DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the  2^nd   day of August,  2022

Present      :   Sri.Vinay Menon V.,  President

                  :   Smt.Vidya A., Member                          

                      :  Sri.Krishnankutty N.K., Member                                                

 Date of Filing: 20/10/2018    

     CC/130/2018

Achuthan,

S/o.Velayudhan,

Pattikaravalappil,

Muthuthala Post, Muthuthala Village,

Pattambi Taluk, Palakkad

(By Adv.E.R.Stalin)                                                                                         -              Complainant

                                                                                                                  Vs

1. Muthuthala Ksheerolpadaka Sahakarana Sangam,

       Rep.by Secretary, Muthuthala Post,

Muthuthala Village, Pattambi, Palakkad.

2. New India Assurance Co.,

        Rep.by Divisional Manager,

 Divisional Office II, Shafeer Complex,

Opposite YMCA,  Kannur Road,

Kozhikkod

3. Malabar Milma Union,

        Rep.by Chairman,

MRCMPU Ltd., Head Office

Peringolam, Kunnamangalam,

Kozhikkode                                                                                       -              Opposite parties

(OP1 by Adv. Arun R.

(OPs 2 by Adv.K.V.Sujith,

OP 3 by  Adv.G.Ananthakrishnan & KB Priya)

O R D E R 

By Sri. Vinay Menon V.,  President

1. In brief, the complaint allegations are that he had availed an insurance policy under “Pasumithra Suraksha Pandhathi” of opposite party  3 from the 2^nd opposite party. On 12/9/2017, he had insured two of his cows and as per the policy, the complainant was entitled to 50% of insurance amount upon the cow suffering from permanent total disability.  Off the two cows insured, the one having tag No.420026/586625 developed permanent total disability and the doctors certified accordingly. The Insurance Company had on 2/2/2018 repudiated the claim raised by the complainant on untenable grounds. This complaint is filed seeking an amount of Rs.20,000/- being the insurance amount and 50,000/- being compensation together with interest.
2. Opposite parties entered appearance and filed respective versions.

Opposite party 1 filed version denying the complaint allegations stating that they had rendered all assistance to the complainant and that they had no role in repudiation of the claim.

The 2^nd opposite party filed detailed version contending that the cow with ear tag No.4200026/586625 did not suffer from mastitis or permanent total disability. They contended that upon inspection, the cow in question did not have an ear tag or a hole in the ear. The policy was repudiated  on the basis of “NO TAG NO CLAIM “ policy. 

The 3^rd opposite party also filed version raising their ignorance regarding the facts and circumstances of the case. 

3. The following issues arise for consideration upon a reading of the aforesaid pleading.

1. Whether the complainant is entitled to the insurance amount ?
2. Whether  there is any deficiency in service / unfair trade practice on the part of   opposite   parties ?
3. Whether the complainant is entitled to any reliefs as sought for ?
4. Reliefs,  if any ?

4. Evidence on the part of the complainant consisted of proof affidavit and Exts.A1 to A7. Complainant was examined as PW1.  Exts.A5 & A6 were marked subject to proof on the ground that they were issued by the doctors and the same should be proved through the person who issued them. Opposite parties 2 & 3 filed proof affidavit. Exts.B1series of photographs were marked on the side of the opposite party 2 and Ext.B2 was marked on the part of Opposite party No.3

In view of the fact that this Commission is not bound by the principles of Evidence Act and in view of absence of pleading on the part of the opposite parties that the said documents are forged or fabricated, Exts.A5 & A6 are taken in evidence.  

                Issue no. 1

5. In order to ascertain whether the repudiation of the claim is illegal, we have to first consider the reason for repudiation. Ext.A7 is the letter of repudiation. The contents of Exts.A7 giving reasons for repudiation is as follows:

 “AS PER THE INVESTIGATION OF OUR PANEL INVESTIGATOR ON 23/11/2017 IT IS REVEALED THAT THE ANIMAL WAS NOT TAGGED WITH THE PROVIDED TAG NO. 420026/586625.

AS PER THE REPORT OF INVESTIGATOR, THE TAG WAS KEPT WITH THE CUSTODY OF THE FARMER WHICH IS THE VIOLATION OF POLICY CONDITON

WE REPUDIATE THE CLAIM AND CLOSE THE FILE AS PER POLICY CONDITON NO TAG NO CLAIM.”(Sic)

6. In paragraph 4 of the version, opposite party 2 had stated that it was not possible to identify the cow which was suffering from mastitis without the tag and that the investigator found that the cow in question did not have an ear tag or a hole in the ear.

                The 2^nd opposite party improvises in the proof affidavit stating that in the policy document colour of the cow is brown, where as the cow which was alleged to have suffered acute mastitis  is brown and white.

7.            To ascertain the legality or illegality of the ground for repudiation, two questions are to be answered:

                1.            What is the colour of the cow tagged with no. 420026/586625?

                2.            Whether the cow was wearing a tag?

8.            Question 1 -  What is the colour of the cow tagged with no. 420026/586625?

                On a perusal of the documents adduced by the complainant and marked in evidence, reference to the cow, its colour and  tag number is seen made. It is worthwhile to go through the said documents to ascertain the answer to the 1^st question.

                (a) Ext. A2 is a valuation certificate issued by a veterinary surgeon. This

document shows that the cow having tag no. 420026/586625 is brown in external appearance.

