Insurers are not liable for losses arising from the insured's failure to follow operational guidelines; the burden of proof lies on the complainant to establish policy coverage.

1. The present complainant has been filed by a public limited company and prayed for direction to the opponent to pay the complainant the sum of Rs.82,97,446 towards reimbursement of loss suffered by it on account of machinery breakdown which was insured under the policy issued by the opponent and further prayed for interest @18 % from the date of loss. The complainant also claimed special compensation for alleged hardship, mental agony, harassment due to negligent attitude and indulgence of opponent in Unfair Trade Practice and cost of complaint.

2. It is stated in the complaint that the complainant is a Public Limited Company having its manufacturing plant at Survey No. 1453, Village Rajpur, Taluka: Kadi, Kadi - Mehsana Highway, North Gujarat, Pin: 382715. The complainant is engaged in manufacturing of papers of various kind including Map litho, News Print, Duplex Board, Cast Coated paper, Colour Paper, Fluorescent Paper, and Coated papers etc. The complainant company possess costliest machineries for the use of manufacturing activities and to indemnify the loss of accidental breakdown of machinery, insurance policy known as "Machinery Breakdown Insurance" availed from the opponent insurer on payment of necessary premium. The details of insurance policy are mentioned hereunder:

3. It is stated in the complaint that during the insurance period, on 5.10.2008, at about 1.56 a.m., the operator on duty, inadvertently supplied steam to Turbo Generator - 2 (10 MW) from the boiler at the pressure meant for 5 MW turbine (Turbo Generator - 1) which caused mechanical breakdown and stopped working and caused serious damage to Rotor of 10MW turbine. This was reported to opponent Insurance Company and therefore the opponent insurer deputed surveyor M/s. Mehta Padamasy Pvt. Ltd. The surveyor paid visit to the site and verified the loss and called upon the complainant company to provide documents to substantiate the loss. It is stated that this procedure took long time as surveyor had arranged series of tri - party meetings with supplier and complainant. The complainant finally submitted all necessary information to register the claim for loss of Rs.1,63,72,260 vide letter dt.22.8.2009 and submitted claim bill on 18.12.2009. However, the complainant then vide letter dated 4.1.2010 requested the opponent insurer to expedite the settlement of claim. However, the opponent insurer vide its letter dated 7.1.2010 communicated to the insured that the claim is not payable since cause of loss is not falling within the scope of the policy. The complainant thereafter, sought services of another IRDA approved licensed surveyor Mr. B G Bhatt & Co. The complainant states that the said surveyor B G Bhatt & Co. also visited site, examined various documents, and studied cause of loss and gave his report on 19.1.2010 to the effect that claim is admissible under the policy. The said surveyor however assessed loss to the extent of Rs.81,83,917 and charged Rs.1,11,028 towards survey fees. The complainant therefore, vide its letter dated 20.1.2010, lodged protest against arbitrary and unjustified repudiation made by the opponent insurer and also further informed that repudiation of claim is based on faulty or erroneous interpretation of so - called clause 5 of Policy and therefore it is not acceptable to the complainant. The complainant issued legal notice through advocate P S Gupta on 16.4.2010 and called upon the opponent insurer to settle the genuine claim of complainant. It is stated that copy of report of surveyor BG Bhatt was also supplied to the opponent insurer and requested to consider it and release the payment of claim. It is stated that at one point of time, the opponent insurer informed the complainant tha