KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD THIRUVANANTHAPURAM APPEAL NO.579/09 JUDGMENT DATED 6.1.2010 PRESENT JUSTICE SHRI.K.R.UDAYABHANU -- PRESIDENT SHRI.M.K.ABDULLA SONA -- MEMBER 1. The New India Assurance Co.Ltd. Public Sector Branch, Palayam, Trivandrum. 2. The Branch Manager, -- APPELLANTS New India Assurance Company Ltd., Changayil Buildings Pathanamthitta. (By Adv.Sreevaraham G.Satheesh) Vs. M.C.Thomas Mulavelil House, Pariyarathumala, -- RESPONDENT Thukalassery, Thiruvalla. JUDGMENT JUSTICE SHRI.K.R.UDAYABHANU,PRESIDENT The appellant is the opposite party/Insurance Company in CC.19/06 in the file of CDRF, Pathanamthitta. The appellant is under orders to pay a sum of Rs.1,35,000/- towards the medical expenses with interest at 8% from the date of complaint and Rs.5000/- as compensation and 2,000/- as costs. 2. Complainant has claimed reimbursement of medical expenses for the treatment undergone during the period of coverage of Pravasi Suraksha Policy. He underwent surgery in the St. Gregorious Cardio Vascular Centre. He claimed a sum of Rs.1,35,000/-. The opposite party repudiated the claim on the ground that the illness was pre-existing. 3. The evidence adduced consisted of the testimony of Ext.PW1, DW1 and Exts.A1 to A3. 4. We find that the opposite party appellant has not adduced any positive evidence to establish the fact that the deceased was pre-existing. There is nothing on record to establish that the illness was pre-existing. 5. The counsel for the appellant has pointed out that the Kudumha Arogy scheme is a part of the policy and covered only Rs.1 lakh per individual towards medical expenses. We find that the same is specified in Ext.A1 copy of the policy. The same was not brought to the notice of the Forum. In the circumstances, the order of the forum is modified to the effect that the amount liable to paid is to Rs.1 lakh and interest at 8 % from the date of complaint and also compensation of Rs.5000/- and cost of Rs.2000/-. The rest of the directions of the Forum is sustained. The appeal is allowed in part as above. JUSTICE K.R.UDAYABHANU -- PRESIDENT M.K.ABDULLA SONA -- MEMBER | 
