Kerala

Idukki

CC/20/2020

Sibichen Varghese - Complainant(s)

Versus

unaited india insutance com - Opp.Party(s)

Adv: Gigi dal

15 Sep 2022

ORDER

DATE OF FILING : 22/01/2020

IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, IDUKKI

Dated this the 15^th day of September 2022

Present :

              SRI.C.SURESHKUMAR                                               PRESIDENT

              SMT.ASAMOL P.                                                          MEMBER

              SRI.AMPADY K.S.                                                        MEMBER

CC NO.20/2020

Between

Complainant                            :     Sibichan Varghese, S/o Varghese,

                                                      Kochuveettil House, Cumbammettu P.O.,

                                                      Karunapuram Village, Udumbanchola

                                                       (By Adv.Gigi Dal)

                                                          And

Opposite Party :                        :     United India Insurance Company Ltd.,

                                                       Thodupuzha Branch,  Represented by its Manager,

                                                         Prakash Building, TB Junction Thodupuzha P.O.

O R D E R

SRI.AMPADY K.S., MEMBER

 

This complaint is filed raising the following allegations against opposite parties.

.
1 . The complainant has bought two cows by availing a loan of Rs.1,90,000/- from IDCB Vandanmedu Branch. Thereafter the two cows were insured with the opposite party for Rs.50,000/- each on 19/09/2019 by paying an amount of Rs.4100/- each through a DD issued from SBI Kootar. The insurance coverage of the cows are for the period from 19/09/2019 to 18/09/2020 and the insurance Tag No. of the cows were 897950 and 706146.

 

2 . The cow bearing insurance tag No.897950 was died on 20/09/2019. In pursuance a postmortem was conducted by the Veterinary Doctor and a postmortem report was given to the complainant.

 

                                                                                              (Cont……2)

-2-

 

3 . The intimation of the death of the cow was given on 20/09/2019 itself to the opposite party. A claim form was sent from the opposite party to the complainant. The complainant submitted the claim form along with a postmortem report to the opposite party.

 

4 . But on 18/10/2019 a letter was issued by the opposite party to the complainant stating that the insurance premium paid by the complainant through DD No.43213 for the amount of Rs.4100/- was not cleared to the opposite party's account. So they were not on risk in respect of the issued policy and thus the claim of the complainant rejected.

 

5 . In fact that the insurance premium was paid to the opposite party through a DD issued by State Bank of India, Koottar Branch on 17/08/2019. After receiving the amount through the DD the opposite party returned the insurance premium paid by the complainant by a cheque of Rs.4100/- to him. Thus the opposite party has not allowed the insurance claim of the complainant.

 

6 . The cow died due to 'toxemia' and the complainant was not aware of the said fact. The cow died all of a sudden. There was no malicious or willful injury and also no negligence on the part of the complainant towards the cow.

 

7 . But the action of the opposite party in denying the insurance claim to the complainant is an unfair trade practice and is intended to cause heavy financial burden to the complainant. There is deficiency in service and the action of the opposite parties are intended to cause financial burden and also physical and mental agony to the complainant.

 

8 . The cause of action for this complaint arose on 19/09/2019 and continuously thereafter in Idukki District within the jurisdiction of this Hon'ble Forum.

 

 

 

                                                                                              (Cont……3)

 

-3-

 

Hence he prayed for the following reliefs.

 

A . The opposite party may be ordered to pay the complainant the insurance amount of Rs.50,000/- with 18% interest from 20/09/2019 till date of realization.

 

B . The opposite party may be ordered to pay Rs.25,000/- to the complainant as compensation for the physical and mental agony suffered by him from the act of the opposite party.

 

C . The opposite party may be ordered to pay cost of Rs.25,000/- to the complainant.

 

D . Such other reliefs that deemed just and equitable also may be granted.

 

He filed copy of 4 documents along with the complaint.

 

Opposite party filed written version putting forth the following contentions.

 

1 . The complaint is not maintainable. It is humbly submitted that there is no deficiency of service of this opposite party to attract jurisdiction of this Hon'ble Forum.

