Back
KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Valsala Sarangadharan and S. Chandra Mohan Nair, Members
NATIONAL INSURANCE CO. LTD. - Appellant
Versus
V. SASIKUMAR AND ANR. - Respondents
Appeal Nos. 892 and 1013 of 2003
Decided on : 27-05-2008
Mr. M. Nizamudeen, Advocate, for the Appellant; Mr. G.S. Prakash, Advocate, for the Respondent
The duty of the doctor to file a report convincing himself of the fact whether the cow is pregnant or not, and the liability of the insurance company for the payment due to the doctor's negligence in filing a report.
Headnote:
Insurance - Claim Dispute - Kerala Consumer Protection Act, 1986 - Section 14(1)(d) - Section 21(1) - Section 21(2) - Section 21(3) - Section 21(4) - Section 21(5) - Section 21(6) - Section 21(7) - Section 21(8) - Section 21(9) - Section 21(10) - Section 21(11) - Section 21(12) - Section 21(13) - Section 21(14) - Section 21(15) - The court discussed the provisions of the Kerala Consumer Protection Act, 1986, particularly Section 14(1)(d) and Section 21(1) to Section 21(15) in relation to the claim dispute. The court emphasized the duty of the doctor to file a report convincing himself of the fact whether the cow is pregnant or not, and held that the doctor had not taken proper care in examining the cow, leading to the insurance company's liability for the payment. The court also agreed with the findings of the Forum below that the complainant had to incur expenses in feeding the cow which was not pregnant, thereby incurring a huge loss. The court confirmed the order directing the 1st opposite party to pay the awarded amount with costs.
Fact of the Case:
The complainant purchased two milch cows after availing a loan and insured one of the cows with the 1st opposite party. The cow was reported to be pregnant, but a later report found it was not. The complainant filed a complaint claiming expenses for maintaining the cow and compensation.
Finding of the Court:
The court found that the cow was not pregnant at any point in time and held the insurance company liable for the payment due to the doctor's negligence in filing a report. The court also confirmed the awarded amount with costs.
Issues: Dispute over the pregnancy status of the insured cow, liability of the insurance company, and the complainant's claim for expenses and compensation.
Ratio Decidendi: The duty of the doctor to file a report convincing himself of the fact whether the cow is pregnant or not, and the liability of the insurance company for the payment due to the doctor's negligence in filing a report.
Final Decision: Both the appeals were dismissed, confirming the order of the lower Forum. The 1st opposite party was directed to pay the awarded amounts within one month from the date of the order, failing which interest would be applicable.
ORDER
S. Chandra Mohan Nair, Member - The above appeals arise out of the order dated 6.10.2003 passed by the CDRF, Thiruvananthapuram in OP No. 401/01 wherein and whereby the 1st opposite party is directed to pay to the complainant a sum of Rs. 7,500 as compensation and Rs. 1,000 as cost. However dissatisfied by the order the complainant has come up in Appeal 1013/03 and the 1st opposite party is the appellant 892/03.
2. The case of the complainant before the Forum was that he had purchased two milch cows after availing a loan of Rs. 25,000 from the Backward Classes Development Corporation, Thiruvananthapuram, under its employment programme for a dairy unit. One of the cows was insured with the 1st opposite party/appellant in Appeal 892/03. Though the cow was inseminated it did not become pregnant and as per the directions of the doctor, the 1st opposite party was informed. The 1st opposite party deputed a veterinary doctor to examine the cow and the doctor filed report stating that the cow was 7- 8 months pregnant. It was on the basis of the report that the complainant's claim was repudiated. Later the complainant obtained a certificate from a Senior Veterinary Surgeon who found that the cow was not pregnant and when the complainant insisted for the claim, the 1st opposite party sent the earlier Veterinary Surgeon who is the 2nd opposite party for a second examination. However, after the second examination the 2nd opposite party filed a report stating that the cow was not pregnant and as such the company allowed a sum of Rs. 9,000 on 27.6.2001. The complainant was not satisfied by the low amount of payment since he had to incur Rs. 120 per day for feeding the cow which was actually not pregnant and hence the complaint was filed claiming Rs. 43,200 as expenses for maintaining the cow and Rs. 5,000 as compensation along with cost. A sum of Rs. 5,000 was prayed as compensation against the 2nd opposite party also.
3. The 1st opposite party filed version contending that it was on the basis of the opinion of the second opposite party that the claim was repudiated at the 1st instance. However on the basis of the second report by the 2nd opposite party, the claim was settled for a sum of Rs. 9,000. The 1st opposite party raised the further contention that the complaint was not maintainable as the complainant had received the claim amount as full and final settlement and hence he could not be allowed to raise a further claim on the settled amount. It was also the case of the 1st opposite party that there was no negligence or deficiency of service on their part since they have paid the amount at the earliest stage on the 2nd report of the 2nd opposite party and prayed for the dismissal of the complaint.
4. The 2nd opposite party also filed a version stating that the cow seemed to be 7-8 months pregnant during his first visit and it was presumed that the cow was pregnant as no advance technologies like x-ray or scanning could be made applicable to animals. However, on the second inspection it was found that the cow was not pregnant and as such the second report was filed stating that the cow was not pregnant.
5. The evidence consisted of Exts. P1 to P17 and oral testimony of the 2nd opposite party as DW1 and documents Dl to D7.
6. We heard the appellant in appeal No. 892/03 who argued his case based on the contentions raised in the version and the grounds urged in the memorandum of the present appeal. He vehemently submitted before us that, there was no negligence or deficiency of service on the part of the appellant/Insurance Company as the claim was repudiated at the 1st instance on the basis of the report filed by the 2nd opposite party/2nd respondent. It is his further contention that as soon as the 2nd opposite party filed his report on 16.4.2001 the claim was processed and an amount of Rs. 9,000 which was the eligible amount, was paid on 27.6.2001 itself and hence there was no deficiency on their part. The complainant's contentions that
