Clinical Depression Constitutes Sufficient Cause to Condonе 250-Day Delay: Delhi Consumer Commission [Read Judgment]

New Delhi: The Delhi State Consumer Disputes Redressal Commission has set aside a District Commission order that dismissed in limine, as time-barred, a widow’s complaint against Tata AIG General Insurance over a repudiated mediclaim of Rs. 25.73 lakh.

Holding that the complainant, who was undergoing treatment for clinical depression after her husband’s death, had shown sufficient cause for a delay of 250 days, the Commission condoned the delay and directed the District Commission to decide the complaint on merits within three months.

The appeal, First Appeal No. 360/2026, was decided by a Bench of Justice Sangita Dhingra Sehgal (President) and Bimla Kumari (Member) on 07.10.2026. The appellant, Priya Mehrotra, the widow of Saurabh Mehrotra, challenged the District Commission-III (West), Janak Puri order dated 02.02.2026 in CC No. 464 of 2025.

According to the complaint, Saurabh Mehrotra held a Tata AIG Medicare policy, first taken on 08.06.2019 and renewed, covering both spouses for a sum assured of Rs. 20 lakh. After he fell ill on 16.08.2021, he was treated at Kukreja Hospital, Sir Ganga Ram Hospital and the Institute of Liver & Biliary Sciences, where he died on 27.10.2021. The complainant claimed Rs. 25,73,529 for his treatment. The insurer repudiated the claim by letter of 14.01.2022, stating that the claim was for treatment of cirrhosis falling within a two-year waiting period under Section 3(1)(ii), Exclusion 02. The Grievance Redressal Cell rejected it on 17.12.2022, and the Insurance Ombudsman rejected her complaint on 31.01.2023.

The complainant had sought condonation of the delay under Section 5 of the Limitation Act, 1963, pleading that she suffered severe distress after her husband’s death, was treated for severe clinical depression from June 2024, and became capable of understanding her legal position only after May 2025, when she consulted counsel. The delay was counted at 250 days from two years after the Ombudsman’s order.

The District Commission dismissed the complaint in limine, after a detailed survey of case law, including Kandimalla Raghavaiah & Co. v. National Insurance Co. Ltd. (2009) 7 SCC 768 and State Bank of India v. B.S. Agricultural Industries (2009) 5 SCC 121, on the mandatory nature of the two-year limit in Section 24A of the 1986 Act and Section 69 of the Consumer Protection Act, 2019, and the rule that correspondence and representations do not extend limitation. It also recorded that no reason for the delay, “much less an application for condonation of delay”, had been placed on record, and concluded that the period expired in December 2024.

Before the State Commission, the appellant submitted that the District Commission had misapplied the “sufficient cause” standard, that the waiting-period clause could not be invoked as the husband’s sudden liver dysfunction was an acute condition and not a pre-existing disease, and that her prolonged treatment for clinical depression explained the delay. Counsel for the appellant, from Neha Gund & Associates, appeared; the insurer was not recorded as appearing.

The Commission set out Section 5 of the Limitation Act, which allows an appeal or application to be admitted after the prescribed period if the applicant satisfies the court that there was “sufficient cause”, together with Section 69(1) of the 2019 Act, under which a complaint is not admitted unless filed within two years of the cause of action. Applying them to the record, it held:

“[W]e find that there has been a delay of 250 days in filing the Complaint before the District Commission, for which, the Appellant has given sufficient cause, being that she was seeking treatment for clinical depression after the demise of her husband, as is clear from the Prescription adduced by the Appellant… therefore, it would be in the interest of justice to condone the delay.”

The Commission accordingly condoned the delay, set aside the order of 02.02.2026 and allowed the appeal, returning the matter to the District Commission (West), Janak Puri, to decide the complaint on merits within three months. The parties were directed to appear before the District Commission on 17.11.2026, and a copy of the judgment was ordered to be sent to the District Commission immediately. The Commission did not examine the merits, including the correctness of the insurer’s reliance on the waiting-period exclusion for cirrhosis, which remains open before the District Commission.

Appearances:

For the Appellant: Neha Gund & Associates, Advocates.

Case Title: Ms. Priya Mehrotra vs. M/s. Tata AIG General Insurance Co. Ltd., First Appeal No. 360/2026

[Read Judgment]