An insurance claim cannot be granted based solely on an estimate if the claimant fails to provide proof of actual expenditure or the required documentation to the insurer.

ORDER

M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

PLOT NO.76, ARERA HILLS, BHOPAL

FIRST APPEAL NO. 1393 OF 2017

(Arising out of order dated 29.06.2017 passed in C.C.No. 08/2017 by District Commission, Neemuch)

SUNIL KUMAR,

S/O SHRI KHYALILALJI GOPAWAT,

R/O BUNGLOW NO.35, NEEMUCH CANT,

DISTRICT-NEEMUCH (M.P.) … APPELLANT.

Versus

BRANCH MANAGER,

THE ORIENTAL INSURANCE CO.LTD.

BRANCH OFFICE-AMBEDKAR NAGAR,

NEEMUCH (M.P.) ... RESPONDENT.

BEFORE :

HON’BLE JUSTICE SUNITA YADAV : PRESIDENT

HON’BLE DR. MONIKA MALIK : MEMBER

COUNSEL FOR PARTIES :

Shri Nitin Jain, learned counsel for the appellant.

Shri Ravindra Tiwari, learned counsel for the respondent.

O R D E R

(Passed On 05.03.2026)

Per Say Justice Sunita Yadav, President:

The complainant/appellant has filed this appeal against the order dated 29.06.2017 passed by the District Consumer Disputes Redressal Commission, Neemuch (for short ‘District Commission) in C.C. No. 08/2017 whereby the complaint filed by the complainant/appellant has been dismissed.

Facts of the case in short as narrated by the complainant/appellant are that the complainant’s car bearing registration number MP-44 A-1677 was insured with the opposite party/respondent- insurance company for the period w.e.f. 08.10.2014 to 07.10.2015. On 27.01.2015 the subject vehicle on its way from Neemuch to Udaypur stopped due to fall of oil from the engine of which intimation was given to the insurance company. The insurance company appointed surveyor in the matter. It is submitted by the complainant that Hyundai Showroom Udaypur gave an estimate of Rs.1,41,860/- whereas the surveyor has assessed the loss to the extent of Rs.15,751/- and the insurance company denied to make payment of claim to the extent of Rs.1,41,860/-. The complainant therefore alleging deficiency in service on part of the insurance company filed a complaint before the District Commission seeking relief.

The opposite party-insurance company in its reply before the District Commission submitted that in the claim form the complainant has submitted that while going to Udaypur from Neemuch near Udaypur a stone hit the front glass of the car due to which the car became unbalanced and stroked by a stone at the side of the road, and the glass of the car and lower part of the car got damaged whereas in the legal notice given in the C.C.No.41/2015 it is mentioned that the car became unbalanced as one stone hit the front glass of the car and the car became unbalanced and stroked by a stone at the side of the road. The complainant did not give immediate notice of rebuttal and therefore assessment could not be made by the surveyor. The surveyor assessed the loss of Rs.15,751/- and the complainant is entitled to receive this much amount only. The complainant has filed this complaint by alleging unnecessary allegations, therefore, the complaint be dismissed.

The District Commission dismissed the complaint holding that the amount assessed by the surveyor cannot be said to be illegal as the complainant failed to prove that he spent the amount as per estimate in repairs.

Learned counsel for the complainant/appellant argued that the impugned order passed by the District Commission is perverse and against the settled principles of law. It is submitted that on 27.01.2015 a stone hit the front glass and the car became unbalanced and stroked with a stone resulting which the glass of the car and oil chamber got damaged. It is submitted that the complainant spent Rs.1,41,860/- in repairs and receipt was filed in the earlier complaint no.41/2015. In C.C.No.41/2015 the District Commission vide order dated 11.11.2016 directed the complainant to make available the documents to the insurance company and thereafter the insurance company to decide the claim within one month. Thereafter the complainant made available documents to the insurance company despite that the insurance company repudiated the claim and submitted that t