Insurance claims must be assessed justly, with surveyor reports not being conclusive and subject to scrutiny.

1. The present Consumer Complaint has been filed by the M/s Mehndiratta Foods Pvt. Ltd. (hereinafter referred to as the Complainant) under S.21(a) read with S.12 and S.13 of the Consumer Protection Act, 1986 (hereinafter referred to as the Act) against National Insurance Co. Ltd. (hereinafter referred to as the Opposite Party No.1 / Insurance Company / Insurer) and Nainital Bank Ltd. (hereinafter referred to as the Opposite Party No.2 / Bank) with main prayer to pay compensation, as claimed, along with other prayer.

2. The Complainant stated that they were carrying on the business of manufacturing and marking of chips, namkeen, etc. under the brand name of Rajmahal etc. The Bank / Opposite Party No.2 provided credit facility and secured loan facilities to the Complainant for carrying out its business and also, being an Agent of Insurance Company / Opposite Party No.1, helped provide an insurance coverage vide Standard Fire and Special Perils Policy (Earthquake, fire and Burglary) totaling Rs.7 crores for the period 13.5.2010 to 12.5.2011 issued by the Opposite Party No.1.

3. On 3.1.2011, a fire broke out in the factory of the Complainant and admittedly there was heavy damage to stocks i.e. raw materials and the packing materials, Building and Plant & Machinery resulting into huge loss. The Complainant after due intimation to the concerned, including the Insurance, Company filed a total claim of Rs.5,45,69,628 which includes claim against Plant and Machinery (Rs.71,94,231), Building (Rs.55,23,500) and Stock (Rs.4,18,51,897). The Insurance Company appointed the Surveyor i.e. Atul Kapur & Company, who gave its report dated 30.12.2011. It assessed the loss towards stocks at Rs.1,08,99,477, Plant & Machinery at Rs.57,14,810 and Building at Rs.18,71,025, totaling Rs.1,84,95,312. However, the Surveyor recommended loss of Stock only and disallowed the claim of Plant & Machinery and Building, on the ground that these were not covered in the Policy. The copy of the Surveyor Report was given to the Complainant on 26.04.2012. The Insurance Company based on the Surveyors Report allowed the claim for Rs.1,08,99,477 only as full and final settlement amount. It asked the Complainant to give its consent but the Complainant initially refused the same. The Complainant stated the Insurance Company threatened that if the consent was not given, they would repudiate the entire claim. On pressure, the Complainant gave the consent letter on 13.8.2012 and the payment was released on 11.9.2012.

4. The Complainant stated that the Coverage of Insurance was intended for stocks, Building and Plant & Machinery but the Policy did not have endorsement for Building, Plant & Machinery. In the earlier Policies for 2008-2009 & 2009-2010 taken from Opposite Party No.1 / Insurance Company, the policy papers indicated the risk coverage for stocks, Building and Plant & Machinery and, therefore, there were no reasons why the same should not have been intended for the relevant period 13.5.2010 to 12.5.2011. The Policy papers were always kept by the Opposite Party No. 2 / The Nainital Bank Limited and, therefore, the Complainant never had access to the same and did not instantly know about the same.

5. When the Complainants Director was in the Office of the Opposite Party No. 2 / Bank and after seeing the Policy papers, noticed that there was no endorsement for Building and Plant & Machinery, he wrote to the Bank on 20.5.2010 to get the said endorsement made by the Insurer. The Bank vide letter dated 22.5.2010 sent by courier on 4.6.2010 wrote to the Insurer to carry out endorsement in the policy indicating coverage towards (i) Raw Material Rs. 200 lakhs (ii) packing materials Rs. 200 La