Non-disclosure of mental health conditions cannot void an insurance policy if it was not present at the time of issuance.

1. Heard Mr. S.M. Tripathi, Advocate, for the appellant and Mr. Nikhlesh Jain, Authorised Representative, for respondent - 1.

2. The office has reported 75 days delay, in filing the appeal. The appellant has filed an application ( IA No. 3834 of 2012) for condonation of delay. In view of the order of Supreme Court passed in Suo Moto Writ Petition No. 3 of 2020, delay in filing the appeal is condoned.

3. This appeal has been filed against the order of State Consumer Disputes Redressal Commission Delhi, dated 3.2.2012, passed in Consumer Complaint No. 1094 of 2019, whereby, the complaint was allowed and the appellant was directed to reimburse the medical claim of the complainant of Rs.16,09,336 with interest @ 6% per annum from the date of repudiation till the date of payment. Respondents - 2 to 6 were held as not liable.

4. Vineet Khanna (respondent - 1) filed Consumer Complaint No. 1094 of 2019, for directing the opposite parties, jointly or severally to pay (i) Rs.16,09,336 along with interest @ 24% p.a., (ii) Rs.10,00,000 for physical and mental harassment and (iii) Rs.1,55,000 as cost of litigation and (iv) to pass such other order, which the Commission deems fit and proper under the circumstances of the case. It has been stated that Vivek Khanna (the deceased Insured), (the brother of the complainant), obtained a Mediclaim Insurance Policy from Appollo Munich Health Insurance in the year 2013-14, which was renewed up to 2016-2017. Vivek Khanna obtained ported Mediclaim Insurance Policy from Star Health & Allied Insurance Company Ltd. (the appellant), on 27.2.2017, i.e. Policy No. P / 161118/01/2018/018520, which was valid till midnight of 26.2.2018. This policy was renewed on 27.2.2019 vide Endorsement No. P / 161118/01/2019/022545, by the appellant, for coverage of Rs.25,00,000, which was valid from 27.2.2019 to midnight 26.2.2020. The mother of Vivek Khanna expired on 2.11.2017, thereafter, he came in depression. In the morning of 6.9.2019, Vivek Khanna became unconscious. He was immediately admitted to Columbia Asia Hospital, for treatment, where the doctors initially diagnosed "Neuroleptic Malignant Syndrome due to Anti Psychotic Drug Sepsis". Later on, the doctors diagnosed "Neuroleptic Malignant Syndrome due to Anti Psychotic Drug Rhabdomyolysis Aki Ventilator Associated Trachetis". The complainant was not satisfied with the treatment and asked the doctor to discharge the patient for treatment in higher centre. Vivek Khanna was discharged from Columbia Asia Hospital on 17.09.2019 and admitted to Sir Ganga Ram Hospital on the same day, where he remained admitted till 25.9.2019. His condition was not improved and the family was not in condition to bear the medical expenses, therefore, he was brought to home, where he expired on 27.9.2019. While discharging from Columbia Asia Hospital, Dr. Piyush Goel prepared Discharge Summary, in which "known case of Schizophrenia" was mentioned. The complainant, immediately, protested and told that Vivek Khanna was suffering from depression and not Schizophrenia, then Dr. Piyush Goel told that it was medical term for the depression. After admission of Vivek Khanna on 6.9.2019, Columbia Asia Hospital sent the requisite papers to Star Health & Allied Insurance Company Ltd., for granting approval, for cashless treatment, which was refused. Columbia Asia Hospital charged Rs.10,61,867 for treatment from 6.9.2019 to 17.9.2019, which was paid by the complainant. Sir Ganga Ram Hospital charged Rs.4,74,357 for treatment from 17.9.2019 to 25.9.2019, which was paid by the complainant. The complainant also purchased medicines from market of Rs.34,816 during this period. The complainant lodged medical claim with Insurer (the appellant) and submitted