DATE OF FILING: 23.02.2016.
DATE OF DISPOSAL: 20.06.2017.
Dr. Alaka Mishra, Member:
The complainant has filed this consumer dispute under Section 12 of the Consumer Protection Act, 1986 alleging deficiency in insurance service against the Opposite Parties ( in short the O.Ps) and for redressal of her grievance before this Forum.
2. The brief fact of the complainant’s case is that she had availed a loan from the bank of the O.P. No.2 to run his diary farm at Kumarbegpalli and accordingly a sum of Rs.5,00,000/- was financed by the O.P.No.2 in favour of the complainant after keeping the mortgage of related documents of a house and the plot where her diary firm is going on and a fixed deposit of Rs.30,000/-. Accordingly the complainant had purchased ten numbers of cows in two phases with the verification report of the Veterinary Department, Chatrapur, Ganjam. The complainant is eking out her livelihood from the income from that diary firm and used to repay the loan regularly. The said cows were also properly insured with the O.P.No.1 bearing policy No.55060147130400000006 dated 25.07.2013 which was valid from 25.07.2013 till 24.07.2016. During the validity of the said insurance policy two of the cows of the complainant bearing identification Tag No. 40141 and 40148 died in natural death which was immediately reported to the Additional Veterinary Assistant Surgeon, Chatrapur who also conducted Post Mortem over the dead body of the said two cows and submitted his report on 13.11.2014. Then as per the terms and condition of the insurance policy the complainant claimed the death benefit against the death of her two cows but to her misfortune the O.P.No.1 paid a deaf ear to the claim for which she could not purchase cows to harvest milk to earn her livelihood and to repay the burden of the loan amount. The O.P.No.1 has neither taken any step nor responded to the complainant till date for the reasons best known to the O.Ps and for that she has also sustained heavy financial loss in her business for which the O.Ps have deliberately made the deficiency in service by paying a deaf ear to the grievances of the complainant which comes under the ambit of the Consumer Protection Act, 1986. Alleging deficiency in service on the part of the O.Ps the complainant prayed to direct the O.Ps to pay the sum assured of Rs. 50,000/- against two dead cows and to pay compensation along with cost of litigation in the best interest of justice.
3. Upon notice the O.P.No.1 filed version through his learned counsel Sri P.C. Panigrahi, Advocate, Berhampur. He filed his written version on 7.6.2016 and written argument on 23.08.2016. It is stated the averments made in the complaint are not true and correct. The complainant has to prove the same which are not specifically admitted herein and they are deemed to be denied. It is not to the knowledge of this O.P. that the complainant had purchased 10 cows by availing loan of Rs.5,00,000/- from the O.P.No.2 by keeping the mortgage of a house and land. So the complainant has to prove the same. The senior Branch Manager of the O.P.No.1 received a letter on 24.11.2014 from the O.P.No.2 stating therein that two numbers of cows bearing Tag No.40141 and 40148 covered under policy No.5506014712000000033 died on 12.11.2014 along with vas report. After perusal of the above policy it is ascertained that the cows relating to Tag No.40141 and 40148 are not covered under policy No. 5506014712000000033. Accordingly they expressed their inability to entertain the claim as the cows are not insured and intimated the same to the O.P.No.2 vide letter dated 26.11.2014 with a request to provide the policy copy if at all the cows are insured with them under any valid policy. While the matter stood thus the O.P.No.2 vide its letter dated 26.12.2014 submitted a corrected policy copy with a request to the O.P.No.1 to process the claim. After getting correct policy and relevant documents relating to the death of above cow from the O.P.No.1, it is ascertained that the complainant has issued a letter to the Veterinary Department of Chatrapur requesting them to provide compensation for death of one cow vide Tag No. 4041 on 12.11.2014. The said letter was forwarded to the Branch Manager, SBI, Chatrapur. Apart from it the O.P. has submitted two post mortem relating to the death of two cows said to have been conducted by the Additional Veterinary of Chatrapur on two different dates i.e. on 06.01.2014 and on 13.11.2014 without furnishing ear tags of the deceased cows. As per claim procedure as well as condition of policy the claim must be intimated within 24 hours of the occurrence, so that the insurer can depute their investigator for verification of carcass and also physical tagging of animal which is mandatory as per their claim procedure. In the present case the complainant or her banker never gave intimation to this O.P. relating to the death of her cows within the stipulated period for which they have deprived of making verification of carcass and also physical tagging of animal which is mandatory as per their claim procedure through their investigator. This O.P. got intimation of death of cows of the complainant on 26.11.2014 after 11 months of death of one cow relating to Tag No. 40148 and after 15 days of death of another cow relating to Tag No. 40141 from the O.P.No.2 for which they have deprived of making verification of carcass and also physical tagging of animal which is mandatory as per their claim procedure through their investigator. Apart from it the O.P.No.2 failed to clarify relating to the actual number of cow dead and they have also could not be submitted physical Tag No. 40141 & 40148 for processing the claim for which this O.P. constrained to close the file as “No claim” and intimated the said fact to the Chief Manager of the O.P.No.2 by this O.P. vide its letter No.55601/MISC. CLAIMS/2016/ dated 26.03.2016. The stories of the death of alleged cow are created for purpose of the case. The complainant in connivance with the so called Veterinary Doctor has created the alleged post mortem report to grab the public money. In fact no such cow of the complainant was dead. If the complainant lost her cow on account of natural death, she could have lodged her claim immediately before this O.P. Due to non intimation of the incident, this O.P. had been deprived of getting matter investigated relating to carcass of dead cow prior to postmortem by some qualified investigator. Apart from it though two post mortem reports are available but she has claimed for one cow. As such the complainant has not approached to Hon’ble Forum with clean hand. She has played fraud by creating some documents to grab the public money. This O.P. has rightly repudiated the claim of the complainant. The present case is otherwise not maintainable under law. The present case is barred by limitation. Hence the O.P.No.1 prayed to dismiss the case with exemplary cost in the interest of justice.
