JUDGMENT - G.G. Loney, President:---In this complaint allegations are made against New India Assurance Co. Ltd. for being deficient while settlement of complainants claim as regards the mediclaim policy. It is alleged by complainant No. 1 that on 12-5-1989, he was approached by an Agent of New India Assurance Company to go in for mediclaim policy. The complainant also alleged that he was promised rebate of 10% in the premium if the members of his family were covered. Relying on the said representation and after going through the prospectus of the opposite party the complainant obtained an insurance policy for the period 12-5-1989 to 11-5-1990 on payment of premium. The said policy was renewed for a period of 12 months between 12-5-1990 to 11-5-1991. In July, 1990 the complainant No. 2 felt ill and was admitted in Nanawati Hospital for angiography and later admitted to Hinduja Hospital. The complainant had to incur Rs. 59,588 expenses, which under the terms of the policy in question the opposite party was bound to reimburse. However, the complainants claim which was processed by the opposite party was not settled on unsustainable ground and hence this complaint has been filed by the complainant claiming Rs. 1,37,600/- on account of medical cost incurred, Rs. 59,588/- with interest at the rate of 18% p.a. on Rs. 22,427/- from 8-8-1990 and on 37160 from 13-8-1990 till 15-4-1992 being the date of filing of the claim, punitive damages being of Rs. 50,000/- and cost of engaging legal service being Rs. 10,000/-. The claim was opposed by the opposite party on the ground of limitation and on other technical grounds. Inter alia, the opposite party accused the complainant of being guilty of not describing material facts and of fradulently suppressing the fact that complainant No. 2 was suffering from diabetes and hypertension prior to the obtaining of the policy. It is further contended that the complainants claim was investigated through the Panel Doctor, who by report dated 25-2-1991 stated that complaint No. 2 was suffering from diabetes millitius and hypertension. 2. We have heard Shri Kudroli, Advocate for the complainant and Shri Motiwala, Advocate for the Insurance Company. 3. Shri Kudroli invited our attention to the prospectus issued by the opposite party as regards the hospitalisation and domicialiary hospital benefit policy. In that prospectus there is a proposal form for obtaining aforesaid policy. 2. We have heard Shri Kudroli, Advocate for the complainant and Shri Motiwala, Advocate for the Insurance Company. 3. Shri Kudroli invited our attention to the prospectus issued by the opposite party as regards the hospitalisation and domicialiary hospital benefit policy. In that prospectus there is a proposal form for obtaining aforesaid policy. In the said prospectus there is no mention, such question No. 10 or 11 to be answered by the complainant. The proposal form of complainant is filed on record and in Question No. 10 the details of knowledge of any positive existence or presence or any ailment sickness or injury which may require medical attention in immediate future is mentioned to which complainant answered in negative. To Question No. 11, details of medical treatments/surgical operation during preceding 12 months, the complainant had also answered in negative. The emphasis of the opposite party is on the answers of complainant in negative to the aforesaid two questions. Even after the perusal of the record, we do not find that the answers given by complainant to the two question Nos. 10 and 11 disentitled him for the settlement of his mediclaim in question. We have considered report dated 25-2-1991. The said report is relied upon by opposite party. It is on page 18 annexed with their written statement. It is only a copy of the original report which is not signed by any one. It is not even an authenticated copy. It is stated in that report that Nanavati Hospital, Indoor case paper shows that the insured had PTB D.M. and H.T. It is alleged that she was suffering from the aforesaid ailments before admission in Nanavati Hospital. But no documentary evidence to support this contention has been placed on record to show that the complainant was suffering from such ailments prior to the issue of the policy. No evidence has been tendered by the opposite party in support of this submission. The National Commission in (The Oriental Insurance Company Ltd. v. Ramesh M. Jadhav)1, first Appeal No. 249 of 1991, decided by National Commission, has held that if the complainant received medication for the ailment prior to issue of mediclaim policy then it is the duty of the Insurance Company to establish the fact of such ailment of the complainant and the medication received by him by convincing evidence. The National Commission in the aforesaid appeal has ruled that the responsibility to prove the allegations of previous medication by the consumer lies on the Insurance Company. In the instant case, we find that the opposite party totally failed to discharge the burden of proving the previous ailments of the complainant before the grant of the policy. Under these circumstances, it is clear that the opposite party failed to discharge its burden of proving the previous medication received by complainant. We are of the view that the complainants claim has been refused for no justified reasons. 4. The complainant has claimed the amount of Rs. 59,588/- for medical expenses with 18% p.a. interest from 8-8-1990. The complainant has also claimed for punitive damages of Rs. 50,000. In our view, it will meet the ends of justice if the complainant is given compensation cost of Rs. 59,588/- with 18% p.a. interest and Rs. 500/- as cost of this complaint. The rest of the claims are hereby rejected. Hence the following order :- ORDER 5. The complaint is allowed. The opposite party the New India Assurance Company Ltd. is directed to settle the complainants claim for his mediclaim policy for incurring the expenses of Rs. 59,588/- in terms of the policy with 18% p.a. interest for the delay in settlement of the policy from 8-8-1990. We award the interest by way of compensation and, therefore, no other compensation is granted. The complainant also be awarded Rs. 500/- as cost. Rest of the complainants claims are rejected. Complaint allowed. *****