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WEST BENGAL STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, CALCUTTA
Hon’ble Mr. Justice A.K. Bhattacharjee, President;
Prof. Sunil Kanti Kar & Mrs. Sikharini Dutta, Members
ORIENTAL INSURANCE COMPANY LTD.—Appellant
versus
KEDAR NATH SINGH—Respondent
S.C. Case No. 99/A of 1994—Decided on 24.1.1996
An insurance company cannot avoid liability based on misrepresentation and suppression of facts unless it is supported by cogent documents.
Headnote:
INSURANCE - CATTLE INSURANCE - MISREPRESENTATION AND SUPPRESSION OF FACTS - INSURANCE COMPANY'S LIABILITY - INSURANCE COMPANY CANNOT AVOID LIABILITY BASED ON MISREPRESENTATION AND SUPPRESSION OF FACTS UNLESS SUPPORTED BY COGENT DOCUMENTS - INSURANCE COMPANY LIABLE TO PAY CLAIM AMOUNT WITH INTEREST AND COMPENSATION FOR UNREASONABLE DELAY.
Fact of the Case:
The complainant took out an insurance policy for his cross-bred cow. During the subsistence of the policy, the cow fell ill and died. The complainant submitted a claim form and the insurance company appointed a surveyor who certified the genuineness of the claim. However, the insurance company denied the claim alleging misrepresentation and suppression of facts.
Finding of the Court:
The court found that the insurance company's allegations of misrepresentation and suppression of facts were baseless and without any reason. The court also found that the insurance company had unreasonably delayed in settling the claim.
Issues: Whether the insurance company can avoid liability based on misrepresentation and suppression of facts without supporting evidence.
Ratio Decidendi: The court held that the insurance company cannot avoid liability based on misrepresentation and suppression of facts unless it is supported by cogent documents. The court also held that the insurance company is liable to pay the claim amount with interest and compensation for unreasonable delay.
Final Decision: The court dismissed the appeal and awarded interest at the rate of 12% p.a. on the claim amount from July 1991 until payment, along with compensation of Rs. 1,000/- and costs of Rs. 200/- as awarded by the District Forum. The court also awarded costs of Rs. 500/- to the complainant.
Prof. Sunil Kanti Kar, Member—That the order dated 23.12.93 passed by the learned District Forum, Purulia has been assailed by this instant appeal.
2. By the said impugned order, the learned District Forum, Purulia award a sum of Rs. 7,000/- being the cost of the cattle which was insured under the policy and also awarded a sum of Rs. 1,000/- as compensation and cost of Rs. 250/-payableby the appellant within 15 days from the date of order.
3. The complainant/respondent took out an insurance policy being No. MIS/1380/90/ Cattle dated 6.12.90 valid for one year against payment of premium of Rs. 840/-.
4. During subsistence of the said insurance policy, cross breading cow fell ill on 18.12.90 and died on 21.12.90 at Talkalpara, Purulia. The insured submitted its claim form on 23.12.90 and the same has been annexed as Ext. 2. The Insurance Company appointed a Surveyor who submitted its report certifying that the claim of the complainant/respondent is to be genuine, that the said report has been marked as Ext. 3 before the learned District Forum, Purulia. The post mortem report and the certificate by Veterinary Surgeon have been marked as Exts. 4 and 5 respectively. From all the documents it has been established that the cow insured by the captioned policy died due to chronic hepatic fascioliasis, has been duly established by the complainant/respondent, the market value of the cow was Rs. 7,000/-.
5. The learned District Forum, Purulia considering the pros and cons of the matter awarded the aforesaid reliefs in favour of the complainant/respondent. The appellant/Insurance Company in its ground of appeal has challenged the said order of the learned District Forum, Purulia on the grounds inter a lia that the District Forum has misconceived the facts and circumstances of this case and the learned District Forum has failed to appreciate that the claim form submitted by the complainant/respondent represent various relevant facts and that the learned District Forum appreciated that the claim form submitted by the complainant/respondent bears untrue statement with regard to relevant facts and the learned District Forum failed to appreciate that the attendance, treatment and examination of the insured cow in question by the Veterinary Surgeon were most important with regard to claim in question and that the District Forum failed to appreciate the fact that neither any cash memo nor any prescription-nor any certificate was submitted in support of the contention of the complainant/respondent that the cow in question was treated, attended and examined on 17th, 20th and 21st December, 1990 by any Veterinary Surgeon as alleged that the District Forum, failed to appreciate that the prescription dated 17.12.90 relied on by the respondent does not bear any relevancy with regard to the alleged illness of the insured cow and that the learned District Forum failed to appreciate that nowhere in the certificate issued by veterinary surgeon it was mentioned the date, visit, treatment and examination and attendance of the cow and that the learned Forum failed to appreciate that the certificate issued by the Veterinary Surgeon does not bear cause of death for which it should be presumed that the Veterinary Surgeon did not examine the cow in question and that the learned District Forum failed to appreciate that the cow was suffering from chronic disease and by suppressing the fact, it disentitled respondent to any insurance benefit and that the Forum to appreciate that no prescription was disclosed by the opposite parties in support of the purported attendance, visits, examination and treatment of the cow in question by the Veterinary Surgeon and that the District Forum should dismiss the claim application of the opposite party, in view of the misrepresentation of the fact and stating untrue statement in the claim form and prayed for dismissal of the judgment dated 23.12.93 passed by the learned District Forum, Purulia.
6. From the grounds of appeal, it ap
