Order by:

Sh.Amrinder Singh Sidhu, President

1.       The complainant  has filed the instant complaint under section 35 of the Consumer Protection Act, 2019  on the allegations that the Complainant just to run her house and just to give the helping hand to her husband and to earn their livelihood for her family, had purchased two buffalos from Baljinder Singh and at the time of purchasing the buffalos, they were healthy and in this regard, the health certificate issued by Dr.Anil Kumar Gupta, B.V.Sc & A.H. (PB0 is attached. Further  alleges that after purchasing the buffalos, the complainant availed the loan from Bank of India, Dala Brach and then insured the buffalos with Opposite Parties by paying Rs.6726/- as premium vide Customer ID as P076523419 against policy No.3611004719500000031 valid for the period w.e.f. 21.12.2019 to 20.12.2020 and accordingly, the Opposite Parties issued identification Tag numbers to buffalos as 982126058498696 and 982126058498697. Further alleges that in  the first week of April, 2020 one buffalo fell ill and suffered with constipation and at that time due to Covid-19 the curfew and lockdown was imposed by the government throughout the country and the complainant contacted the doctor to get the medical treatment, but no one was ready to come and give the treatment  to the ill buffalo. The complainant also informed the bank as well as Opposite Parties-Insurance Company regarding the illness of the insured buffalo. Ultimately, the buffalo died on 14.04.2020 and after the death of insured buffalo the complainant informed the Manager/ Concerned person of Bank of India as well as to Opposite Parties-Insurance Company so that they may fulfill the necessary requirement and to get the post mortem of the deceased buffalo, but they showed their inability to come and to get the post mortem conducted due to Covid-19. In the evening, the body of the insured buffalo started spaceflight and thereafter the complainant informed the Panchayat members of the village regarding the whole matter and the panchayat members came to the house of the complainant  and when they seen that there is possibility of spreading the disease, then the member panchayat under their supervision, sent the dead buffalo to Hadd Rori (dump yard for dead animals) and at that time,  the panchayat members also clicked photographs of dead buffalo which shows that the whole proceedings were done under the  supervision of the village Panchayat and the village panchayat also passed a resolution in this regard on the letter head of the panchayat. Thereafter, the complainant filed a claim of the dead buffalo with the Opposite Parties-Insurance Company and completed all the formalities, but the Opposite Parties-Insurance Company refused to admit the rightful claim of the complainant and                did not pay any heed to the genuine request of the Complainant. In this way, said conduct of the Opposite Parties clearly amounts to deficiency in service and as such, the Complainant is left with no other alternative but to file the present complaint.  Vide instant complaint, the complainant has sought the following reliefs.

a)       Opposite Parties may be directed to pay the insured amount of Rs.71,000/- of dead insured and also to pay Rs.15,000/- as compensation on account of mental tension, physical harassment  or any other relief to which this District Consumer Commission may deem fit be also granted.

2.       Opposite Parties  appeared through counsel and contested the complaint by filing  the written version  on the ground inter alia that the complaint is not maintainable; that there is no deficiency in service on the part of the Opposite Parties and that the complaint is absolutely false and frivolous.  The complainant lodged the claim with the Opposite Parties-Insurance Company regarding the death of buffalo and they immediately on receipt of the claim, registered and processed the same. Mr.Piara Singh, Surveyor and Loss Assessor was deputed for investigation and he investigated the matte and submitted his report dated 08.09.2020 alongwith documents. In his report, the surveyor concluded that in the absence of post mortem report and chip, it could not be proved that buffalo is the same which is insured by the Opposite Parties-Insurance Company/ loaned by the bank. After receipt of the investigation report alongwith documents, the claim file of  the complainant was duly scrutinised in terms of insurance policy and after applying the mind by the Opposite Parties-Insurance Company, the claim of the complainant was found not payable as per the terms and conditions of the policy and same was repudiated vide letter dated 18.09.2020.   On merits, the Opposite Parties took up almost the same and similar pleas as taken up by them in the preliminary objections. Remaining facts mentioned in the complaint are also denied and a prayer for dismissal of the complaint was made.

