IN THE DELHI STATE CONSUMER DISPUTES REDRESSAL COMMISSION Date of Institution: 06.01.2024 Date of Hearing: 16.12.2025 Date of Decision: 28.04.2026 FIRST APPEAL NO.- 13/2024 IN THE MATTER OF ICICI LOMBARD GENERAL INSURANCE COMPANY LIMITED, (THROUGH ITS AR)

TH AT: 4 FLOOR, RED FORT CAPITAL, PARASAVNATH TOWERS, BHAI VEER SINGH MARG, GOLE MARKET NEW DELHI-110001 (Through: Mr. S.K. Sharma, Advocate)

…Appellant VERSUS MS. RAKHI R/O RZ-65 NAND VIHAR, KAKROLA NEW DELHI-110078.

(Through: Mr. Shripal, Advocate)

…Respondent CORAM:

HON’BLE JUSTICE SANGITA DHINGRA SEHGAL (PRESIDENT)

HON’BLE MS. BIMLA KUMARI, MEMBER (FEMALE)

Present: None for the Appellant Mr. Shripal, counsel for the Respondent PER: HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, (PRESIDENT)

JUDGMENT

1. The facts of the case as per the District Commission record are as under:

“2. Briefly stated the facts of the case are that complainant had taken a online health insurance policy bearing no. 4128i/iH/162247038/00/000 on 21.12.2018 from OP. It is further stated that said policy was valid from 21.12.2018 to 20.12.2019 for the sum insured of Rs.5,00,000/- (Rupees Five Lakh only).

3. The complainant got admitted in the Parth Hospital for her treatment on Adaye 13.09.2019 and remained hospitalized till 17.09.2019. The above said hospital generated a bill of Rs.37,950/- (Rupees Thirty Seven Thousand Nine Hundred Fifty only) which was paid by complainant.

4. It is also alleged that complainant claimed the aforesaid bill amount before the OP, but OP rejected the claim 220100532409 on 29.10.2019 with reason mentioned as under:

"Claim rejected as policy has been cancelled."

5. It is further stated that the case was withdrawn from south west consumer १ forum on 26.05.2023 with liberty to file it in the Competent Commission having jurisdiction.

6. It is also stated that the complaint has been filed within the period of limitation. The cause of action arose to file the present case when the claim of the complainant was rejected by OP on

29.10.2019.

It is prayed that OP be directed:

i) To pay Rs.37,950/- to the complainant on account of the medical expenses incurred on the treatment of the complainant/insured alongwith pendent lite interest @ 18% p.a.

from 29.10.2019 till the actual realization.

ii) OP be also directed to pay Rs.2,00,000/- as damages/compensation for the loss, pain and injury suffered by the complaint on account of mental agony, harassment and inconvenience suffered by the in service of the OP and complainant due to deficiency Rs.1,00,000/- as litigation expenses.”

2. The District Commission after taking into consideration the material available on record passed the order dated 22.11.2023, whereby it held as under:

“8. Notice of the complaint was issued to OP pursuant to which none appeared for OP. An application moved by complainant to strike off the defence of OP as WS was filed beyond the statutory period. It is stated that OP was served on 12.06.2023 but WS was filed on 26.07.2023 which is beyond the statutory period. Reply filed opposing the application stating that complete set of complaint was supplied only on 26.07.2023 as such the WS is within the statutory period.

9. It is to be noted that none has appeared for OP on the date of hearing of 28.07.2023 after service and pointed out that complete set of complaint and documents has not been supplied.

10. In this regard, the Hon'ble Supreme Court held in the case titled New India Assurance Company Ltd. Vs. Hilli Multipurpose Cold storage Pvt. Ltd. reported in 2020 (5) SCC 757 as under:

"the objection of not having received a copy of the complaint along with the notice should be raised on the first date itself and not thereafter, otherwise if permitted to be raised at any point later would defeat the very purpose of the act, which is to provide simple justice and speedy redressal of consumer disputes"

11. It is to be noted that Section 38 Sub-section 3 (a) of the Consumer Protection Act, 2019 provides as under: "(a) refer a copy of such complaint t