PER DR. S.M. KANTIKAR, MEMBER 1. The Petitioner filed the present Revision Petition under Section 21(b) of the Consumer Protection Act 1986 against the order dated 28.11.2013 passed by the State Consumer Disputes Redressal Commission, (in short, tate Commission in FA/427/2013 whereby the State Commission allowed the Appeal filed by the Respondent No. 1 /Complainant . 2. Facts in brief relevant to dispose of this petition are ; The complainant Mrs. Kirti was advised diagnostic tests and surgery for symptoms of severe abdominal pain and menstrual problems. Accordingly, she underwent diagnostic Laparoscopy and Myomectomy at Ivy Hospital. As per policy conditions, prior to the admission a Cashless request was sent to the Petitioner company -Apollo Munich Health Insurance Co. Ltd (the OP-2). But, no avail came. Hence, the Complainant spent Rs.73,510/- on her treatment and thereafter lodged a claim with the OPs for payment of the said amount. However, OP No. 1 & 2 repudiated the claim on the ground that said ospitalization is related to treatment of infertility (Primary Infertility since 1 years) which is excluded from policy under standard exclusion under Section 6-e. 3. Therefore, alleging deficiency in service by OPs, who did not provide cashless facility, a complaint before the District Consumer Disputes Redressal Forum, (in short, istrict Forum was filed by the complainant. The District Forum dismissed the complaint. 4. Aggrieved by the order of District Forum, the complainant filed the first appeal before the State Commission. 5. The State Commission perused evidence, the medical records and concluded that, the OPs who repudiated the claim of Complainant are deficient in service, and held that, treatment for infertility, was not excluded from coverage of insurance policy issued to the complainant. The treatment taken by Complainant was for fibroid uterus and not for Primary Sterility. Hence, the State Commission allowed the appeal and directed the Petitioners/OPs 1 and 2 to pay Rs.73,510/- as compensation, plus Rs.20,000/- towards mental agony, along with Rs.10,000/- as costs to the complainant. 6. Against, the impugned order of State Commission, the OP-1 and 2 filed this revision. 7. We have heard the Counsel for the petitioner. He argued vehemently and denied of any deficiency in service by OPs and that the repudiation was correct, as per the terms and conditions of policy under exclusion clause. We have perused the hospital records, the policy and it terms and conditions. 8. The counsel for the OP/Petitioners stated that as per Section 6(e) (ix) of the Terms and Conditions of the policy, the treatment for nfertility was permanently excluded. He further contended that, the pre-authorization form for cashless facility was received on 28.02.2012 for the treatment of primary infertility, for 1 years with Provisional/Different Diagnosis of Fibroid Uterus from Ivy Super-Speciality Health Care, Mohali. The estimated cost was Rs.85,000/-. In the discharge summary, it mentions the diagnosis, as a) Primary Infertility b) Fibroid Uterus; hence the cashless authorization was specifically denied by OPs, as the claim was not payable 9. The evidence on record shows that the, complainant took a Mediclaim Policy, from the OPs, since 2009 and thereafter, it was being renewed, on yearly basis. The claim made by Complainant was during subsistence of this policy period from 24.12.2011 to 23.12.2012. The discharge summary of IVY Hospital clearly mentioned as follows: Diagnosis: A. Primary Infertility B. Fibroid Uterus Procedure: A. Diagnostic Laparoscopy proceed myomectomy done under GA on 01/03/12. Findings: Large posterior - superior fibroid uterus (9x10 cm) present in the post wall of uterus. Clinical Summary: A 35 years old non-diabetic, normotensive female patient presented with H/O heavy bleeding during menses and lower abdominal pain, and inability to conceive after 1 years of marriage. 10. No doubt the patient/complainant was diagnosed as a case of Primary Infertility, but she was also diagnosed as having fundal fibroid. The Ivy Hospital performed diagnostic laparoscopy and then myomectomy. This operation was necessary to control her symptoms of heavy menstrual bleeding and her abdominal pain. We are of the considered view that, removal of fibroid was an absolute necessity, for better health of patient. Fibroid is one of the causes of infertility, but many patients, may conceive, even in presence of fibroids. The analysis of the case reveals that the OP Company rejected the claim on the basis that the primary cause for the surgery was Primary Infertility. Hence, the repudiation of claim by the OPs, under exclusion clause Section 6(e)(ix) is just and arbitrary act. 11. Yet, the insurance companies usually attribute a reason for an ailment which would make it convenient for them to reject the claim. If a reason is attributed, the onus would lie on the insurance company to medically prove the correctness of its contention. The medical records, Ultrasound report and Discharge Card show that the Insured was treated for fibroid, which was presented with heavy menstrual bleeding and lower abdominal pain. She got admitted to the hospital due to sickness or emergency health problems, not for Primary infertility. Therefore, insurance companies cannot just assume a reason, for an ailment, according to its own convenience, and / or whims and fancies. 12. On the basis of forgoing discussion, we find no error or any illegality in the order passed by the State Commission. We dismiss this revision petition with a punitive costs of Rs.25,000/- which the Petitioners, will pay to Mrs. Kirti within 90 days, from the receipt of this order, otherwise it will carry 9% interest, till it realization .