DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD
Dated this the 24th day of August, 2023
Present : Sri.Vinay Menon V., President
: Smt.Vidya A., Member
: Sri.Krishnankutty N.K., Member Date of filing: 23/01/2021
CC/15/2021
Ravunni
S/o Nappan Ezhuthachan,
Kunnath Veedu,
Thekkum Cherode,
Mangalam (PO)
Ottapalam,
Palakkad - Complainant
(By Adv. K.Sujith Kumar &Adv.P.Rajesh)
V/s
The United India Insurance Company Ltd.,
PB No.12, 2nd Floor,
Parappurath Tower,
Main Road
Ottapalam – 679 101. - Opposite party
(By Adv. Rathnavally)
O R D E R
By Smt. Vidya.A, Member
1. Pleadings of the complainant in brief
Complainant took insurance policy from the opposite party with Policy No.3008024720P108580389 for his 2 cows covering a period from 30/10/2020 to 29/10/2021. As per the Terms & conditions of the policy, if any of the cows mentioned in the policy dies, the OP is bound to pay Rs.1,20,000/- to the complainant.
The cow which is insured with the OP and having Ear Tag number UII 10120034605 died on 15/12/2020 and its postmortem was conducted by the Veterinary surgen of Lakkidi, Peroor and the report was submitted to the opposite party. As per the report, the cow was having Ear Tag at the time of postmortem. The complainant requested the OP to allow his claim; but they send reply stating that the claim cannot be allowed for the reason of non-production of Ear Tag.
The conduct of the OP in repudiating the genuine claim of the complainant is a deficiency in service on their part. So he approached the Commission for directing the opposite party
- To pay Rs.1,20,000/- together with 12% interest from 15/12/2020 and to pay Rs.5 lakhs for the mental agony and damages suffered by the complainant together with cost of the litigation.
2. Complaint was admitted and notice was issued to the opposite party. They entered appearance and filed their version.
3. The main contentions raised by the OP in their version is as follows:
They admit the issuance of the policy bearing No. 3008024720P108580389 to the complainant for the period from 30/10/2020 to 29/10/2021. As per this policy, 2 cows at the rate of Rs.60,000/- was insured separately with two separate tag numbers. The ear tag is the important document and only token badge to connect the animal with the policy. Whenever there is a claim in the case of illness, the insured should supply tag numbers and in other cases like death, ear tag should be returned to the company with the claim form. In this case, the complainant approached the company without Ear tag. As per the terms and conditions of the policy, the claim was repudiated.
Two cows were insured for Rs.60,000/- each, but on 16/12/2020, the OP received a claim form from the insured stating that his cow bearing tag No.UII 1012003468 died and the valuation of the same is shown as Rs.1,20,000/-. Since the tag is not returned to the insurance company, they specifically states that this is not the cow that died out of Anoxia. The deceased animal was not the one insured with the same tag number. The Doctor and the insured has got a joint duty to retain the tag and to submit to the insurance company; but both of them did not take care to produce the tag.
The repudiation made by the company was as per the Terms and Conditions and there is no deficiency in service on their part. The complaint has to be dismissed with cost of the opposite party.
4. From the pleadings of both parties, the following points arise for
consideration.
- Whether the repudiation of the claim was as per the Policy Terms and Conditions ?
- Whether there is any deficiency in service on the part of the OP ?
- Whether the complainant is entitled to the reliefs calimed ?
- Reliefs, if any, as cost and compensation.
5. Complainant filed proof affidavit and Exts.A1 to A3 marked from his side. OP filed proof affidavit and Exts.B1toB5 marked. B2 is a series of photographs. After closing of evidence, OP filed 2 applications IA 548/22 and IA 551/22 to reopen evidence and to cross the complainant and both IAs were allowed. Inspite of several chances being given, the complainant did not stand trial and the evidence of complainant was closed. OP filed IA 552/22 to cross examine the veterinary surgeon and it was allowed. Veterinary Doctor was examined as DW1. Opposite party filed notes of arguments.
Point No.1
6. Complainant’s case is that he insured his two cows with the opposite party with Policy No.3008024720 P108580389 for a period from 30/10/20 to 29/10/21. As per that, he is entitled to get Rs.1,20,000/- if any of the cows dies during the policy period. One of the cows with Ear Tag died on 15/12/2020 and the Veterinary Surgeon of Lakkidi conducted postmortem. The cow was having Ear Tag at that time and some how it was lost later on. The complainant approached the OP for the claim amount, but they rejected the claim for the reason of non-production of Ear Tag.
