone in her mobile number within immediate days.

          3. The Complainant received letter dated 23.06.2020  from the Opposite Party that the PTD claim is repudiated  for the reason that “no tag no claim and not given immediate notice in writing to the company regarding the death of cow etc”  for which the Complainant had given explanation  to the Opposite Party. Complainant further states that even thereafter the Complainant received a letter from Opposite Party dated 21.07.2020 rejecting the claim saying that clarification is not satisfactory.  According to the Complainant there is no wilful  omission  from his part  other than a few days delay in sending the reply due to the Covid-19  pandamic and lock down issues.  According to the Complainant the repudiation of claim on untenable reason amounts to gross violation of terms of insurance policy.  Hence the  Complainant alleging  deficiency of service and unfair trade practice in insurance service and according to the Complainant the Opposite Party is liable to  compensate for the loss sustained to the Complainant.

          4. Upon notice from the Commission the Opposite Party appeared through their  counsel  and filed their versions.  It is stated in the version that the cow bearing  ear tag No.3544832  mentioned  in the proposal form signed by the Complainant was insured with the Opposite Party for the insured sum of Rs.70,000/-  where as the new ear tag No.420045688477 was surrendered by the Complainant to the Opposite Party.  The retagging  of the cow  with new tag number is  not intimated to the Opposite Party.  The retag letter dated 07.03.2020 issued by the Veterinary Surgeon  was produced by the Complainant along with claim form on 01.06.2020.  The Complainant in violation of the policy condition,  did not intimate the death of cow in time  and the Opposite Party came to know about the claim only on 01.06.2020 after a delay of 84 days from the date of alleged death.  The Complainant  violated  the conditions 4,5 and 8 of the policy conditions.  Though the Opposite Party intimated the complainant on 23.06.2020 about the inability to  entertain the claim still 2 weeks time  was given from the date of receipt of the letter.  The Complainant accepted the notice on 26.06.2020 but did not substantiated his claim hence the claim was repudiated on 21.07.2020. Thereafter the Complainant issued  lawyer notice for which the Opposite Party had sent the reply.  According to the Opposite Party  since the repudiation of the claim is for valid  reasons,  based on policy condition,  the Complainant is not entitled to get any relief as prayed in the complaint, and prayed for dismissal of the complaint.

          5. The oral evidence of the Complainant consists  of PW1 and PW2    and Exts.A1 to A9 and X1 series were marked.  OPW1 was examined and Ext.B1 marked from  the  side of the  Opposite Party.

          6. The following question are coming  up for  consideration.

1.  Whether the Complainant had sustained to any deficiency of service or unfair trade practice from the Opposite Party?
2. Whether the complaint is entitled to get any compensation from the Opposite Party?  If so the quantum of compensation.
3. Whether the Complainant is entitled to get  cost of the proceedings?

7. The Commission considered  the matter in detail.  It is  deposed by the

Complainant during cross examination “2-mw aXv  Dr. iÀ½nf Ipf¼v tcmK-¯n\v Ip¯n-h-¡m³ h¶-t¸mÄ 12 A¡ \¼À DÅ ear tag  sh¨p.   2-mw aXv  ear tag   h¨ Imcyw I¼-\nsb Adn-bn-¨p. t^m¬ aqew Adn-bn-¨p.  08.03.2020 \mWv ]ip N¯-Xv.  Cu hnhcw FXr-I-£nsb Adn-bn-¨Xv 01.06.2020 \mWv   ]ip N¯m DS³ Xs¶ I¼\nsb Adn-bn-¡-W-sa¶pw I¼-\n¡v ]iphns\ ]cn-tim-[n-¡-W-sa¶pw Dff Imcyw Adn-bnÔ.    Further the Complainant deposed that “ Tag amänb Imcyw insurance broker  sd phone   A-dn-bn-¨n-cp¶p”  further states “Ext.A1 to A9 insure sNbvX ]ip-hntâXv Aà F¶p ]d-ªm icn-b-Ô.    

          8. PW2 (name stated as Sarmadha in the deposition instead of Sharmila) is  the Veterinary Surgeon who  conducted the post mortem, through whom X1 series were marked ie the document  with reference to the retagging of the cows.  PW2 deposed  that “  Ipf¼tcmK Ip¯n-hbv¸v {]Imcw  12 digit number  thWw AXn-\m BWv  retag sN¿p-¶Xv  certificate {]Imcw old identity  bpw retag No.   Dw  ]d-ªn-«p-­v. Insured  policy number  Dw certificate   D­v”.     PW2 further deposed  that “08.03.2020 \mWv post mortem  sNbvXXv  Ext.X1 series se  8þmw as¯ tcJ-bm-WnXv Fs¶ ImWn-¨-Xv.  Cause of death Acute pulmonary edema- due to vaccination”.  He further states “Certificate issue    sNbvXXv 26.05.2020 \mWv”.  According to the witness the delay caused due to the lock  down situation.  In cross PW2  deposed that “Cu case  tag \jvS-s¸-Sp-Itbm   retag sNsb­-Xmtbm  h¶n-«n-Ã.  Rm³ tag  sNbvXXv vaccination \p th­n-bm-Wv.  B tag No. Insurance  ASn¨ptNÀ¯n-«nà Ipf¼v tcmK-¯n\v square type tag BWv. Animal Husbandry Dept   BWv  tag \ÂIp-¶Xv”.