 

2 . Complainant has no cause of action against this opposite party. It is admitted that on 19/09/2019, this opposite party received a proposal for the insurance of two cattle of the complainant along with DD No.043213 of SBI, Koottar for Rs.4,100/- which includes the premium amount of Rs.3,446/-, Rs.6,20/- towards CGST and SGST and Rs.34/- towards Kerala Flood Cess. On 20/09/2019, complainant came to the office of this opposite party at Thodupuzha and collected the receipt dated 19/09/2019 and original policy. But he suppressed the fact of death of the cattle. Copy of the receipt produced herewith may be marked as Ext.R1. In the receipt it is specified that the receipt is subject to realization of the negotiable instrument. On the strength

 

                                                                                          (Cont……4)

-4-

 

 

of Ext.R1, policy was also issued on the same date, copy of which is produced herewith may be marked as Ext.R2. DD received towards consideration of the premium was sent for collection through IndusInd Bank Ltd., and on 24/09/2019, the same was returned with an endorsement, “PAYEE NAME MISMATCH”. Original cheque return memo produced herewith may be marked as Ext.R3. On 27/09/2019, this opposite party sent registered notice to the complainant intimating the dishonor of the document and informing the cancellation of policy since inception with copy to the financier IDCB Vandanmedu. Also it was informed that, if the complainant wants to take insurance premium, he has to pay premium with fresh proposal form. Office copy of the notice produced herewith may be marked as Ext.R4. Claim intimation was received on 03/10/2019. Claim intimation and related documents such as filled up claim form and  postmortem report are produced herewith may be marked as Ext.R4 series.

 

3 . As no consideration was received towards the contract of insurance, this opposite party was constrained to cancel the policy from inception. Notice regarding rejection of the claim was sent to the complainant vide letter dated 04/10/2019. Office copy of the notice along with postal acknowledgment card are produced herewith may be marked as Ext.R5 series. The dishonored negotiable instrument was forwarded to the complainant vide letter dated 09/10/2019. Office copy of the said letter along with postal acknowledgment card produced herewith may be marked as Ext.R6 series. This opposite party received a notice from the complainant on 16/10/2019 making false averments regarding the realization of the negotiable instrument in question. In the said notice it is averred that complainant has enquired with Koottar, SBI and he was informed that the DD was realized, which is a flat lie. Original notice produced herewith may be marked as Ext.R7. This opposite party, send reply to the same by letter dated 18/10/2019. Office copy of the letter produced may be marked as Ext.R8.

 

 

 

                                                                                        (Cont……5)

-5-

 

4 . Without prejudice, it is submitted that even as per the policy issued, exception No.2, diseases contracted prior to commencement of risk, and provided always that any claim arising out of disease or illness contracted by the animal during the first 15 days from the commencement date of policy are excluded. In this case, cattle died on the next date of inception of policy, ie on 20/09/2019, due to Toxemia. So it is evident that before the date of commencement of policy, the cattle had the disease, which led to the death of the cattle on 20/09/2019. Due to this reason also complainant is not entitled to be indemnified.

 

So the opposite party prayed for dismissal of the complaint with costs.

 

Opposite party has filed 8 documents with written version.

 

When the case was posted for evidence on 13/08/2022 complainant was present in person. Opposite party was not present. No representation also for opposite party.

 

Complainant filed proof affidavit and marked copy of following documents as Ext.P1 to Ext.P4.

 

1 . Ext.P1 – Receipt No.10110110219108492645 dated 19/09/2019 for Rs.4100/-.

 

2 . Ext.P2 – Claim form (Number and date not shown) in respect of dead cow with tag No.897950.

 

3 . Ext.P3 – Postmortem report dated 21/09/2019 of the cow.

 

4 . Ext.P4- Letter dated 18/10/2019 issued by opposite party in respect of letter of complainant stated to be received by opposite party on 16/10/2019.

 

 

 

 

                                                                                           (Cont……6)

-6-

 

 

As the opposite party was not present and no representation for them. 7 documents were marked as Ext.R1 to Ext.R7. Document No.1 filed by opposite party is same as that of Ext.P1. Hence it is not marked on the side of opposite party.

