ORDER

(Per: Ms. Kumkum Rani, President):

This appeal has been directed against the impugned judgment and order dated 26.04.2022 passed by learned District Consumer Disputes Redressal Commission, Haridwar (hereinafter to be referred as “The District Commission”) in consumer complaint No. 376 of 2017, styled as Sh. Ashok Tyagi Vs. PNB Metlife Insurance Company Limited and others, wherein and whereby the consumer complaint was allowed and the appellant / opposite party No. 1 (insurance company) was directed to pay to respondent No. 1 / complainant, an amount of Rs. 10,00,000/-, the insured amount of the policy held by his deceased wife – late Smt. Megha Tyagi together with interest @6% p.a. from the date of filing of the consumer complaint, i.e., 29.12.2017 till payment, besides to pay Rs. 5,000/- towards counsel fee & litigation expenses and Rs. 5,000/- towards mental, physical & financial agony. The consumer complaint was dismissed against respondent Nos. 2 & 3 / opposite party Nos. 2 & 3.

2. The facts giving rise to the present appeal, in brief, are, as such that respondent No. 1 / complainant and his wife late Smt. Megha Tyagi were having a Savings Bank Account with respondent No. 2 – Punjab National Bank, Civil Lines, Roorkee. The agent of the appellant / opposite party No. 1 (insurance company) that a plan has been launched by the insurance company for providing coverage against illness to the accountholders of Punjab National Bank. During her lifetime, on 08.02.2016, late Smt. Megha Tyagi had obtained an insurance policy from the insurance company through bank known as MetLife Major Illness Premium Back Cover bearing policy No. 21807461 for a term of 10 years’ on payment of premium amount of Rs. 5,725.68/-. Under the aforesaid policy, total 35 illnesses including heart ailment were covered. On 26.06.2016, the deceased life assured felt heaviness in chest; vomiting and dizziness, whereupon she got herself treated by Dr. Ajay Panwar of Matrachhaya Hospital, Roorkee. The deceased life assured underwent ECG, which was not normal. After consuming prescribed medicines for two days’, the deceased life assured did not get any relief. Thereafter, on 29.06.2016, the deceased life assured visited Dr. Ajay Bhargava, Roorkee, who also told that the deceased life assured is suffering from heart ailment and again conducted ECG, report whereof was also abnormal. The deceased life assured was asked to come on 30.06.2016, on which date, the medicines were repeated and the deceased life assured was directed to come on 04.07.2016 and 07.07.2016 respectively. On 08.07.2016, the deceased life assured was got admitted in the hospital. The deceased life assured was discharged on 10.07.2016, on her condition being improved and she was prescribed medicine for three days’. The deceased life assured remained under treatment till 26.07.2016. However, on 29.07.2016, the deceased life assured died due to heart attack and Dr. Ajay Bhargava declared the deceased life assured as dead. An amount of Rs. 28,000/- approximately was spent in the treatment of the deceased life assured. After performing last rites of the deceased life assured, the complainant gave intimation of death of the deceased life assured to the insurance company on 04.08.2016 and later on, submitted claim along with requisite documents. However, the insurance company through letter dated 19.04.2017 wrongly repudiated the claim. Alleging deficiency in service on the part of the opposite parties to the consumer complaint, the consumer complaint was set in motion by the complainant before the District Commission.

3. The appellant / opposite party No. 1 (insurance company) filed written statement before the District Commission and pleaded that under condition No. 2.1 of the insurance policy, it was clearly mentioned that “There is no death or survival benefits in this policy during the policy term”. The complainant has submitted the death claim with the insurance company, which was not payabl