BEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, IDUKKI

Dated this the 29th day of June, 2009

Present:

SRI.LAIJU RAMAKRISHNAN PRESIDENT

SMT.SHEELA JACOB MEMBER

SMT.BINDU SOMAN MEMBER

C.C No.206/2008

Between

Complainant : K.G. Yohannan,

Koottumkalpurathu House,

Kanjiyar P.O, Labbakkada,

Ayyappankovil Village.

(By Adv: V.C Sebastian)

And

Opposite Parties : 1. The Divisional Manager,

Oriented Insurance Co. Ltd.,

Divisional Office,

T.H. Tower, Market Road,

Muvattupuzha, Pin: 686673.

(By Adv: K Pradeepkumar)

2. The Manager,

K.L.D. Board Limited,

Mudavoor P.O, Muvattupuzha.

(By Adv: Biju Vasudevan)

3. The Manager,

K.L.D. Board Limited,

Branch Office, Kattappana,

Kattappana South P.O.

Pin: 685515.

(By Adv: Biju Vasudevan)

4. Dr.Suman B.S.

Anjali, Near Sivan Kovil,

Koottappana P.O.

Thiruvananthapuram.

O R D E R

SRI.LAIJU RAMAKRISHNAN(PRESDIENT)

Complainant is engaged in the business of a cattle farm. The complainant's cow was insured to the 1st opposite party's Insurance company in the scheme of the 2nd and 3rd opposite party for Rs.20,000/-. The period of policy was from 13/10/2007 to 12/10/2008. The premium amount is Rs.620/-, the half of the amount is paid by the complainant to the 4th opposite party doctor. Unfortunately the cattle was died. The complainant filed claim form to the opposite party. But they have rejected the claim for the reason that the premium was not paid to the 1st opposite party by the 2nd and 3rd opposite party. So this petition is filed for getting the Insurance amount of the complainant's cow.
 

2. 1st opposite party filed a written version stating that the complainant is not a consumer of the 1st opposite party, because no premium was received from the complainant or from the 3rd or 4th opposite party. As per Section 64 VB of the Insurance Act the 1st opposite party has no liability unless the premium is paid to the opposite party.

3. The 2nd and 3rd opposite party filed written version. As per the written version, they are not aware of the fact that the cow of the complainant was insured to the 1st opposite party. The 4th opposite party is a doctor who was appointed by the 3rd opposite party for 179 days. The 2nd and 3rd opposite party are not aware of the act of the 4th opposite party, doctor. No information was given to 2nd and 3rd opposite party by the 4th opposite party about the Insurance Certificate given by the 4th opposite party.
 

4. The 4th opposite party filed a written version. The 4th opposite party, while working at the office of the 3rd opposite party, had issued more than 50 Insurance Certificates after examining the cows. The complainant's cow was also examined by the 4th opposite party, received premium from the complainant and issued Insurance Certificate to the complainant. Premium was send to the 1st opposite parties office and report was given to the 2nd opposite parties office. Details of this is at 3rd opposite party's office. 4th opposite party is remembering that the cow of the complainant died on 13/01/2008. The form for claim, and form for the report of postmortem also given to the complainant by the 4th opposite party. 4th opposite party was relieved from service on 18/01/2008. No claim form was received till that date. The 4th opposite party was applied for extending his job. But the 3rd opposite party and 2nd opposite party denied the same.
 

5. The point for consideration is whether there was any deficiency in service on the part of the opposite parties, and if so, for what relief the complainant is entitled to?
 

6. The evidence consists of the oral testimony of PW1 and Exts.P1 and P2(series) marked on the side of the complainant and the oral testimony of DW1 and Exts.R1 to R3 marked on the side of the opposite parties.
 