7. Opposite party’s contention in this regard is that Ear Tag of the animal is the preliminary factor to process the claim and as per the policy conditions, No.6, it is clearly mentioned that “Ear Tag should be surrendered at the time of claim, otherwise no claim is recoverable under the policy.” It is also stated that in the event of death of animals covered under the policy, claims shall not be entertained unless the ear tags are surrendered to the company. The special condition/exclusions also states that “No Tag, No claim.” Here Tag is not surrendered by the complainant and the claim is rejected.
8. Further the OP in their affidavit has stated that as per the description of animal insured in the Policy No.3008024720 P108580389, the Tag ID No.UII10120034608 is a cattle which is Female, Black white colours on under area. The colour of the cow in the photograph produced by the complainant along with claim form is black and no black white combination can be observed in the under area of the cow. So the death reported by the complainant is not of the cow which is insured with opposite party.
9. The OP produced the policy with conditions which is marked as Ext.B1 and the photographs are marked as Ext.B2 series.
As per Ext.B1 policy Conditions No.6, “Ear Tag should be surrendered at the time of claim. Otherwise no claim is recoverable under the policy.
As per conditions No.8 “On death of any animal here by insured, the Insured shall give immediate notice thereof to the company (at the office which has issued the policy, and shall give the company an opportunity of inspecting carcass untill at least the expiration of twenty four hours after such notice shall have been received by the Company). The insured shall also within fourteen days submit such Veterinary Certificates and satisfactory proof and to furnish the company such information accompanied by the death identity and value of the animal as the company may require. The ear-tag should be surrendered with the above certificates.”
10. Ext.B4 is the Veterinary certificate issued by Dr.Jini.K.S, Veterinary
Surgeon, Veterinary Dispensary, Lakkidi, Peroor. As per Ext.B4, colour of
the animal is shown as Black.
As answer to query No.7, the Doctor has answered. “ Did you examine the Insurance and do you identify the animal ? Yes, identified the animal, but unable to find one piece of ear tag.”
11. This Doctor was examined as DW1. As per her deposition (page 2 &3)
“Veterinary certificate ലും Ear Tag കണ്ടതായി രേഖപ്പെടുത്തിയിട്ടില്ല എന്നു പറഞ്ഞാൽ ശരിയാണ്. Post mortem Report ൽ Ear Tag number, note ചെയ്തത് Policy document പ്രകാരമാണ്. Number ഉള്ള piece missing ആയിരുന്നു.....(Page:3 last sentences) Ear Tag കണ്ടതിന്റെ അടിസ്ഥാനത്തിലല്ല, Policy holder ന്റെ request പ്രകാരമാണ് ചെയ്തതെന്നു പഞ്ഞാൽ ഇതൊരു genuine case ആണെന്ന് തോന്നിയതിനാലാണ് note ചെയ്തത്. ”
She was not cross examined by the complainant inorder to prove their contentions. So no ear tag was seen by the veterinary doctor who conducted the post-mortem. In the absence of ear tag, the repudiation of the claim was as per the Policy Terms of conditions.
Point 2 to 4
12. Since the repudiation of the claim was as per the terms and conditions of the policy, there is no deficiency in service on the part of the opposite party and the complainant is not entitled to the reliefs claimed.
In the result, the complaint is dismissed.
Pronounced in open court on this the 24th day of August, 2023.
Sd/-
Vinay Menon V
President
Sd/-
Vidya.A
Member
APPENDIX
Documents marked from the side of the complainant:
Ext. A1 : Copy of Insurance Policy, No.3008024720P108580389.
Ext. A2 : Postmortem Report dated 21.12.2020.
Ext. A3 : Claim denial letter from United India Insurance Company Ltd., dated
12/2/2018.
Documents marked from the side of opposite parties:
Ext. B1 : Terms and conditions of Insurance policy.
Ext. B2 : Series of photographs
Ext. B3 : Claim form of United India Insurance company Ltd.
Ext. B4 : Life stock claim policy of United India Insurance company Ltd.
Ext. B5 : Communication dated 25.02.2021 from United India Insurance
Company Ltd.
Witness examined from the complainant’s side: Nil
Witness examined from the opposite parties side: DW1 – Dr.Jini.K.S (Veterinary Surgeon)
Cost: Nil
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.
