VISHAL DHUPAR Vs. NEW INDIA ASSURANCE CO. LTD.

JUDGEMENT

(1.) This appeal under Sec. 51 the Consumer Protection Act, 2019 (in short, the 'Act') is directed against the order dtd. 18/1/2023 of the Haryana State Consumer Disputes Redressal Commission, Panchkula (in short, 'State Commission') in Complaint no. 40 of 2021 disallowing the complaint.

(2.) We have heard the learned counsel for the parties and perused the records. The delay of62 days in the filing of the appeal was considered in light of the application seeking condonation of the delay. For the reasons stated therein, the delay was condoned in the interest of justice.

(3.) The relevant facts of the case, in brief, are that the appellant who had purchased a health insurance policy called New India Floater Mediclaim (in short, 'Policy') from the respondent was denied the benefit of re-imbursement under it for treatment of Stage IV Neuro Endocrine Cancer detected on 31/10/2020 at the Rajiv Gandhi Cancer Institute and Research Centre, New Delhi (RGCIRC) which prescribed chemotherapy every 28 days and which treatment commenced on 7/11/2020. A claim of Rs.1,02,867.00 was repudiated by the respondent on grounds of exclusion under the policy as the treatment through injection Sandostatin was held to not be a treatment but a prescription of a growth hormone which was to be administered as a non-listed day care procedure. The complaint filed was disallowed by the State Commission on the ground that the complaint did not fall under the pecuniary jurisdiction of the State Commission and holding that 'hospitalization' implied stay in the hospital for over 24 hours unless day care was permitted under the Policy and the treatment through Sandostatin injection did not specifically mention 'chemotherapy'. This order is in challenge before us.