7. The POINT:- Complainant is filed for getting the Insurance amount of his diseased cow. Complainant was examined as PW1. The complainant's cow was died and the matter was duly informed at 3rd opposite party's office. 4th opposite party was there, he inspected the carcass of the cow and postmortem was also conducted. Ext.P2(series) is the copy of the photographs of the diseased cow. The ear tag and all the other details of the cow were given to 4th opposite party. The cow was duly insured by the complainant. Premium amount Rs.320/- was paid to 4th opposite party. A policy certificate was issued by 4th opposite party from 3rd opposite party's office. Copy of the same is marked as Ext.P1. 3rd opposite party was examined as DW1. He deposed that the policy was issued to the complainant by 4th opposite party. The office seal, designation seal, office seal of 1st opposite party were not printed on the certificate. The policy is issuing with the co-operation of the Oriental Insurance Company, and the doctor who is in charge. The model of the policy certificate issuing by them is marked as Ext.R2. The premium and policy receiving by the doctors are processing by the higher officer. Ext.R3 is the copy of such a letter of another policies. No report of this cow is informed in 3rd opposite party office. The 4th opposite party is appointed by 3rd opposite party. Considering the evidence, complainant has paid premium to 3rd opposite party's office, and it was received by the doctor. 4th opposite party who was in the office, who is authorized to receive the premium, and the doctor was the staff of the office of 2nd and 3rd opposite party. But 2nd and 3rd opposite parties are not responsible to the act of the 4th opposite party because 4th opposite party was a temporary staff of 3rd opposite party. The details of the policy was not found in the office. But they are not aware of the Insurance policy certificate of the complainant, whether it is issued from their office. But in the copy of the policy certificate Ext.P1 produced by the complainant, the seal of the 1st opposite party and 3rd opposite party and their authorized signature also affixed.

As per 4th opposite party the policy was issued by 4th opposite party to the complainant after examining the cow and the premium was also collected by him, duly sent the same to the 1st opposite party's office and the report was given to 2nd opposite party's office. 1st opposite party is not accepting the policy, only because they have not received the premium. In this type of policy the half of the premium is paid by the consumer and the balance half amount is paid by the KLD Board. The complainant has paid the half of the premium and KLD board has paid half of the amount, which is Rs.310/- each. It is also written in Ext.P1. But as per 1st opposite party they are not accepting the policy certificate. They have produced another policy, which is a model of the same policy which is marked as Ext.R2. But we cannot find any difference between Ext.P1 and Ext.R2. The serial number of Ext.R2 is 10584 and that of Ext.P1 is 10233. That means Ext.P1 has issued earlier than Ext.R2. Ext.R3 is the copy of the proceedings of the 2nd opposite party to 3rd opposite party about the premium. It is written in Ext.R3 that the premium of policy certificate No.10744 to 10747 were received. So if that premium is received, the premium of policy No.10233 might have received early. Other wise they should have enquired about that, before issuing the policy No.10744, that the premium in previous numbers were received. Another important aspect is that if such a policy certificate is issued by 4th opposite party with the office seal and signature of the 1st opposite party and 3rd opposite party, and if it is not issued by them, they ought have initiated criminal prosecution proceedings against 4th opposite party. Not even a single complaint or investigation done by OP1, OP2 and OP3 about the same. After accepting the premium, the policy has already issued to the poor public, then when claim arised, it is repudiated stating that they have not renewed the premium. It is a gross deficiency in the part of 1st opposite party. If any amount is due by 1st opposite party to OP2 and OP3 that should be recovered from them. It is not proper to repudiate the claim of the consumer. There is no dispute regarding the death of the cow and Insurance amount. Hence we think that it is proper to direct 1st opposite party to pay the Insurance amount to the complainant.
 

Hence the petition allowed. 1st opposite party is directed to pay the Insurance amount of the diseased cow to the complainant, which is Rs.20,000/- as per Ext.P1 with 12% interest from the date of this petition. 1st opposite party is also directed to pay Rs.2,000/- for the cost of this petition within one month of the receipt of a copy of this order, failing which the amount shall carry further interest at 12% per annum from the date of default.

Pronounced in the Open Forum on this the 29th day of June, 2009.

Sd/- SRI.LAIJU RAMAKRISHNAN(PRESIDENT)

Sd/-

SMT.SHEELA JACOB(MEMBER)

Sd/-

SMT.BINDU SOMAN(MEMBER)

APPENDIX

Depositions :

On the side of Complainant :

PW1 - Yohannan

On the side of Opposite Parties :

DW1 - Arunkumar P.S.

Exhibits:

On the side of Complainant:

Ext.P1 - Copy of Insurance Certificate dated 13/10/2007.

Ext.P2 (series) - Photographs of the diseased cow.

On the side of Opposite Parties :

Ext.R1 - Copy of Order dated 18/01/2008.

Ext.R2 - Copy of model of the policy certificate.

Ext.R3 - Copy of letter dated 21/05/2009.