By Sri. MOHANDASAN.K, PRESIDENT
The complaint in short is as follows:-
1. The complainant purchased a cow worth Rs.65,000/-. The complainant approached Ariyallur Service cooperative bank for a loan of Rs.30,000/- and the grama Panchayath allowed Rs.30,000/- to purchase the cow. The complainant herself added Rs.5,000/- to purchase the cow. On the day of purchase i.e., 29/03/2021 the complainant insured the cattle with the opposite party vide policy No.3006814720P115208646 for the period 29/03/2021 to 28/03/2024. The policy assured sum was Rs 60,000/-. The opposite party, Insurance company allowed a tag No.31579 to identify the cow on the same day. But the cow died on 17/09/2021 and the vetinery doctor confirmed the death of cow and issued a report to that effect. The complainant just that time came to know the tag of the cow had been lost. The Vetinery doctor told her that in case of loss of tag the policy holder is bound to inform the vetinery doctor about the loss of tag and to be provided another tag and the insurance claim to be renewed.
2. The husband of the complainant is a mentally ill person and the husband also was not aware of the loss of tag. The act of non-informing loss of tag was not willful one. The sole source of income of the family was selling milk.
3. The complainant submitted a claim application before the opposite party on 18/09/2021 and the same was received by the opposite party on 24/09/2021. The insurance company repudiated the claim on the ground of loss of tag. The act of non-informing of the loss of tag to the insurance company was not a willful act. The complainant at present is not able to repay the loan amount and also struggling for livelihood. So, the complainant prays for the insurance amount to purchase another cow for the purpose of livelihood of the family.
4. On admission of the complaint notice was issued to the opposite party and the opposite party entered appearance and filed version. The opposite party admitted the issuance of insurance policy to the complainant covering a cow for the period 29/03/2021 to 28/03/2024. It is submitted that the insurance policy is a contract and both parties are bound by the terms and conditions of the policy. The insured animal had been tagged with ear tag number 31579. The tagging is done by a government vertinery doctor who gives his report along with the proposal form of the policy. The cow is identifying by the ear tag, because that is the simplest and most effective method to identify an insured animal. The practice of ear tagging has been introduced for insurance purposes and this is the industry standard world over. The clauses regarding ear tag have been approved by IRDAI, the statutory board supervising insurance matters in India. The policy itself it is stated that tag should be surrendered at the time of claim, otherwise it will be treated as no claim. In the event of death of animal covered under the policy, claim shall not be entertained unless the ear tag is surrendered to the company. In the event of loss of ear tag it is the responsibility of the insured to give immediate notice to the company and get the animal re-tag.
5. In this complaint the complainant admitted that the ear tag was not handed over to the opposite party and so the opposite party repudiated the claim stating the conditions of the policy. The opposite party submitted that they are public sector under taking and has no discretion when there is a breach of policy condition. The animal involved in this complaint is said to have died on 17/09/2021 and the complainant submitted the claim on 20/09/2021 and the documents on 24/09/2021 and also an explanation letter on 29/09/2021. The repudiation letter was issued on 26/10/2021. Hence the submission of the opposite party is that the opposite party has acted according to law and there is no any sort of deficiency in service and not indulged in any unfair trade practice and so prayer is to dismiss the complaint.
6. The complainant and opposite party filed affidavit and documents. The documents on the side of complainant marked as Ext. A1 to A8. Ext. A1 is copy of cattle insurance policy number 3006814720P115208646.Ext. A2 is photo copy of certificate of vetinery surgeon dated 17/09/2021. Ext. A3 is letter issued by the vetinery surgeon to the opposite party directing to issue a claim form dated 18/09/2021. Ext. A4 is copy of certificate issued by the vetinery surgeon. Ext. A5 is photo copy of insurance cattle insurance claim form dated 20/09/2021. Ext. A6 is photo copy of application submitted by complainant before the opposite party dated 29/09/2021. Ext. A7 is photo copy of repudiation letter issued by the opposite party dated 26/10/2021. Ext. A8 is photographs (3 numbers) . The documents on the side of opposite parties marked as Ext. B1 to B3. Ext. B1 is copy of insurance policy (Ext. A1). Ext. B2 is copy of application submitted by complainant before the opposite party (Ext. A6). Ext. B3 is copy of repudiation letter dated 26/10/2021 (Ext. A7).
Heard complainant and opposite party, perused affidavit and documents.
7. The following points arise for consideration:-
1) Whether the repudiation of the claim is justifiable?
2) Whether there is deficiency in service?
3) Relief and cost?
8. Point No.1 &2
The opposite party filed version and affidavit admitting the issuance of policy number 30068114720P115208646 in favor of the complainant to cover a cow for the period 29/03/2021 to 28/03/2024. The case of the complainant is that the cow died on 17/09/2021 and the same was reported to the vetinery doctor and he came to the spot and confirmed the death of cow. He prepared Ext. A2 certificate. At the time of examination by the vetinery doctor it was found the ear tag has been lost. The complainant was not aware of the loss of ear tag. The complainant came to know about the procedure to be followed in such situation only from the information furnished by the vetinery doctor at that moment. The complainant approached the opposite party with the documents for the insurance benefit, but the opposite party repudiated the claim since there was no tag for the insured cow at the time of death. The contention of the opposite party is that at the time of issuance of the policy it was stated tag should be surrendered at the time of claim, otherwise it will be treated as no claim. It is definite that the complainant failed to furnish ear tag along with insurance claim.
