D.O.F:01/06/2022

                                                                                                      D.O.O:10/07/2023

IN THE CONSUMER DISPUTES  REDRESSAL COMMISSION, KASARAGOD

CC.104/2022

Dated this, the 10^th day of July 2023

PRESENT:

SRI.KRISHNAN.K                          : PRESIDENT

SMT.BEENA.K.G                          : MEMBER

P.C Muralidharan

Devadatham, Elambachi P.O,

South Thrikaripur 67131, Kasaragod                                      : Complainant                                                 

                                                                        And

United India Insurance Company Ltd

Frutomanz Building, Byepass Road,

Vennala, Kochi- 682028, Eranakulam                                    : Opposite Party

(Adv. K. Vinod Kumar)
 

ORDER

SRI. KRISHNAN.K : PRESIDENT

The case of the complainant is that he has purchased a cow insured with the Diary department with tag No: 420059/44437.  The said cow died on 29/10/2021 due to illness.  It was informed to veterinary doctor, he conducted postmortem.  The complainant applied for compensation; personally contacted and also produced cattle enrolment list, copy, treatment copy, postmortem copy and also submitted claim form.  Though claim form is sent on 17/11/2021 to the insurance company, but it was rejected by the opposite party.  Complainant suffered mental tension by delay in getting compensation.  Therefore complainant prayed for compensation and cost and insurance benefits.

          The opposite party filed written version denying the allegations in the complaint.  As per the terms and conditions of the policy death of cow should be informed immediately without delay to avoid malpractices, to verify genuineness of the incident.  Company made enquiry found repudiation of the policy is as per the terms of the policy. There is no deficiency in service or negligence from opposite party.  The date of illness is 20/10/2021 death of cow is on 29/10/2021 but intimated on 6/12/2021 by mail submitted to opposite party on 14/02/2022.

          Claims governed by insurance contract, parties are bound by the terms and condition of the policy. The opposite party is not liable to pay compensation and hence prayed for dismissal of the complaint.  Complainant filed chief affidavit cross for opposite party Ext A1 to A5 documents marked from his side.  Ext A1 cattle enrolment list, Ext A2 treatment certificate copy, Ext A3 postmortem report, Ext A4 claim form, Ext A5 copy of letter sent to opposite party.  The opposite party has not adduced any evidence.

          Considering the rival contentions following points raised for consideration:

1. Whether complainant is entitled for insurance benefits?
2. Whether there is delay in submitting the claim for the insurance benefits?
3. Whether complainant is entitled for compensation? If so  what is the reliefs?

The complainant while in the box denied having received any letter seeking explanations for causing the delay in submitting the claim.

The opposite party admits the cow being insured, it is also admitted the cow died due to illness.  And postmortem conducted is also admitted by the insurance company.  Cow died due to illness claim is submitted by the complainant to the insurance company.  These are all admitted facts.  The opposite party disputed and denied the liability only for the reason that there is delay in submitting the claim form.

So the fact that the cow is died.  It is covered by valid insurance policy.  Death of cow is confirmed by issue of Ext A3.  Therefore insurance company is liable to pay the insurance to the company who is the owner of the cow as well as the policy holder.

H’ble Supreme Court held that insurance company is not entitled to deny the insurance benefits only on account of delay in submitting the claim in various judgments.  It will not be fair or reasonable to reject genuine claims which is verified and found correct by investigator.

     Hence it is found that opposite party is liable to pay insurance amount of Rs. 60,000/- claimed by the complainant.  Despite claim is found genuine, insurance company failed to pay benefits and denied payment citing delay in submitting the claim, the claim as a reason though it is a settled position that insurance benefits cannot be denied on the ground of delay, and thus there is serious negligence and deficiency in service of opposite party.  Thus complainant is entitled for compensation.

In the result complaint is allowed in part opposite party, the insurance company is directed to pay Rs. 60,000/- (Rupees Sixty thousand only) towards insurance benefits and Rs, 10,000/- (Rupees Ten thousand only)as  for deficiency in service and also an amount of Rs. 5000/- (Rupees Five thousand only) towards cost to the litigation within 30 days of the receipt of the order.

     Sd/-                                                                                    Sd/-

MEMBER                                                                            PRESIDENT

Exhibits

A1- Cattle enrolment list

A2- Treatment Certificate copy

A3- Postmortem Report

A4- Claim Form

A5- A letter Dt:17/11/2021

Witness Examined

Pw1- Muralidharan. P.C

      Sd/-                                                                                             Sd/-

MEMBER                                                                                      PRESIDENT

Forwarded by Order

                                                                      Assistant Registrar

Ps/