OMPRAKASH MAHAVAR vs United India Insurance Co. Ltd.

THIS appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 5.8.2002 in Complaint No. 165/2001 by District Consumer Disputes Redressal Forum, Bilaspur (hereinafter called the ''District Forum'' for short) dismissing the complaint of the appellant.

THE averments of the complainant stated in brief are that he had insured 10 of his cows with the respondent No. 1 insurer through respondent No. 2, Bank. THE insurance covered the risk from 30.10.2002 to 29.10.2001, and a consolidated Policy No. 457851 was issued in favour of the complainant/appellant. It was further averred by the complainant that one of the insured cows bearing tag No. 19156 died on 26.4.2001. THE intimation of the death of cow was given by the complainant to the respondent No. 1 on 27.4.2001 and he had also submitted the claim form with necessary documents. THE claim was however, repudiated by the respondent No. 1/insurer by its letter dated 27.7.2001. Aggrieved by the repudiation as above, the complainant approached the District Forum and filed the complaint. The complaint was resisted by the respondent No. 1. The main averments of the respondent No. 1 was that investigation was conducted by Dr. T.J.R. Naidu, Veterinary Assistant Surgeon. It was reported by Dr. Naidu that the complainant had sold his cattle before the alleged date of death of the cow on 26.4.2001. Thus as the complainant had suppressed the material fact of sale of the insured cow, he had breached the terms of the policy, and was, therefore, not entitled to any benefits thereunder.

The District Forum in the impugned order held that the complainant had not been able to prove his averments regarding the death of insured cow and accordingly dismissed the complaint.

THE learned Counsel for the parties were heard and record perused. As noticed earlier, the claim of the appellant was repudiated only on the strength of report dated 18.9.2001 of Dr. T.J.R. Naidu that the insured cow had already been sold prior to its alleged date of death of 26.4.2001. The main question that arises for consideration in this appeal is: as to whether the respondent No. 1, insurer has satisfactorily proved the ground of repudiation as above?

IT may be noticed in the above context that, undisputably the complainant/appellant had intimated the respondent No. 1 about the death of his cow on 27.4.2001 and had also submitted the claim form. In the said claim form, the Veterinary Asstt. Surgeon has recorded a certificate regarding the death of cow and has also mentioned therein the tag number of the cow. The post-mortem examination report submitted by the Veterinary Asstt. Surgeon is also filed on record. IT also appears that the respondent No. 2, Bank had sent the ear tag, post-mortem report and the claim form etc. to respondent No. 1 by their letter dated 10.5.2001; a copy of which is placed on record. The respondent No. 2 thereafter, had sent letters dated 18.4.2001 and 30.5.2001 to the respondent No. 1, imploring them to settle the claim of the complainant/appellant. However, it appears that there was no response from respondent No. 1 despite efforts as above. As noticed earlier, the respondent No. 1 relied upon the report of Dr. Naidu dated 18.9.2001, according to which, Dr. Naidu went for investigation for the first time on 6.9.2001 and thereafter on 17.9.2001. It is, therefore, clear that Dr. Naidu undertook the alleged investigation as above after about 5 months after the death of the cow. The said report of Dr. Naidu also indicates that some of the cattles of the complainant had died prior to April, 2001, whereafter the complainant sold some cattle in April-May, 2001. The said report does not indicate that the insured cow in question was sold to somebody else or did not die, while in the custody of the appellant as has been alleged by the complainant. It may further be noticed in the above context that, Dr. Naidu apparently relied upon the statements of some witnesses. However, affidavits of those witnesses have not been filed on record by respondent No. 1. Therefore, investigation report is not duly supported by corroborative and independent evidence. The report of Dr. Naidu is not based on his personal knowledge nor any affidavit of Dr. Naidu has been filed. As already noticed, he went for conducting inquiry belatedly, after about 5 months, after the death of the cow. In the above circumstances the report of Dr. Naidu firstly, cannot be relied upon. Secondly, even it was taken into the consideration, it does not disclose that the insured cow was sold by the complainant before its death. The complainant had submitted the ear tag, post-mortem report and other documents along with his claim form. In the foregoing circumstances, the repudiation of the appellant''s claim by the respondent No. 1 was not justified. The complainant/appellant, therefore, appears to be entitled to get the compensation under the policy.

THE question that now arises is as to what should be the quantum of compensation? THE cow was undisputably insured for Rs. 14,000/-. THE report of Veterinary Asstt. Surgeon dated 27.4.2001 mentions that the cow was worth about Rs. 16,000/-. In view of the above, it is clear that the complainant/appellant is entitled to get Rs. 14,000/- from the respondent No. 1 as has been claimed by him.

ACCORDINGLY, this appeal is allowed. The impugned order dismissing the complaint is set aside. It is directed that the respondent No. 1 shall pay to the complainant/appellant Rs. 14,000/- (Rupees fourteen thousand) only with interest at the rate of 9% per annum thereon from the date of complaint. Appeal allowed.