4. Similarly, on notice the O.P.No.2 filed version through his advocate. It is stated the allegations made in the complaint petition are not all true and the complainant is put to strict proof of such of the allegations which are not expressly admitted hear in. The allegations made in Para 1 of the complaint petition that the complainant availed a loan of Rs.4,25,000/- from the O.P.No.2 to set up a dairy unit were insured with the New India Assurance Company Ltd are true. It is also not disputed that two of the cows bearing Tag No. 40141 & 40148 were covered by valid insurance policy. It is also not disputed that after the death of the cows of the complainant post mortem of dead bodies of the cows was done by the Additional Assistant Veterinary Surgeon, Chatrapur. The insurance claims made by the complainant were forwarded to the O.P.No.1. During the examination of insurance claims the insurance policy number mentioned in the complaint was found wrong although the Tag numbers were correctly mentioned. Subsequently on 26.12.2014 the O.P.No.2 furnished the correct policy number vide the letter number General 58/45 dt.26.12.2014. It is most unfortunate that the O.P.No.1 without considering the above letter dated 26.12.2014 turned down the insurance claim. This O.P. is not answerable to the claims made by the complainant and as much as there is no negligence on the part of or deficiency of service made by this O.P. in dealing with the claims of the complainant. The complaint is not otherwise maintainable under law and is liable to dismiss against this O.P.No.2.
5. On the date of hearing we heard argument from both sides at length. We perused the complaint petition, written version, written argument and documents available in the case record. On verification of case record it appears that the O.P.No.2 advanced a loan of Rs.4,25,000/- to the complainant who purchased 10 (ten) numbers of cows. It is also found that the complainant insured her 5 cows with O.P. No.1 vide Cattle Insurance Policy bearing No.55060147130400000006 dated 25.07.2013 on payment of Rs.12,750/- towards premium for the period of insurance coverage from 25.7.2013 to 24.7.2016. As contended by the complainant out of five cows, two insured cows bearing identification tag No.40141 and 40148 were died. On perusal of case record it further appears that the above referred two cows did not die on a single day and postmortem report of death of two cows were not conducted on a single day and the post mortem report dated 13.11.2014 does not relate to both the cows. It transpires from the records that a bovine species brown colour female cow aged about 5 years of the complainant bearing identification Tag No. 40148 died on 5.1.2014 at 5 PM and postmortem of the dead body of the said cow was conducted on 06.01.2014 at 11 A.M. It also reveals that on 12.11.2014 at about 8 PM a Bovine spices brown color female cow of aged about 8 years of the complainant Jhumuri Gauda was died and postmortem on the dead body of the said cow was conducted on 13.11.2014 at 8 P.M. It is also clear that the complainant with regard to dead cow Tag No.40141 which was died on 12.11.2014 reported the matter to the O.P. No.2 with Post Mortem Report and endorsement of Addl. Veterinary Asst. Surgeon, Chatrapur, Ganjam, that the fact is true. The O.P. No.2 has also acknowledged the letter of intimation of death of the cow on 21.11.2014 and it was forwarded to the O.P.No.1 vide Letter No.Gen58/35 dated 24.11.2014 of O.P.No.2 which has been placed on the case record as Annexure - A filed by O.P.No.1 along with their list of documents. In the said letter the O.P. No.2 had also furnished Tag No.40148 of another dead cow along with postmortem report but the policy number was wrongly mentioned. Accordingly the O.P.No.1 in his letter No.550601/Cattle Cl./14/1929 dated 26.11.2014 pointed out about wrong policy number and the O.P. No.2 in his letter No.Gen 58/45 dated 26.12.2014 furnished details of Tag numbers and correct policy number to the O.P.No.1. From the foregoing discussion it is amply clear that the complainant had intimated the death of her cow bearing Tag No.40141 to the O.P. No.2 along with postmortem report and tags within due time of 30 days as per the policy guidelines and the O.P.No.2 had also intimated the same to the O.P.No.1 which is beyond dispute or doubt. However, on careful perusal of the materials placed on record we could not find the death intimation letter of second cow bearing Tag No.40148 which was died on 05.01.2014. The photographs of dead cow show the Tag No.40141 only and it does not show the Tag No.40148. It is also confirmed that the O.P. No.2 bank has received the death intimation of dead cow bearing Tag No.40141 along with postmortem report from the complainant which was acknowledged but in case of death of cow bearing Tag No.40148 there is nothing placed on record to prove that it was intimated to either O.P. No.1 or O.P.No.2. However, the O.P.No.2 had forwarded the Postmortem report along with Tag number of both cows to the O.P.No.1 for settlement of claim. On perusal of the postmortem report of cow bearing Tag No.40148 which was died on 05.01.2012 as claimed by the complainant, there is no seal and signature of Veterinary Surgeon but the postmortem report of dead cow bearing Tag No.40141 bears the seal and signature of Addl. Veterinary Asst. Surgeon, Chatrapur, Ganjam. From the foregoing discussion, it is proved beyond doubt that the complainant has intimated death of cow bearing Tag No.40141 to the O.P.No.1 through O.P.No.2 properly but there is no substantial documents placed on the case record to show that there was death of cow on 05.01.2014 bearing Tag No.40148 as because the postmortem report also does not bear any seal and signature of any Veterinary Surgeon.
