The insurer must settle valid insurance claims timely, and failure to substantiate claims can lead to repudiation; however, claimants must provide adequate documentation to support their claims.

JUDGMENT

DR.SUDHIR KUMAR JAIN, JNMLKJIHGFEDCBA

1. Briefly stated relevant facts of the case are that the complainant for the purpose of securing its stock of vehicle spare parts stored and kept at two warehouses situated at Delhi and Panipat, had taken a floater Standard Fire & Special Perils Policy since the year 2011 from opposite party no.l. The complainant for indemnification of any unforeseen perils and losses had been paying hefty amounts towards premium each year under the said policy. The stock kept in the premises of the complainant was hypothecated with Standard Chartered Bank which was duly informed to the Insurer. The complainant was never provided with the terms and conditions of the "Standard Fire and Special Perils Policy" obtained by the complainant. A devastating fire took place on 12.10.2013 at around 11:30 pm in the Panipat office/warehouse of the complainant on account of short circuit which caused huge loss to the stock and building of the warehouse and office. The documents maintained by the complainant and kept at the office cum warehouse were also burnt in the fire incident.

1.1 The complainant on 13.10.2013 informed the opposite party no 1/Oriental Insurance Company Limited about the fire incident. Subsequently FIR bearing NCR No. 621/2013 was lodged on 15.10.2013 with the Police Station Chandni Bagh, District Panipat, Haryana. The complainant submitted a claim form on 14.10.2013 whereby claimed Rs.6,97,37,720/- towards the loss of stock of spare parts stored by the complainant. The opposite parties 1 & 2 after receipt of claim form appointed M/s Atul Kapur and Company, Fore, LOP, Miscellaneous & Marine Surveyors/ the opposite party no 3 to assess the loss suffered by the complainant in the fire incident happened on 12.10.2013. The opposite party no 3 vide letter dated 28.11.2013 requested the complainant to submit requisite documents which were submitted by the complainant. The opposite party no 3 vide email dated 27.02.2014 acknowledged the receipt of documents/information from the complainant and also informed that the documents were under consideration. The complainant was also requested to provide copies of the purchase bills of the claimed items duly co-related with the claim bills and was informed that any other requirements, if any, would be intimated only after examination of the documents and receipt of the purchase bills from the complainant.

1.2 The Standard Chartered Bank vide letter dated 6.03.2014 informed opposite parties no. 1 & 2 that they maintained the account of the complainant as the complainant had availed a Channel Finance facility with the bank. The Standard Chartered Bank also informed that the account of the complainant has been classified as Non-Performing Asset and a sum of Rs.65,713,482.12 was outstanding in the account of the complainant. The opposite party no 3 vide email dated 12.03.2014 sent to opposite parties no. 1 & 2 whereby informed that they had received some documents from the insured and that the insurer was advised to keep the insurance claim estimated at a provisional reserve of Rs.600 lakhs subject to further verification. The opposite party no 3 as such vide email dated 12.03.2014 had prima facie made an estimate of Rs.600 lakhs which was the approximate value of the insurance claim made by the complainant.

1.3 The complainant sent another email dated 21.03.2014 to opposite parties no 1 & 2 wherein stated that all the docum