3.       In order to  prove  her  case, the complainant has tendered into evidence her affidavit Ex.C1  alongwith copies of documents Ex.C2 to Ex.C6 and closed his evidence.

4.       On the other hand,  to rebut the evidence of the complainant,  Opposite Parties tendered into evidence affidavit of Smt.Sunita Mahajan Ex.Ops1/A  alongwith copies of documents Ex.Ops1 to Ex.Ops20 and closed the evidence on behalf of the Opposite Parties.

5.       We have heard the ld.counsel for the parties, perused the written submissions filed by the Opposite Parties and  gone through the documents placed  on record.

6.       During the course of arguments, ld.counsel for the Complainant has  mainly reiterated the facts as narrated in the complaint and  contended that  the written version  filed on behalf of Opposite Party  has not been filed by an authorized person. Therefore, the written version so filed is not maintainable. Opposite Party  is limited Company and written version has been filed on the basis of special power of attorney given  to ld.counsel for the Opposite Party.  Further contended that the Complainant just to run her house and just to give the helping hand to her husband and to earn their livelihood for her family, had purchased two buffalos from Baljinder Singh and at the time of purchasing the buffalos, they were healthy and in this regard, the health certificate issued by Dr.Anil Kumar Gupta, B.V.Sc & A.H. (PB0 is attached. Further  alleges that after purchasing the buffalos, the complainant availed the loan from Bank of India, Dala Branch and then insured the buffalos with Opposite Parties by paying Rs.6726/- as premium vide Customer ID as P076523419 against policy No.3611004719500000031 valid for the period w.e.f. 21.12.2019 to 20.12.2020 and accordingly, the Opposite Parties issued identification Tag numbers to buffalos as 982126058498696 and 982126058498697. Further alleges that in  the first week of April, 2020 one buffalo fell ill and suffered with constipation and at that time due to Covid-19 the curfew and lockdown was imposed by the government throughout the country and the complainant contacted the doctor to get the medical treatment, but no one was ready to come and give the treatment  to the ill buffalo. The complainant also informed the bank as well as Opposite Parties-Insurance Company regarding the illness of the insured buffalo. Ultimately, the buffalo died on 14.04.2020 and after the death of insured buffalo the complainant informed the Manager/ Concerned person of Bank of India as well as to Opposite Parties-Insurance Company so that they may fulfill the necessary requirement and to get the post mortem of the deceased buffalo, but they showed their inability to come and to get the post mortem conducted due to Covid-19. In the evening, the body of the insured buffalo started spaceflight and thereafter the complainant informed the Panchayat members of the village regarding the whole matter and the panchayat members came to the house of the complainant  and when they seen that there is possibility of spreading the disease, then the member panchayat under their supervision, sent the dead buffalo to Hadd Rori (dump yard for dead animals) and at that time,  the panchayat members also clicked photographs of dead buffalo which shows that the whole proceedings were done under the  supervision of the village Panchayat and the village panchayat also passed a resolution in this regard on the letter head of the panchayat. Thereafter, the complainant filed a claim of the dead buffalo with the Opposite Parties-Insurance Company and completed all the formalities, but the Opposite Parties-Insurance Company refused to admit the rightful claim of the complainant and  did not pay any heed to the genuine request of the Complainant. In this way, said conduct of the Opposite Parties clearly amounts to deficiency in service.

7.       On the other hand, ld.counsel for the Opposite Parties  has repelled the aforesaid contention of the ld.counsel for the complainant  on the ground that admittedly, the  complainant lodged the claim with the Opposite Parties-Insurance Company regarding the death of buffalo and they immediately on receipt of the claim, registered and processed the same. Mr.Piara Singh, Surveyor and Loss Assessor was deputed for investigation and he investigated the matte and submitted his report dated 08.09.2020 alongwith documents. In his report, the surveyor concluded that in the absence of post mortem report and chip, it could not be proved that buffalo is the same which is insured by the Opposite Parties-Insurance Company/ loaned by the bank. After receipt of the investigation report alongwith documents, the claim file of  the complainant was duly scrutinised in terms of insurance policy and after applying the mind by the Opposite Parties-Insurance Company, the claim of the complainant was found not payable as per the terms and conditions of the policy and same was repudiated vide letter dated 18.09.2020. 

