The negative attitude of the Insurance Companies in repudiating the claims, defeats the very purpose of the Law Makers drafting the Insurance Act: Karnataka State Consumer Disputes Redressal Commission

APPEAL No.955 2018 Date of Filing :26.06.2018 Date of Disposal : 26.10.2021 BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION BENGALURUHON’BLE Mr JUSTICE HULUVADI G RAMESH : PRESIDENT Mr K B SANGANNANAVAR: JUDICIAL MEMBER Mrs DIVYASHREE M:LADY MEMBER APPEAL NO.955 2018 M s United India Insurance Co. Ltd. Regional Office Krishi Bhavan 5th Floor Nrupathunga Road Near Hudson Circle Bengaluru 560001. Rep. by its Regional Manager By Mr Y K Sheshagiri Rao Advocate) Versus Mr B S Sathish S o Mr Shiva Kumar Major R at Bettadahalli village Gubbi Tq. Tumkuru District 572222 By Mr V B Siddaramaiah Advocate) Respondent Mr. JUSTICE HULUVADI G RAMESH : PRESIDENT This Appeal is filed under Section 15 of Consumer Protection Act 1986 aggrieved by the Order dated 28.05.2018 passed in Consumer Complaint No.85 2017 by District Consumer Disputes Redressal Forum Tumkuru (for short the District Forum). 2 APPEAL No.955 2018 The brief facts of the case are that the Complainant insured his Cow under Micro Insurance Product Cattle Insurance Policy bearing No.0714844716P107631819 with Ear Tag No. 136015 with the Sum Assured being Rs.50 000 valid till 10.08.2017 However when the Cow died on 29.05.2017 submitted a Claim to OP but OP Repudiated the claim on the ground that the Ear Tag on the Cow was not submitted. Hence Complainant lodged the instant Complaint under Section 12 of CP Act seeking direction to the OP to settle the Insurance Claim of Rs.50 000 with interest @ 18% p.a from the date of claim application till realisation Rs.50 000 towards mental agony torture and pain and cost. OP while contesting the case denied the allegation of the Complainant and pleaded that in the event of death of animals covered under their Insurance Policy scheme Claims if any shall be settled if only the Claim is received along with the surrender of Ear Tag. In the event of loss of Ear Tag it is the responsibility of the insured to give notice to the OP to get the animal tag. As per the Terms & Conditions of the Policy Complainant has not met this requirement and thus OP has not committed any deficiency in service as alleged and sought Dismissal of the Complaint. The District Forum after an enquiry deemed it fit to allow the Complaint and directed the OP to settle the Insured amount of Rs.50 000 along with interest at 9% p.a from the date of Claim till realisation with Cost of Rs.5 000 within 30 days from the Date of the Order. Aggrieved by the said Order OP is in Appeal taking a stand that as per Terms &Condition No. 8 of the Policy ‘no Tag no Claim’’ is not liable to admit the Claim of the ComplainAant and thus seeks to set aside the Impugned Order by allowing the Appeal. Heard the arguments of the Learned Counsel for the Appellant. None represented the Respondent. 3 APPEAL No.955 2018 Perused the Records & the Impugned Order. It is not in dispute that the Complainant insured his Cow under Micro Insurance Product Cattle Insurance Policy from OP vide Policy bearing No.0714844716P107631819 Ear Tag No. 136015 with Sum Assured of Rs.50 000 valid till 10.08.2017 and the Cow died due to ill health on 29.05.2017. The reasons for Repudiation of the Claim by OP was that the Ear Tag No.136014 was not submitted to honour the Claim. However OP has not disputed the PM Report nor the Death Certificate dated 01.06.2017 and in this regard OP has not taken any steps to investigate the matter. In the circumstances Death Certificate issued by Dr T Kanagaraj Veterinary Consultant Tumkur reveals the death of Cow and as on the date of death the Policy was in force and OP is liable to honour the Claim of the Complainant. Also when the Insurance Companies happily collects the premiums it should also take moral responsibility to resolve the grievances of its poor clients who with great difficulty pay the premiums with a fond hope that when there is an absolute crisis the Sum Assured in the Insurance Policy will come to their rescue. The negative attitude of the Insurance Companies in repudiating the claims defeats the very purpose of the Law Makers drafting the Insurance Act and its further fine tuning from time to time to reduce the grievance of the Insured. However with regard to rate of interest awarded at 9% p.a by the District Forum is concerned we are of the considered opinion that it is on higher side hence it is felt appropriate to reduce it to 6% p.a which would meet the ends of the justice and accordingly Impugned Order is modified in the following ORDER is allowed in part. Consequently Order dated 28.05.2018 passed in Consumer Complaint No.85 2017 by District Consumer Disputes Redressal Forum Tumkuru is hereby modified 4 APPEAL No.955 2018 and directed the OP to pay the Assured Sum of Rs.50 000 along with interest @ 6% p.a from the Date of Claim till realisation with cost of Rs.5 000 to the Respondent Complainant within 30 days from the date of receipt of this Order. The statutory Amount in deposit is ordered to be transferred to the District Commission for disbursement to the Complainant. Send a copy of this Order to the District Commission as well as to the parties concerned immediately. Lady Member Judicial Member President 

Summary: The Commission opined that, when Insurance Company collects premiums, it should also take responsibility to properly address the complaints of its poor clients, who pay the premiums with extreme difficulty in the hope that the Sum Assured in the Insurance Policy will rescue them in case of crisis. This was held in the matter of M/s United India Insurance Co. Ltd v. Mr. B S Sathish [ Appeal No. 955/2018] before Hon’ble President Mr. Justice Huluvadi G Ramesh. The brief facts of the case are as follows; the Complainant insured his Cow under the Micro Insurance Product Cattle Insurance Policy from the Opposite Party (OP).  Rs. 50,000 was insured till 10th August 2017. The Cow died on 29th May 2017. When he claimed the insurance, OP rejected his claim on the ground that the Ear Tag No. of the policy was not submitted by him, while not challenging the PM Report or the Death Certificate dated 1st June 2017.  The Death Certificate indicated that as on date of death , the Insurance Policy was still in effect. The District Commission allowed the Complaint for deficiency of service against the OP. Aggrieved by this decision, the OP sought an appeal before the State Commission claiming that the 8th Term&amp; Condition explicitly mentions the ‘No Tag No Claim’. After perusing the submissions of both the parties, the State Commission held that, “the Policy was in force and OP is liable to honor the Claim of the Complainant. Also, when the Insurance Companies happily collects the premiums, it should also take moral responsibility to resolve the grievances of its poor clients, who, with great difficulty pay the premiums, with a fond hope that when there is an absolute crisis, the Sum Assured in the Insurance Policy will come to their rescue. The negative attitude of the Insurance Companies in repudiating the claims, defeats the very purpose of the Law Makers drafting the Insurance Act and its further fine tuning from time to time, to reduce the grievance of the Insured. However, with regard to rate of interest awarded at 9% p.a by the District Forum is concerned, we are of the considered opinion that it is on higher side, hence, it is felt appropriate to reduce it to 6% p.a which would meet the ends of the justice and accordingly, Impugned Order is modified in the following terms.”