2.  Ext.A4 is the proposal cum veterinary certificate issued for availing the policy cover. It is seen prepared by the complainant and one veterinary doctor. In Ext. A4, the cow having tag no.420026/586625 is shown as brown. 
3. Ext.A5 is the treatment certificate issued by one veterinary surgeon for cow having tag no.420026/586625. Colour of the cow is brown.
4.  Ext.A6 is the permanent total disability certificate issued for a   brown cow with tag No. 420026/586627. Herein the tag number of the cow differs. No explanation is forthcoming as to what caused this difference. Hence, we hold that Ext.A6 certificate is not a good evidence in this case.

9.            Ext.A2, A4 and A5 were issued or countersigned by veterinary surgeons after physically examining the condition of the cow. They have clearly stated that the brown cow is having a tag bearing no. 420026/586625. The 2^nd opposite party has no case that the said documents were signed / issued by the doctors to defraud the insurance company. 

                                On going through the aforesaid Exts. A2, A4 & A5, we find that the contention of 2^nd opposite party that the colour of the cow which suffered acute mastitis is brown and white is only an after-thought.  Ext.A5 proves that the cow bearing tag no.420026/586625 is brown and is suffering from mastitis.

10.          Incidentally, based on above finding that the 2^nd opposite party has raised a pleading in evidence (as stated in proof affidavit) regarding colour of the cow as an after-thought, made with the sole intention of defeating the claim of the complainant, we hold that the attempt to defeat the claim of the complainant through any ulterior means possible and available is nothing but an attempt at unjust enrichment and an abuse of the process of law.

11.          Question No. 2 : Whether the cow was wearing a tag?

              The next contention of the 2^nd opposite party is that when the investigator of the company visited the complainant, the cow in question was not wearing a tag. There was no hole in the ear lobe of the cow. The 2^nd opposite party has produced 8 photographs of the cow and the ear tags. They submit these pictures to be conclusive evidence of the fact that the cow was not tagged.  But Ext.A2, A4 & A5 were issued by Doctors who had seen, examined and certified that the complainant’s brown cow was not tagged with tag no. 420026/586625.

                              If the 2^nd opposite party had a case that the cow in question was tagged, they had ample opportunities to examine the doctors who had issued the aforesaid certificates. Therefore, the contention of the 2^nd opposite party that the cow in question was not wearing a tag is unsubstantiated by cogent evidence. Further the 2^nd opposite party has also not adduced any evidence to prove that the cow in question is the cow in the photographs produced by them. This Commission cannot automatically come to a conclusion by seeing the photograph of a cow that this is the picture of the cow which is in the  eye of the storm.  On that count also case of the opposite party No.2 fails.

12.        O.P.2 has not produced the report of the investigator or his findings for this Commission to come to a conclusion as to the legality of the conclusion reached by him and subsequently adopted by the 2^nd opposite party to repudiate the claim of the complainant.

Therefore, for want of a  better evidence to the contra, we hold that the cow in question was the one that was insured. Repudiation of complainant’s claim is therefore illegal.

               Issue No.2

13.        The only natural conclusion that we can arrive at, after appreciating the evidence adduced by the parties, is that  that there is deficiency in service and unfair trade practice on the part of opposite party No.2. Opposite parties 1 & 3 are absolved of any liability whatsoever.

              Resultantly, this complaint stands allowed.

        Issue Nos.3 & 4

14.          In view of the findings above, we hold that the complainant is entitled to the insurance amount. Further he is also entitled to compensation and cost. We quantify the dues to the complainant as follows:

                a)  The complainant is entitled to Rs.20,000/- (Rupees Twenty thousand only) being

                     the insurance amount payable together with interest @10% from the date of   

                    claim till date of payment.

                b)  The complainant is entitled to a compensation of Rs.20,000/- (Rupees Twenty

      thousand only)

                c)  The complainant is entitled to a cost of Rs.15,000/- (Rupees Ten thousand only)

The 2^nd opposite party shall   comply with  the order within 45 days from the date of receipt of copy of this order failing which  the opposite party shall pay  an amount of Rs.250/- per month or part thereof by way of solatium to the complainant till date of final  payment.

                Pronounced in open court on this the 2^nd    day of August,  2022.

                                                                                                                       Sd/-

                                                                                                                                         Vinay Menon V

                                                              President

         Sd/-

    Vidya.A

                        Member   

                              Sd/-  

                                                                                                                           Krishnankutty N.K.

                                                                                                                                  Member

APPENDIX

Exhibits marked on the side of the complainant

Ext.A1 – Photocopy of cattle insurance policy   bearing No.76130047170400002005

Ext.A2 – Photocopy of valuation certificate dated 28/11/17   issued by veterinary surgeon

Ext.A3 – Photocopy   of claim form dated 17/10/17

Ext.A4 –  Photocopy of proposal cum veterinary  certificate for Milma Pasumithra Suraksha

                 Padhathi

Ext.A5 -  Photocopy of treatment certificate dated 17/10/17 issued by veterinary surgeon

Ext.A6-  Photocopy of permanent total disability certificate dated 24/10/2017 issued by

                veterinary doctor

Ext.A7 – Photocopy of the letter of repudiation dated 2/2/18

Exhibits marked on the side of the opposite party

Ext.B1 –  Series of 8 photographs

Ext.B2 – General circular dated 17/11/2015.

 Court Exhibit

 Nil

Witness examined on the side of the complainant

Nil

Witness examined on the side of the opposite party

NIL

Court Witness

Nil

Cost :  10,000/- allowed as cost of the proceedings.

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.