S. B. Mhase. President— Heard Advocate Irfan A. Shaikh for the Complainant. This matter was kept yesterday i.e. 16/Nov/2011 for hearing on admission. Since the point of limitation was raised by the State Commission in view of provisions of Section 24A of the Consumer Protection Act, 1986 (‘the Act’ for brevity), the Learned Counsel for the Complainant sought time and has per his request the matter is placed today for admission. Heard.

2. Section 24A of the Act mandates the Consumer Fora shall not admit a consumer complaint unless it is filed within a period of two years from the date on which the cause of action has arisen and, therefore, a duty has been cast upon the Consumer Fora at the time of hearing the complaint for admission to see as to whether the complaint is filed within the prescribed period of limitation as provided under the said Section and further to see if there is a delay, whether any application for condonation of the delay is made.

3. The facts involved in the present consumer complaint are as follows:

The Complainant has taken from the Opponent, namely ICICI Lombard General Insurance Company (hereinafter referred to as ‘the Insurance Company’ for the sake of brevity) an insurance policy which is titled as ‘Home Safe Plus Secure Mind Policy’. Said insurance policy has been issued 28.7.2006 and the period of said insurance policy was from 28.7.2006 to 27.7.2011. Under this insurance policy apart from home loan secured, further benefits and coverage have been provided for as stated in Clause No.7 of the insurance policy. As per this clause, major medical illness and procedures have been provided and particulars of the same have been enumerated in Column No.2 of Clause No.7. Column No.2 states about coverage insured events applicable:

“(a) Diagnosis of the following illnesses, namely:

……….

(c) Occurrence of the following medical events: List of covered events: Stroke, Paralysis and Myocardial Infarction”.

4. In the last column of Clause No.7, the sum assured is stated to be of Rs.41,14,000. Rest of the part of Clause No.7 is not relevant and, therefore, not reproduced. In paragraph (2) of the Schedule of the said policy, definitions have been provided for and in Clause No.(2.1) thereof, there is a definition of ‘Myocardial Infarction (Heart Attack)’, which reads as follows:

“The first occurrence of an acute myocardial infarction leading to the death of a portion of heart muscle (Myocardium) as a result of inadequate blood supply to the relevant area.

The diagnosis for the same must be evidenced by all of the following:

An episode of typical chest pain.

The occurrence of a typical new acute infarction (ST-T elevation) on the electrocardiograph and progressing to development of pathological Q waves Elevation of Cardiac Troponin (T or I) to atleast 3 times the upper limit of normal reference range or an elevation in CPK-MB to atleast 200% of the upper limit of the normal reference range.

But excluding non-Stemi with elevation of troponin I or T. Other acute coronary syndromes, including but not limited to angina or chest pain are excluded from this definition.”

5. Relying upon these clauses, the Complainant has made an insurance claim. The Complainant was admitted in Shraddha Polyclinic & Nursing Home ICCU for the period 29.7.2007 to 5.8.2007 and the diagnosis as disclosed from the Discharge Card was ‘Anterolateral wall non-Q wave Infarct— changes regressed Pancarditis’. Therefore, according to the Complainant, he had suffered ‘Myocardial Infarction and he is entitled to recover the amount on the basis of insurance policy as stated in Clause No.7 of the said insurance policy referred to above and an amount of Rs.41,14,000. The claim in this respect was made to the Insurance Company by the Complainant on 6.5.2009. However, said claim was repudiated by the Insurance Company on 11.9.2009 and thereafter, the present consumer complaint was filed before this State Commission on 14.6.2011.

6. A