 

1 . Ext.R1Series (4 in Nos) – Letter dated 30/09/2019 sent by Veterinary Surgeon, Combammettu, Idukki to United India Insurance Company, Thodupuzha which states the forwarding of claim form, postmortem report and bank details.

 

2 . Ext.R2 – Certified copy of cancelled policy certificate for two cows having ear tag nos. 897950 and 706146 of the complainant.

 

3 . Ext.R3 – Cheque return memo dated 25/09/2019 issued by IndusInd Bank Ltd., Kochi to the opposite party showing name mismatch.

 

4 . Ext.R4 Series(2 in Nos) – Letter dated 04/10/2019 and its acknowledgment card issued by the opposite party to the complainant showing rejection of the insurance claim of the cow bearing ear tag No.897950 stating that DD No.43213 of SBI, Koottar for Rs.4700/- for the reason that DD has been returned as uncleared. Hence the insurance claim raised was rejected.

 

5 . Ext.R5 – Letter dated 09/10/2019 issued by the opposite party to the complainant stating the return of original DD bearing No.43213 of SBI, Koottar as the same was returned for the reason “PAYEE NAME MISMATCH” along with acknowledgement card.

 

6 . Ext.R6 – Letter dated nil sent by the complainant to the Manager United India Insurance Company Ltd., Thodupuza stating the incidence happened from taking of policy upto the rejection of claim under the policy and requesting to settle the claim amount and informing the institution of the legal action in the absence of settlement.

 

 

                                                                                          (Cont……7)

-7-

 

 

7 . Ext.R7 – Letter dated 18/10/2019 sent by the opposite party to the complainant stating the rejection of the claim amount once again based on the letter dated 16/10/2019 of the complainant.

 

Evidence in this case consists of proof affidavit of complainant and  Ext.P1 to Ext.P4 and Exts.R1 to Ext.R7 on the side of opposite party.

 

Complainant was heard.

 

We have examined rival pleadings addressed by both sides and perused documents filed.  On a perusal of the same, following points arise for consideration.

 

1 . Whether there is any deficiency in service or unfair trade practice on the part of opposite party?

2 . Whether the complainant is entitled to insurance amount as claimed?

3 . Reliefs and costs.

 

Point No.1

 

The complainant’s allegation is that even though he has taken insurance for the cow bearing tag No.897950 and for another cow by paying Rs.4,100/-each through a DD from SBI, Koottar on 19/09/2019, suddenly the cow bearing the above tag number died on 20/09/2019 due to “Toxemia”.  Complainant was not aware of the said facts.  Intimation of the death of cow was given on 20/09/2019 itself to the opposite party.  They sent claim form to him and he submitted the claim alone with postmortem report.  But they have rejected his claim by letter dated 18/10/2019 stating that the premium amount Rs.4100/- paid by DD No.43213 was not cleared to their account and they rejected the claim raised.

 

 

                                                                                          (Cont……8)

-8-

 

On the other hand the contention of opposite party is that on 20/09/2019 complainant came to their office and collected the report dated 19/09/2019 and original policy. But he suppressed the death of the cattle.  Ext.R1 policy was issued on that day.  The DD was returned by the collection bank on 24/09/2019 with endorsement “PAYEE NAME MISMATCH”.  Hence they have sent registered notice to complainant informing the dishonor of the DD and informing the cancellation of the policy since inception with copy to the financier IDCB, Vandanmedu.  Notice regarding rejection of the claim was sent to the complainant as per Ext.R5.  Opposite party has replied to the notice issued by the complainant stating the facts.  Another important contention raised by the opposite party is that even as per the policy exception No.2 disease contracted prior to commencement of risk and any claim arising in the event of death of insured animal due to disease occurring within 15 days from the commencement of risk are excluded.  The cattle died on the next date of inception of policy due to “toxemia”.  Another contention is that as per Ext.R1 receipt, it is specified that receipt is subject to realization of negotiable instrument.  As no consideration was received towards the contract of insurance, they were constrained to cancel the policy from inception.

