ORDER

                                              JUDGEMENT

(PER MR. JUSTICE RAM SURAT RAM (MAURYA), PRESIDING MEMBER)

1.      Heard Ms. Meghna Mital Sankhla, Advocate for the appellant and Mr. K. Maruthi Rao, Advocate, for the respondents. 

2.      Above appeal has been filed against the order of State Consumer Disputes Redressal Commission, Andhar Pradesh, dated 25.09.2014, passed in Consumer Complaint No.68 of 2011, allowing the complaint and directing the appellant to pay Rs.2250000/- with interest @9% per annum from date of filing of the complaint till the date of payment as the insurance claim.

3.      Namasani Venkata Lakshmamma filed CC/68/2011, for directing Shri Ram Life Insurance Company Limited (the appellant) to pay (i) Rs.2250000/- with interest @18% per annum from 31.07.2009 till the date of payment, as insurance claim; (ii) Rs.one lakh, as compensation; (ii) Rs.25000/-, as litigation costs; and (iv) any other relief, which is deemed fit and proper in the facts and circumstances of the case.

4.      The complainant stated that her husband Late Chenna Kesava Rao had obtained “Shri Plus Insurance Policy No.LN100900033143, from Shri Ram Life Insurance Company Limited on 28.03.2009, for the period of 15 years. Annual premium of the policy was Rs.150000/- and it covers ‘accidental shield’ benefit of Rs.1125000/- and ‘accidental death’ benefit of Rs.2250000/-. Late Chenna Kesava Rao met in an accident on 31.07.2009 at Gurazia, Guntur District, while driving Tractor No.AP7 Y6742 and died on the spot. FIR No.51/2009 of the incident was registered on 01.08.2009 at Police Station Marcheria Rural. The police got conducted inquest and post mortem of the dead body, in which, cause of death was mentioned as “ruptured’. Viscera was preserved. The complainant set up insurance claim through insurance agent along with all the relevant documents. Vide letter dated 20.01.2010, the opposite party informed that the claim was closed on the ground of not producing post mortem report and the medical documents/reports pertaining to liver ailments of the insured, in spite of repeated reminders, although all the documents were submitted. The complainant gave legal notice dated 15.03.2010 to settle the claim. The opposite party gave reply notice on 30.04.2010, stating that comprehensive post mortem report and the medical documents/reports pertaining to liver ailments of the insured were not submitted. The complaint was filed on 30.07.2011.

5.      The appellant filed its written reply and contested the complaint. The facts relating to obtaining insurance policy on 28.03.2010 and accidental death of the life assured on 31.07.2010, have not been disputed. The appellant stated that after receiving insurance claim, they appointed Mr. G. Rama Murthy as an investigator, who conducted an inquiry and submitted his Investigation Report dated 09.10.2009, stating that the deceased life assured had concealed his previous ailment for which he had taken treatment in Para Ovarian Cysts at AMG Hospital and Care Hospital Vizag, in the Proposal Form. The officer of the appellant and the Investigator handed over (i) Claim Form-B- Medial Attendant Certificate, (ii) Claim Form-C- Certificate of Cremation/Burial to the claimant on 27.10.2009 and requested her to fill up these form and provide relevant documents. The complainant submitted Claim Forms in July, 2010 but did not provide other relevant documents. The appellant again vide letter dated 03.09.2010, demanded case sheet/ medical records of the treatments taken in Para Ovarian Cysts at AMG Hospital and Care Hospital Vizag but these documents were not supplied. Then the claim was repudiated on 30.09.2010. There is no deficiency on the part of the Insurer.    

5.      State Commission, in the impugned order found that the Insurer raised plea that the deceased life insured was suffering from chronic liver disease and had taken treatment prior to taking insurance policy but no evidence has been produced in this resp