DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD
Dated this the 16th day of May 2018
Present : Smt.Shiny.P.R. President
: Smt.Suma.K.P. Member Date of filing: 17/07/2017
: Sri.V.P.Anantha Narayanan, Member
(C.C.No.106/2017)
Sainaba,
W/o Hamsa,
Puthanpura Veed,
Edathara Post,
Palakkad. - Complainant
(By Adv.N.Rajesh)
V/s
The Manager,
New India Assurance Company Ltd, - Opposite parties
Perinjeri Building,
Round North,
Thrissur.
(By Adv.K.V.Sujith)
O R D E R
By Smt.Suma.K.P. Member
The complainant herein had insured her 5 cows on 26.09.2016 under the scheme Milma Ksheera Mithra, for an amount of Rs.50,000/- each. Out of these the 4th cow fell down on 01.10.2016 and was injured, and was not able to get up and died on 15.10.2016. As per the insurance scheme she is entitled to get a claim amount of Rs.50,000/- as per the policy conditions. She had informed the insurance company about the death of the cow within 24 hours. The Veterinary surgeon of the Parali Veterinary Hospital had conducted the postmortem of the deceased cow and photographs were also produced before the opposite party for the claim. But the opposite party repudiated the above claim for the reason that as per the exclusion clause “death due to diseases contracted prior to and within 15 days of commencement of risk are not liable for non scheme.........”. She had received a repudiation letter on 08.11.2016 stating the above. The complainant alleges that there is no reason for the opposite party to deny the above claim and the opposite party had committed deficiency of service by denying a just and reasonable claim. Hence she had approached before this Forum seeking an order directing the opposite party to pay an amount of Rs.50,000/- which is the sum assured as per the policy along with interest from 08.11.2016 onwards and also to pay Rs.10,000/- towards compensation for the mental agony suffered by her.
Notice was issued to the opposite party for appearance. Opposite party entered appearance through counsel and filed version denying all the allegations in the complaint. Opposite party had stated that as per the postmortem certificate the cow died due to “Downer Cow Syndrome”. The opposite party admits that the cow is covered under Non-Scheme Policy for which conditions are strictly applicable. In the policy schedule it is specifically mentioned that the policy is a “Non-Scheme Policy” and as per condition No.1 “death due to diseases contracted prior to and within 15 days of commencement of risk are not payable for Non-Scheme cattle”. The complainant is not entitled for any amount since the condition of the policy is that “death due to diseases contracted prior to and within 15 days of commencement of risk are not payable for Non-Scheme cattle”. In this case the policy is commenced from 26.09.2016 and the alleged incident took place within 15 days from the date of commencement of the policy. The complainant has conveniently suppressed the important condition of the policy, to repudiate claim. Hence there is no deficiency of service on the part of the opposite party. Hence the complaint had to be dismissed.
Complainant filed chief affidavit. Opposite party filed IA 342/2017 seeking permission to cross examine the complainant. Since no counter was filed IA was allowed. Complainant was cross examined as PW1. Exts.A1 to A5 was marked from the part of the complainant. Opposite party also filed chief examination affidavit. Ext.B1 was marked from the part of the opposite party. Complainant filed IA 47/2017 seeking permission to cross examine the opposite party. Application was allowed and opposite party was cross examined as DW1. Evidence was closed and the matter was heard.
The following issues that arise for consideration are.
- Whether there is any deficiency of service from the part of opposite parties?
- If so, what are the relief and cost?
Issues No.1 & 2
According to the opposite party as per the postmortem certificate the cow died due to “Downer Cow Syndrome” and not because of the fall. The postmortem certificate which was marked as Ext.A5 states that the cow died due to the above disease. The DW1 has spoken to the effect that “Downer Cow Syndrome” is not known to him. According to the opposite party in the policy schedule it is specifically mentioned that the policy is a “Non-Scheme” policy and as per condition No.1 “death due to diseases contracted prior to and within 15 days of commencement of risk are not payable for Non-Scheme cattle”. The complainant is not entitled for any amount since the condition of the policy is that “death due to diseases contracted prior to and within 15 days of commencement of risk are not payable for Non-Scheme cattle”. In this case policy was commenced from 26.09.2016 and the alleged incident took place from the date of commencement of the policy.
We have also perused the documents produced from the part of the complainant. In Ext.A1 the opposite party has stated the condition under which the policies are not payable.
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Under Ext.A2 policy the insurance coverage is from 26.09.2016, 12 am to 25.09.2017, 11.59.59 pm. Hence it is viewed that the cattle possesses a valid insurance coverage at the time of death. From Ext.A3 it is seen that the veterinary doctor had examined the cow for “Downers cow” with hip dislocation on one side on 03.10.2016 morning with fluids anti inflammatory drugs, and consequently the cow died on 15.10.2016 as per Ext.A5. Hence according to the policy conditions the death of the cow was only after 15 days from the date of commencement of the policy, and the opposite party is bound to indemnify the complainant for the death of her cow as per Ext.A1 & A2. The opposite party had committed deficiency of service by not honouring the claim of the complainant.
Hence the complaint is allowed and we direct the opposite party to pay and amount of Rs.50,000/- (Rupees fifty thousand only) being the sum assured as per the above policy along with 6% interest from 18.11.2016 onwards till date of realization. We also direct the opposite party to pay Rs.3,000/- (Rupees three thousand only) as compensation for the mental agony suffered by her along with Rs.1,500/- (Rupees one thousand five hundred only) towards cost of this litigation. Complaint is allowed accordingly.
This order shall be executed within one month from the date of receipt of this order; failing which the complainant is entitled to realize 9% interest p.a from the opposite party on the total amount due to him from the date of this order till realization.
Pronounced in the open court on this the 16th day of May 2018.
Sd/-
Shiny.P.R
President
Sd/-
Suma.K.P
Member
Sd/-
V.P.Anantha Narayanan
Member
Appendix
Exhibits marked on the side of complainant
Ext.A1 - Copy of Proposal Cum Veterinary Certificate under the scheme Milma
Ksheera Mithra Padhathi issued by New India Assurance Company
Ltd, to the complainant
Ext.A2 - Copy of Cattle Insurance Policy issued by New India Assurance Company
Ltd, to the complainant
Ext.A3 - Copy of Treatment Certificate issued by Veterinary Surgeon
Ext.A4 - Photographs
Ext.A5 - Copy of Postmortum Report issued by Veterinary Surgeon
Exhibits marked on the side of Opposite parties
Ext.B1 - Copy of policy with conditions issued to the complainant by the
opposite party
Witness examined on the side of complainant
PW1 - Sainabha.K.S
Witness examined on the side of opposite party
DW1 - Ashok
Cost
Rs.1,500/-