6. In the light of the above discussion and taking into account to the documents filed by the complainant as well as by O.P.No.1, it is beyond doubt established that there was death of cow bearing Tag No.40141 and the same was also duly intimated to the O.P. No.1 through O.P.No.2 within 30 days of death of the cow as per policy conditions which is not at all in dispute. It is also a fact not in dispute that the aforesaid cow has been insured under policy No.55060147130400000006 dated 25.07.2013 which was valid from 25.7.2013 to 24.7.2016. As required by the claim procedure, the claim intimation was also accompanied with the certificate of death of Veterinary Surgeon which is not denied by the O.P. No.1. In view of that the insurance claim for the dead cow bearing Tag No.40141 of the complainant deserves to be allowed by the O.P. No.1 insurance company and liable to be rejected the claim of dead cow bearing Tag No.40148. With regard to insurance claim amount, we would like to state that as per the policy condition in this case the complainant is entitled to Rs.25,000/- the sum assured under the aforesaid cattle insurance policy. The O.P. No.1 received the claim intimation through O.P.No.2 but did not prefer to settle the claim and repudiated on flimsy ground ignoring the merits of the claim. In this context we would like to view that the complainant is entitled for interest on insured amount from the date of filing of the case in this Forum by the complainant till actual payment is made. That apart, in this case, the complainant has also prayed for compensation and cost of litigation to compensate her loss. On this point, we would like to say that the complainant has not filed any cogent and convincing documentary evidence regarding her financial loss so that she can be compensated. However, we are inclined to award cost of litigation since she has hired the services of an advocate to file her consumer dispute in this Forum. As far as the cost of litigation is concerned, it would be just and proper to award Rs.1,000/- towards litigation expenses as per the fact and circumstance of the case. Our finding is fortified by the decision of Hon’ble State Commission, Hariyana in the case of Oriental Insurance Co. Ltd Vs. Mohabir Singh and Others reported in 2013 (1) CLT, 447 where it was held that the “Postmortem Report prepared by Veterinary Surgeon cannot discarded”. In the light of aforesaid decision of law, discussion and taking into account to the fact and circumstances of the case we partially allowed the case of the complainant against O.P.No.1 and dismissed against O.P.No.2 since there is no deficiency in service on part of the O.P.No.2 and the complainant has also not claimed any relief against O.P.No.2 in her complaint.
7. In this case, the learned counsel for the O.P.No.1 has filed a decision of Permanent Lok Adalat for Public Utility Services, Ganjam, Berhampur vide P.L.A. Case No.440/2016 decided on 5th April 2017 in support of his case where the learned P.L.A. dismissed the case of the applicant. In this regard we would like to state that the aforesaid decision of the P.L.A. is not applicable to the instant case due to factual difference of the dispute. We are, therefore, not inclined to accept the same as the said decision is not applicable to this case hence rejected.
8. In the result, we partially allowed the case of complainant against O.P.No.1 insurance company and dismissed against O.P.No.2 bank. The O.P.No.1 is directed to pay Rs.25,000/- (Rupees Twenty Five Thousand) only i.e. the sum assured under the aforesaid policy against dead cow bearing Tag No.40141 along with interest @ 6% per annum from the date filing of the case in this Forum till actual payment is made. As discussed above, the O.P. No.1 is also directed to pay a modest sum of Rs.1,000/- to the complainant towards cost of litigation. The aforesaid orders shall be complied by the O.P.No.1 within two months from the date of receipt of this order failing which the complainant is at liberty to recover the same under relevant Sections of Consumer Protection Act, 1986. The case of the complainant is disposed of accordingly.
9. The order is pronounced on this day of 20th June 2017 under the signature and seal of this Forum. The office is directed to supply copy of order to the parties free of cost and a copy of same be sent to the server of
