Insurers are obligated to act fairly in claim assessments, and claims under insurance policies cannot be dismissed solely based on survey reports lacking independence.

1. The present Consumer Complaint has been filed under S.12 of the Consumer Protection Act,1986 (for short "the Act") by M/s. HCC - CPPL JV (hereinafter referred to as the Complainant Company) against Opposite Party, i.e., ICICI Lombard General Insurance Co. Ltd. (hereinafter referred to as Opposite Party Insurance Company).

2. The brief facts of the case are that the Complainant Company is specialized in Canal Earthworks, Hydro Based Projects and Tunneling Projects. Government of Andhra Pradesh awarded a contract to the Complainant for executing the Vellgonda Tunnel Irrigation Project. The contract was awarded to the Complainant for Rs.7,35,21,00,000 and Agreement with the State Government was entered into on 21.6.2007. The contract value included the cost, transportation, storage, assembling, erection, commissioning and operation of Tunnel Boring Machine till the end of the completion of the Project. In response to quotations invited from various Insurance Companies to cover the Project under Contractor's All Risk (CAR) Insurance Policy, the Opposite Party - Insurance Company offered an All Risk Insurance Policy for the total cost of Project for Rs.7,35,21,00,000 for a premium of Rs.2,03,00,000, which was accepted by the Complainant Company. Accordingly, the Complainant Company obtained an Policy bearing No. 5004/00001335 dated 21.7.2007 valid from 3.7.2007 to 2.7.2012, i.e. for a period of 60 months, from the Opposite Party - Insurance Company after paying the entire premium of Rs.2,03,00,000 to the Opposite Party - Insurance Company. In terms of the Agreement dated 21.6.2007 entered between the Complainant and the Government of Andhra Pradesh, the Policy was lodged with the Irrigation Department. Later on one more set of Policy document bearing No. 5004/00003692 was received by the Complainant mentioning sum insured as Rs.311.72 crores and total premium was shown spread into 18 instalments amounting to Rs.2.47 Crore. It was assumed by the Complainant that this was an annexure to the main Policy, i.e., 5004/00001335, which was lodged with the Irrigation Department.

3. The Project was going on smoothly from 2007 till 2011 except minor problems but unfortunately, on 6.6.2011, head of the tunnel under construction collapsed due to geographical accident resulting into damage to the Tunnel Boring Machine (TBM) and loss to Insured Contract Works. Immediately the Complainant intimated the said loss to the Opposite Party Insurance Company and lodged a claim of Rs.35.70 crores. The Opposite Party - Insurance Company appointed M/s. Cunningham Lindsay International Pvt. Ltd., as Surveyor to assess the loss.

4. After survey, the Surveyor expressed in one of its communication that the loss was not due to accident and is not payable as per terms of the Policy. During the discussion with Surveyor it was revealed that the Surveyor has been assessing the loss in reference to Policy No. 5004/00003692 issued for suminsured as Rs.311.72 crores, whereas the Complainant has lodged the claim in respect of Policy bearing No. 5004/00001335 for total sum insured of Rs.735.21 Crore. Accordingly, the discrepancies were brought to the knowledge of the Opposite Party - Insurance Company. Consequently, vide email dated 4.4.2012, the Opposite Party - Insurance Company advised the Surveyor to assess the liability and quantum of claim under the main Policy, i.e., 5004/00001335. The Surveyor vide its Final Report dated 19.1.2013 recommended repudiation of the claim of the Complainant on the ground that no unforeseen physical loss or damage had occurred to the insured property. Based on the Surveyor's R