       9. OPW2  in cross examination deposed that  Babitha may be the staff of AIMS Broking and B1 policy was issued through broking agent.  On  considering the  Opposite Party’s evidence,  OPW1 deposed that “CS-]m-Sp-I-sfÃmw AhÀ apJm-´n-c-amWv sNbvX-Xv.  ]ip ac-W-s¸« kabw Covid Lock Down issue  Dff Ime-L-«-am-bn-cp¶p”.  Witness deposed  “X1(a)  I¯v In«n-bn-«p­v  06.07.2020 BWv”.  In which the details of vaccination,  subsequent death of the cow,  change of ear tag etc are mentioned. It is also mentioned in the letter that the delay is due to Covid pandemic.  It is  also deposed by  2^nd  Opposite Party that “c­p ear tag Ifpw Ab-¨p-X¶p F¶v letter file  ImWp-¶p­v”.  Which  is X1(b) in the case.  It is also deposed by OPW1  that “ Retag kw_-Ôn¨v company ¡v Dr  Xs¶ intimation X¶n-cp¶p”.  It is also deposed that policy kw_-Ôn¨v condition variation hcp-¯p-¶-Xn\v Xr]vXn-I-c-amb Imc-W-§Ä Ds­-¦n sN¿m-dp­v”. 

          10. Considering the entire  evidence in detail OPW1 admitted that the  time during  which the incident happened was Covid pandemic  period  and there were restriction in the state.  From the reading of the deposition of PW2  and the X1 series the Commission came to the conclusion that the Complainant had proved his case.  It is the case of the Opposite Party that the claim was rejected since the ear tag is not made available to the Opposite Party and the delay occurred  in informing the death of the cow which will not stand to a certain extend in view of the deposition of PW2  and X1 series document.  Of course  there is delay in informing  in writing to the Opposite Party, but according to the Complainant it is informed to one Babitha who  is the staff of AIMS broking  over phone.  The incident happened  during Covid pandemic period.  Hence the reason raised by the Complainant for the delay is found to be satisfactory and  hence the delay happened is to be viewed accordingly.

          11. Hence this Commission is of the  view that the Complainant had proved  his case  and the Opposite Party is liable to compensate the loss sustained to the Complainant.

          Hence the following orders are issued.

1.  Opposite Party is directed to pay Rs.70,000/-  (Rupees Seventy  thousand only) towards  insurance claim of the cow to the Complainant.
2. An amount of Rs.25,000/-  (Rupees Twenty Five thousand only) is to be  paid by the Opposite Party to the Complainant towards compensation.
3. An amount of Rs.5,000/- (Rupees Five thousand only) is also to be paid as costs of proceedings.

Need less to say  that  if  the  above  said  amounts  are  not  paid  within one

month from the date of receipt of this order, the  Opposite Party shall pay interest at the rate of 6% for the same except for the amount awarded as costs from the date of order till the date of realisation.

          Complaint is allowed accordingly.

          Dictated to the Confidential Assistant, transcribed by him and corrected   by   me   and  pronounced  in  the  Open  Commission on this the  12^th   day of June  2023.

          Date of filing:13.10.2020.

                                                                             PRESIDENT:  Sd/-

                                                                             MEMBER    : Sd/-

                                                                   APPENDIX.

Witness for the Complainant:

PW1.           M.D. Sebastian.                       Complainant.

PW2.          Dr. M.K. Sarmadha.                 Veterinary Surgeon.

Witness for the Opposite Party:

OPW1.        Nandakumar. P.                        Assistant Manager, In-charge.

Exhibits for the Complainant:

A1.       Copy of Policy Schedule.                         dt:31.05.2019.

A2(a)    Copy of Cattle Claim Form.                    

A2(b)   Copy of Form for  Discharge Voucher.

A2©     Copy of Valuation Certificate.

A2(d)    Copy of Cattle Claim Form.

A3.       Animal Health Card cum Vaccination Certificate.

A4.       Letter.                                                       dt:23.06.2020.

A5.       Letter.                                                       dt:21.07.2020.

A6.       Letter.                                                       dt:06.10.2020.

A7.       Letter.

A8(a)    Letter.                                                       dt:14.08.2020.

A8(b)    Postal Receipt.                                        

A8(c )   Acknowledgment.

A9.       Letter.                                                       dt:04.09.2020.

Exhibit for the Opposite Party:

B1.        Copy of Policy Schedule.                        dt:31.05.2019.     

X1 series (19 Pages)    Documents produced by Adv. K.M Thomas 

                                     on behalf of the Opposite Party. 

X1(a)      Letter.

X1(b)      Letter.

                                                                                                PRESIDENT:   Sd/-

                                                                             MEMBER    :   Sd/-