Barkat Ali Zaidi, President—This is an appeal against an ex parte order. The District Forum (Central) in complaint case of the complainant awarded an amount of Rs.1,91,437 towards reimbursement of medical expenses with interest @ 9% payable from 28.11.2000 and a compensation of Rs. 5,000 litigation costs Rs. 3,000 in favour of the complainant and against the OP.

2. That is what brings the appellant OP Insurance Company herein appeal in this Commission.

3. Allegations of the complainant in the complaint are that he is the life insurance policy holder containing nine Critical Illness Benefits effective from 24.7.2003 to 24.7.2019 for a sum of Rs. 3,00,000. He suffered from heart attack on 11.11.2007 and was hospitalized wherefrom he was discharged on 16.11.2007 and he paid to St. Stephen Hospital, New Delhi Rs.1,91,437 for his treatment which he claimed to be reimbursed from the OP Insurance Company on basis of his policy, but the OP company on 28.11.2007 repudiated his claim informing that the illness for which he lodged Reimbursement Claim was not covered by the Critical Illness Benefit Rider provided in the insurance policy.

4. We have heard Mr. S.K. Chaddha, Counsel f