8.       Perusal of the contention of the ld.counsel for the complainant   shows  that  the written version  filed on behalf of Opposite Party has not been filed by an authorized person. Therefore, the written version so filed is not maintainable. The Opposite Party  is limited Company and written version has been filed on the basis of special power of attorney given  to ld.counsel for the Opposite Party.  In this regard, Hon’ble Supreme Court of India in case titled as Shubh  Shanti  Services  Limited  v.  Manjula S.Agarwalla and others (2005) 5 SCC 30, decided on 11.05.2005 has  and observed to the following effect:

 “..............As already stated, it has not been  averred in the plaint nor sought to be proved that  any resolution had been passed by the Board of  Directors  of  the  plaintiff  company  authorising  Shri A.K. Shukla to sign, verify and institute the  suit.   It  has  also  not  been  averred  that  the  memorandum/articles of the plaintiff company give ny right to Shri A.K. Shukla to sign, verify and  institute  a  suit  on  behalf  of  the  plaintiff  company.  It, therefore, follows that the plaint  has been instituted by Shri A.K. Shukla only on  the  authority  of  Sh.  Raj  K.Shukla,  CEO  of  the  plaintiff  company.   Such  an  authority  is  not  recognized under law and, therefore, I held that  the  plaint  has  not  been  instituted  by  an  authorised  person.   Issue  No.1  is  accordingly,  decided against the plaintiff and in favour of the  defendants.”

Further,  Hon’ble Supreme Court of India in a judgment (2011)II Supreme Court Cases 524 titled as “State Bank of Travancore Vs. Kingston Computers India Pvt. Ltd.” and in para no.11 of the judgment,  has held that

“the plaint was not instituted by an authorized person. On the plea that one authority letter dated 02.01.2003 was issued by Sh. R.K.Shukla in favour of Sh. A.K.Shukla. Further plaint failed to place on record its memorandum/articles to show that Sh. R.k.Shukla has been vested with the powers or had been given a general power of attorney on behalf of the Company to sign, verify and institute the suit on behalf of the Company.”

Recently Hon’ble State Consumer Disputes Redressal Commission, Punjab at  Chandigarh in FAO No.1235 of 2015 decided on 25.01.2017 in case titled as L.G.Electronics India Private Limited Vs. Sita Ram Chaudhary also held that the plaint instituted by  an unauthorized person has no legal effect.