 

It is a fact that opposite party had received application and DD and the policy was raised on 19/09/2019 itself.  They had sent the DD for collection also.  DD was returned for the reason that “PAYEE NAME MISMATCH”.  It is the duty of the officials of the opposite party company to verify the documents and DD before issuance of policy.  Without performing their duties properly they had issued the policy and thereafter they sent the DD for collection.  Reason stated by the collection bank shows that it was returned due to mismatch of payee’s name.  If the officials of the opposite party company were diligent in verifying the DD, such an issue could have been

 

 

 

 

 

                                                                                              (Cont……9)

-9-

 

avoided.  They have dealt with the matter in a careless manner.  At the same time, the complainant cannot take shelter under policy as there is an exception in the policy document that “company is not liable to pay the claim in the event of death of insured animal due to disease occurring within 15 days from the commencement of risk.  Another aspect is that as per Ext.R1(c) postmortem report, reason for death is shown as ‘Toxemia’ leading to multiorgan failure due to acute mastitis.  In the claim form complainant has stated that death of cow was happened infection in the uterus of the cow and delivery of cow was occurred on 10/09/2019.  The clinical history in the postmortem report shows that animal calved 10 days back was having normal hepatitis, foul smelling odor and discharge seen from the vaginal orifice on the 9^th day postpartum.  Thereafter animal became offted, weak and inactive and collapsed.  From the postmortem report itself it is abundantly clear that the cow was having disease before the inception of policy itself and this fact was not informed to the opposite party. As there was no consideration received by opposite party and in suppression of material facts is serious issue.   In the light of exception clause and above aspects, it is clear that the complainant is not entitled to insurance benefit under the policy. Hence we find that there is no deficiency in service or unfair trade practice on the part of opposite party in repudiating his claim.  So point No.1 is answered in the negative.

 

Point No.2

 

In the light of discussion and our findings shown above.  We are of the considered view that complainant is not entitled to insurance claim under the said policy.  Hence point No.2 is found against the complainant.

 

 

 

 

 

 

                                                                                                              

                                                                                         (Cont……10)

-10-

 

Point No.3

 

In the light of our findings on Point Nos.1 and 2, complainant is not entitled to any reliefs as claimed for.

 

In the result, the complaint is dismissed as devoid of merits and hence dismissed without any order as to costs.

 

Pronounced by this Commission on this the 15^th day of September 2022.

 

                                                                                              Sd/-

                                                                             SRI.AMPADY K.S., MEMBER

                                                                                               Sd/-

                                                                        SRI.C.SURESHKUMAR, PRESIDENT  

                                                                                               Sd/-

                                                                                 SMT.ASAMOL P., MEMBER

 

 

 

 

 

 

 

 

 

 

                                                                                                                

                                                                                            (Cont……11)

 

-11-

APPENDIX

 

Depositions :

On the side of the Complainant :

Nil

On the side of the Opposite Party :

Nil

Exhibits :

On the side of the Complainant :

Ext.P1– Receipt No.10110110219108492645 dated 19/09/2019 for Rs.4100/-

Ext.P2 – Claim form (Number and date not shown) in respect of dead cow

                with tag No.897950.

Ext.P3 – Postmortem report dated 21/09/2019 of the cow.

Ext.P4- Letter dated 18/10/2019 issued by opposite party in respect of letter  

             of complainant stated to be received by opposite party

             on 16/10/2019.

On the side of the Opposite Party :

 

Ext.R1(Series) -   Letter dated 30/09/2019 sent by Veterinary Surgeon,

                Combammettu, Idukki to United India Insurance Company, 

                Thodupuzha

Ext.R2 -   Certified copy of cancelled policy certificate

Ext.R3 -   Cheque return memo dated 25/09/2019 issued by

                 IndusInd Bank Ltd., Kochi

Ext.R4(series) - Letter dated 04/10/2019 and its acknowledgment card

Ext.R5  -    Letter dated 09/10/2019 issued by the opposite party to the

                 Complainant

Ext.R6  -   Letter dated nil sent by the complainant to the Manager

                 United India Insurance Company Ltd., Thodupuza

Ext.R7 -    Letter dated 18/10/2019 sent by the opposite party to the

                 complainant

                                                                                               Forwarded by Order

 

                                                                                          ASSISTANT REGISTRAR