9. The complainant, illiterate poor lady appeared in person before this Commission and submitted that the cow was examined by vetinery doctor at the time of taking insurance policy and the same vetinery doctor did postmortem of the insured cow and issued the certificate to produce before insurance company. The submission of the complainant is that only when the vetinery doctor revealed the procedure in case of loss of ear tag, she came to know the seriousness of loss of ear tag. The ear tag was affixed by the vetinery doctor who conducted the postmortem of the cow. So, the case of the complainant is that the vetinery doctors is very well competent to identify the cow insured by the opposite party. Ext. A4 is a certificate issued by the vetinery doctor and which is stated that the cow died under the owner ship of Sandhya w/o Prakashan, is supposed to be the same given under the project of scheme 2020-21 and policy number. The complainant also submitted that on 30/08/2021 the family of the complainant was under the treatment for covid 19 and the cow was maintained by the brothers of the husband of the complainant during the days. On the day of death of cow, brothers of the husband of complainant contacted vetinery doctor and did all the necessary things. The entire family was being under quarantine complainant could not notice the loss of tag. The complainant and family has been affected their livelihood due to the death of cow and not able to repay the loan amount availed from the service cooperative bank also.
10. The opposite party vehemently contended that in the case of cattle insurance, non-surrendering of ear tag is vital violation of policy condition and it will be treated as no insurance. The principle is “no tag no insurance”. But it is to be noted that the insurance is issued in favor of complainant to cover the cattle. Tag is not insured but the cattle is insured. The tag is provided to identify the cattle only. But the cattle is not aware of the importance of tag which bearing. There is every chance to loss a tag from cattle. So, the consideration is the identification of the insured cow. In this complaint the vetinery doctor who examined at the time of insuring the cow has done postmortem at the time of death also. He rightly issued Ext. A4 document to identify the cow as per the policy. The application form also described the color and class of the cattle. So Ext. A2, A4, A5 are sufficient to identify the cow. That being the fact the denial of the insurance claim only because of absence of ear tag cannot be upheld as a good proposition. Since the cow has been identified, the insurance company is bound to provide insured amount to the complainant. So, the repudiation of claim is not justifiable. Moreover, it is to be noted that the period of death occurred during spread of covid pandemic and the complainant was quarantine at that relevant period. Hence the denial of insurance considering the entire aspects in this complainant is denial of justice. The law cannot be blind towards the human situation. All the machineries acted positively to support struggling human being during the pandemic period. But the opposite party could not rise to the situation and ignored the basic principle of providing insurance coverage. So, we do not find any merit in the contention of the opposite party to repudiate the insurance coverage, which is otherwise entitled by the complainant. The act of opposite party amounts deficiency in service.
11. Point No.3
The complainant purchased the cow for 65,000/-, but it is insured for Rs.60,000/-. The opposite party denied the insurance coverage which is already found as deficiency in service. The complainant is entitled for insured sum. But the complainant claimed huge amount on various counts. We do not find the complainant is entitled for such huge amount of Rs.2,30,000/-. The complainant is entitled for insurance amount with reasonable interest. Complainant is also entitled for compensation due to repudiation of claim and thereby caused hardships, inconvenience and financial loss. The commission allows the complaint as follows: -
- The opposite party is directed to pay Rs.60,000/-, the insured amount of the cattle with 9% interest from the date of complaint to till date of payment to the complainant.
- The opposite party is also directed to pay Rs.25,000/- as compensation on account of deficiency in service on the part of opposite party and thereby caused inconvenience and hardship to the complainant.
- The opposite party is directed to pay Rs.10,000/- as cost of the proceedings.
The opposite party is directed to comply this order within one month from the date of receipt of copy of this order, failing which the entire above amount will carry interest @9% per annum from the date of this order till realization.
Dated this 20th day of June, 2022.
Mohandasan . K, President
PreethiSivaraman.C, Member
Mohamed Ismayil.C.V, Member
APPENDIX
Witness examined on the side of the complainant: Nil
Documents marked on the side of the complainant: Ext.A1 to A8
Ext.A1 : Copy of cattle insurance policy number 3006814720P115208646.
Ext.A2 : Photo copy of certificate of vetinery surgeon dated 17/09/2021.
Ext A3 : Letter issued by the vetinery surgeon to the opposite party directing to issue a
claim form dated 18/09/2021.
Ext A4 : Copy of certificate issued by the vetinery surgeon.
Ext A5 : Photo copy of insurance cattle insurance claim form dated 20/09/2021.
Ext.A6: Photo copy of application submitted by complainant before the opposite party
dated 29/09/2021.
Ext.A7: Photo copy of repudiation letter issued by the opposite party dated 26/10/2021
Ext.A8: Photographs (3 numbers)
Witness examined on the side of the opposite party : Nil
Documents marked on the side of the opposite party : Ext. B1 to B3
Ext.B1 : Copy of insurance policy (Ext. A1).
Ext.B2 : Copy of application submitted by complainant before the opposite party (Ext.
A6).
Ext.B3 :Copy of repudiation letter dated 26/10/2021 (Ext. A7).
Mohandasan . K, President
PreethiSivaraman.C, Member
VPH Mohamed Ismayil.C.V, Member
