D.O.F:27/09/2019
D.O.O:10/02/2022
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.No.186/2019
Dated this, the 10th day of February 2022
PRESENT:
SRI.KRISHNAN.K : PRESIDENT
SRI.RADHAKRISHNAN NAIR.M: MEMBER
SMT.BEENA.K.G : MEMBER
Prakash Ballullaya, aged 56 years,
S/o Late Keshava Ballullaya,
Karthikeya Nivas, Kodavanji, : Complainant
Muliyar, Kasaragod, Kerala
Pin – 671542
(Adv: Rajesh.K)
And
United India Insurance Company Limited
Rep: by its Manager
Tiger Hills, Post Box No.19, Muncipal Office Road : Opposite Party
Kasaragod – 671121
(Adv: C. Damodaran)
ORDER
SRI.RADHAKRISHNAN NAIR.M: MEMBER
The complaint is filed under section 12 of the Consumer Protection Act, 1986 ( as amended)
The facts of the case in brief is that the complainant has insured his cattle with opposite Party vide Policy No.10 200 04717 P110 286156 .The net premium payable was Rs. 3,400/- and sum insured was Rs. 50,000/- The terms of policy was not explained to the insured. The insurance was supported by Diary Department. The insured cattle fell ill on 01-08-2019 and died on 03 - 08 - 2019, during the validity period of insurance.
The veterinary surgeon who conducted postmortem noticed that the tag number was missing but the stub was there on its ears .The complainant could not inform the insurance company about the missing of tag and get re-tagged, due to serious iIIness of the cattle. The veterinary Surgeon specifically noticed the animal in person that the animal was tagged by her in 2017 and issued certificate dated 16.08-2019 to that effect. The complainant noticed the missing of the tag only at the time of the visit of the Veterinary Surgeon. The complainant has intimated the opposite Party about death of the cattle on 08.08.2019. There after the complainant submitted claim petition for insurance amount with all the necessary documents, but the Opposite Party illegally repudiated the claim on the ground that there was no surrender of tag.
The denial of insurance benefit by the opposite party amounts to gross negligence and service deficiency due to which the complainant suffered great mental agony apart from monetary loss . Hence the complaint is filed for the insurance amount of Rs.50,000/-along with compensation of Rs.25,000/-and costs.
The opposite parties entered appearance and filed written Version.
As per the version of the opposite party, the complaint is false frivolous vexatious and un sustainable at law.
The opposite party admitted the Policy but denied that the terms of policy was not explained to the insured. The allegation that the complainant noticed the missing of the tag only at the time of the visit of the Veterinary Surgeon is false and denied.
Surrendering of tag is a material policy condition. Personal identification of tagged cow during 2017 and issuing certificate on 16-08-2019 cannot be believed and create suspicion. The opposite party cannot consider the claim bye- passing a material condition in the policy .The repudiation is quit legal and as per Policy condition. The complaint is experimental and liable to be dismissed.
The Complainant filed proof affidavit in lieu of chief examination and documents
Ext. A 1 to Ext. A 4 are marked. The Ext - A1 is the claim application. Ext - A 2 is the
Certificate issued by the Veterinary doctor. Ext A3 is the Postmortum certificate. Ext. A 4 is the Repudiation Letter dated 22.08.2019.The opposite party did not adduce any oral evidence, but produced documents which are marked as Ext. B1 to B4. The Ext. B1 is the Insurance policy conditions, Ext B2 is the Live stock claim form submitted by the complainant (Ext. B2) , Ext. B3 is the Certificate issued by the Veterinary doctor dated 16.08 2019 (Ext. A2) . Ext. B4 is the Repudiation Letter dated 22.08.2019. (Ext A4).
Based on the pleading of the rival parties the following issues are framed for consideration.
1. Whether the complainant is entitled for insurance benefit.
2. Whether there is any deficiency of service on the part of the opposite party.
3. If so what is the relief?
For convenience an these issues are considered together.
Here the specific case of the complainant is that his cattle which was insured with opposite party , fell ill 01-08-2019 and died on 03 - 08 - 2019 during the validity period of insurance. The veterinary surgeon who conducted postmortem noticed that the tag was missing but the stub was there on its ears .The complainant could not inform the insurance company about the missing of tag and get re-tagged, due to serious iIIness of the cattle. The veterinary Surgeon specifically noticed the animal in person that the animal was tagged by her in 2017 and issued certificate dated 16.08-2019 to that effect. The complainant noticed the missing of the tag only at the time of the visit of the Veterinary Surgeon. The complainant has intimated the opposite party about death of the cattle on 08.08.2019. There after the complainant submitted claim petition for insurance amount with all the necessary documents, but the opposite party illegally repudiated the claim on the ground that there was no surrender of tag.
The denial of insurance benefit by the opposite party amounts to gross negligence and service deficiency due to which the complainant suffered great mental agony apart from monetary loss.
The opposite party admitted the Policy but denied that the terms of policy was not explained to the insured. The allegation that the complainant noticed the missing of the tag only at the time of the visit of the Veterinary Surgeon is false and denied.
Surrendering of tag is a material policy condition. Personal identification of tagged cow during 2017 and issuing certificate on 16-08-2019 cannot be believed and create suspecion. The opposite party can not consider the claim bye- passing a material condition in the policy .The repudiation is quit legal and as per Policy condition.
So the main dispute is due to the non Surrendering of the tag of the cattle. The opposite party argue that and as per the Ext A4, it is a material policy condition that the ear - tag is to be surrendered at the time of claim and otherwise no claim is recoverable under the policy.
The complainant would argue that the necessity of ear tag is only for the purpose of identification of the insured cattle. Here the Veterinary surgeon who conducted the post mortum specifically identified the cattle in person and stated that the animal was tagged by her in 2017 and issued certificate dated. 16.08 2019 to that effect. The documents Ext - A 2 is the Certificate issued by the Veterinary doctor. Ext A3 is the Postmortum certificate would show that aspect. In the Ext A 2 the Veterinary surgeon who conducted the postmortum states that I have identified the animal in person and I am sure that the animal was tagged by me in 2017.
The commission finds no reason to disbelieve the certificate issued by the doctor. The opposite party admits the Insurance Policy and no evidence to show that the insurance is related to some other cattle. Even though the tag was missing, the Doctor who conducted the postmortum of the cattle certifies that the stub was there on its ears.
Considering the facts and circumstances of the case this commission is of the view that the complainant is entitled for the insurance claim amount. The complainant claim Rs.25,000/- towards the compensation for mental agony and hardships. But no details regarding for that. This commission of the view that Rs.5,000 /- will be a reasonable compensation. The complainant is also entitled for Rs.5,000/- towards the cost.
In the result the complaint is allowed in part and the opposite party is directed to pay Rs.50,000/- ,(Rupees Fifty thousand only) the insurance amount to the complainant with interest at the rate of 8 % per annum from 27/09/2019, the date of complaint till the payment, along with Rs.5,000/-(Rupees Five thousand only) towards compensation and Rs.5,000/- (Rupees Five thousand only) towards the cost.
The time for compliance is 30 days from date of receipt of copy of this Judgment.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exhibits
A1- Claim application
A2- Description of Animal
A3- Postmortem Report
A4- Repudiation letter Dt: 22/08/2019
B1- Insurance policy conditions
B2- Live stock claim form submitted by the complainant
B3- certificate issued by the Veterinary doctor
B4- Repudiation letter
Witness Examined
Pw1- K. Prakash Ballullaya
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
Senior Superintendent
Ps/
