ORDER :

Mrs. Salma Noor, Member-Present appeal is preferred against the order dated 28.2.2014 passed by the learned District Consumer Disputes Redressal Forum, Janakpuri, in complaint case No. 657/2011 whereby the complaint of the respondent/complainant has been allowed.

2. Briefly stated case of the respondent/complainant before the learned District Forum was that she was holder of a “Varistha Medical Policy” No. 361801/48/10/8500005034 for the period 25.1.2011 to 24.1.2012 and the total sum assured was Rs. 3 lacs, consisting of Rs. 1 lac towards coverage of hospitalization and Rs. 2 lacs coverage towards critical illness. The policy was designed to cater to the needs of senior citizens. It was stated that Coronary Artery Surgery was covered under the critical illness. Besides Hospitalization Benefits were also covered which included cost of pacemaker along with other allied hospital/medical treatment expenses e.g. Room Boarding expenses, Nursing Home fees of Surgeon. It was stated that on 13.8.2012 respondent/complainant had undergone Coronary Artery Surgery on the advice of Dr. Anshul Jain, Cardiologist at Action Medical Institute, Paschim Vihar, New Delhi. The total medical bill