9.       For the sake of arguments, for the time being, if the written reply filed by Opposite Party is presumed to be correct, the next  plea  raised by the complainant is that  it is not disputed that as per the insurance policy bearing No.36110047195100000031 valid w.e.f. 21.12.2019 to 20.12.2020 only two buffalos bearing tag Nos.982126058498696 and 982126058498697 were insured with the Opposite Parties-Insurance Company and out of which, one buffalo bearing tag no. 982126058498696  had died on 14.04.2020. It is not disputed that after the death of insured buffalo 14.04.2020, the complainant immediately informed the Opposite Parties-Insurance Company as well as  to the Bank from whom the complainant availed the loan, but due to Covid-19  and  curfew/ lockdown by the government throughout the country, no body bothered from the Opposite Parties-Insurance Company for conducting the post mortem and however, in such a circumstances, in the evening, the body of the insured buffalo started spaceflight and thereafter the complainant informed the Panchayat members of the village regarding the whole matter and the panchayat members came to the house of the complainant  and when they seen that there is possibility of spreading the disease, then the member panchayat under their supervision, sent the dead buffalo to Hadd Rori (dump yard for dead animals) and at that time,  the panchayat members also clicked photographs of dead buffalo which shows that the whole proceedings were done under the  supervision of the village Panchayat and the village panchayat also passed a resolution in this regard on the letter head of the panchayat.  Hence, we are of the view that there is no fault on the part of the complainant for non performing the post mortem of the dead  insured buffalo because  to avoid the possibility of spreading the disease, then the member panchayat under their supervision, sent the dead buffalo to Hadd Rori (dump yard for dead animals), more-so in the Covid-19 days when all over world, there was terror of spreading of Covid-19 disease. Moreover, it is not disputed that immediately after  the death of the insured buffallo, the complainant informed the Opposite Parties on the same moment, but due to the fear of Covid-19, nobody bothered to conduct the post mortem of the dead insured buffalo.  In this way,  the Opposite Parties-Insurance Company did not take any action on the intimation of the complainant for conducting the post mortem on the dead buffalo in time as prescribed by IRDAI in the notification under head “15. Claim Procedure in respect of a general insurance policy.” And the Opposite Parties-Insurance Company has failed to explain the satisfactory explanation/ reason of said non performance of post mortem on the dead buffalo and due to the said reason in settling the claim, the complainant has faced litigation and as such, we hold that it is a case of ‘negligence’ and ‘deficiency in service’ and ‘unfair trade practice’ on the part of Opposite Parties-Insurance Company in not conducting the post mortem and by not settling the claim of the complainant for such a long time without any sufficient reason and rhyme and as such, the Opposite Parties-Insurance Company is held liable to pay interest thereon as well as compensation to the complainant.  

10.     Further more,  as referred above, Mr.Piara Singh, Surveyor and Loss Assessor has  submitted his report dated 08.09.2020 alongwith document and concluded that in the absence of post mortem report and chip, it could not be proved that buffalo is the same which is insured by the Opposite Parties-Insurance Company/ loaned by the bank. On the other hand, to avoid the  spreading of the disease, the body of the insured buffalo was disposed of under the supervision of Panchayat Memners and at that time, the panchayat members also clicked photographs of dead buffalo which shows that the whole proceedings were done under the  supervision of the village Panchayat and the village panchayat also passed a resolution in this regard on the letter head of the panchayat. In this regard, we support the law laid down by Hon’ble National Commission in case of New India Insurance Co. Ltd. Vs. State of Haryana 2008 (2) CPJ 371, TPD Gram Sewa Sehkari Samiti Ltd. Vs. Charanjit Kaur 2011 (4) CPJ 390, United India Insurance Co. Ltd. Vs. Palamreddy Aruna 2007 (4) CPJ 389, LIC Vs. Smt.Nidhi Sahi 2005 (1) CPC 533 and this Commission in case of National Insurance Co. Ltd. Vs. Jaswinder Kaur in F.A.No.323 of 2017 decided on 09.08.2017, and also in case Reliance Life Insurance Co. Ltd. Vs. Surjeet Singh in F.A.No.71 of 2017 decided on 20.09.2017, wherein it is held that in the absence of FIR or post mortem report the factum of death in a particular way can be produced other evidence.    

11.     In such a situation the repudiation made by the Opposite Party-Insurance Company regarding genuine claim of the complainant have been made without application of mind. It is usual with the insurance company to show all types of green pasters to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.  The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

12.     In view of the above discussion, we hold that the Opposite Party-Insurance Company have wrongly and illegally rejected the claim of the complainant. Resultantly, the instant complaint is allowed and the Opposite Parties are directed to pay the insured amount of Rs.71,000/- (Rupees seventy one thousands only) of dead buffalo  bearing tag No. 982126058498696, to the complainant  alongwith interest @8 % per annum from the date of filing the present complaint i.e. 20.10.2020 till its actual realization. Opposite Parties are also directed to pay the lump sum compensation to the complainant to the tune of Rs.10,000/- (ten thousands only) on account of harassment, mental tension  and litigation expenses. Copies of the order be furnished to the parties free of cost. File be consigned to record room after compliance.

13.     Reason for delay in deciding the complaint.

          This complaint could not be decided within the prescribed period because the State Government has not appointed any of the Whole Time Members in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.

Announced in Open Commission.

Dated:28.03.2022.