Heard learned counsel for both the parties.

2.              This appeal is  filed  U/S-15 of erstwhile  Consumer Protection Act,1986(herein-after called the Act). Hereinafter, the parties to this appeal shall be referred to  with reference to their respective status before the learned District Forum.

3.                      The case of the complainant, in nutshell is that the husband of the complainant has purchased a policy for sum assured of Rs.1,00,000/- on 13.03.2010 from OP. It is alleged inter-alia that on 02.09.2011 the complainant’s husband died in his residence at Phulbani. Thereafter the complainant being the nominee filed this case  due to non-payment of  assured amount. Finding no other way, the complaint was filed.

4.                  Per contra, the OP filed joint written version stating that the policy holder has defaulted the premium from  June,2010 to March,2011 due to his illness. But the OP revived the policy on the submission of the policy holder that he has good health. The OP took the plea that on 28.06.2011 the policy holder was admitted in the hospital although his death took place  on 02.09.2011. The further plea of the OP is that the policy holder has suppressed his decease for which the claim was repudiated.

5.                   After hearing both the parties, learned District Forum passed the following order:-

                  “   In the above circumstances, the complaint filed by the complainant is allowed. The O.Ps are jointly and severally liable to pay the death claim of the policy holder to the nominee, the complainant of this case. Accordingly the OP No.1 on behalf of all the Ops is directed to pay Rs.1,00,000/- the sum assured under the relevant policy alongwith other admissible benefit if any as per provision to the complainant the nominee of the deceased with 10% annual interest from the date of death of the policy holder it is on 09.09.2011 till the date of payment. The Ops are further directed to comply the said order within 30 days from the date of receipt of this order otherwise the complainant shall be entitled to get 12% annum interest from 02.09.2011 till the date of payment.”

6.             Learned counsel for the appellant submitted that learned District Forum has committed error in law by not going through the written version filed by the Ops. According to him the complainant has suppressed the material fact and the policy holder has suppressed the pre-existing deceases for which the claim was repudiated. Learned  District Forum has failed to appreciate the material on record with proper perspective. So, he submitted to allow the appeal by setting aside the impugned order.

7.               Learned counsel for the respondent submitted that the Ops have miserably failed  to produce the material in support of their submission. So, he submitted that the impugned order is correct and legal and said order should be upheld.

8.              Considered the submission of both the parties, perused the DFR and impugned order.

9.                       No doubt the complainant  is required to prove the deficiency of service on the part of the OP but it is well settled in law in Mithoolal Nayak-Vrs-LIC of India in 1962 AIR-814 that the OP taking plea of pre-existing deceases has to prove the plea U/S-45 of the Insurance Act. The DFR does not disclose  about medical report proved by the appellant in support of their submission like suppression of pre-existing diseases by the policy holder. On the otherhand the complainant  has examined herself and filed the documents which do not show the complainant was in coma stage and she is not  able to explain the facts.  The complainant has already filed the documents. Learned counsel for the appellant  after short visit of the Section-14 of the Act because the learned District Forum has directed the OP to comply the order from the date of impugned order passed.    Since, the OP failed to prove the pre-existing diseases, this Commission is fully agree  with the view of the learned District Forum and as such the impugned order is confirmed. Appeal stands dismissed. No cost.

           Free copy of the order be supplied to the respective parties or they may download same from the confonet  or webtsite of this  Commission to treat same as copy of order received from this Commission.    

           DFR be sent back forthwith.