Two hundred and fifty days late, but not too late: the Delhi State Consumer Commission has accepted that treatment for clinical depression after a husband’s death was sufficient cause to excuse the delay in filing a health insurance complaint.
New Delhi: A widow’s health insurance complaint, thrown out by a District Commission as time-barred, will now be examined on merits. The Delhi State Consumer Disputes Redressal Commission has condoned a delay of 250 days after accepting that she was undergoing treatment for clinical depression following her husband’s death, and has remanded the complaint against Tata AIG General Insurance for a decision within three months [Priya Mehrotra v. Tata AIG General Insurance Co. Ltd.].
The appeal (FA/360/2026) was allowed in a judgment of October 7, 2026 by a Bench of President Justice Sangita Dhingra Sehgal and Member Bimla Kumari. Whether the insurer was right to reject the claim was not decided; that question goes back to the District Commission.
Sufficient cause, in the Commission’s words
Beginning with the rule that a complaint must be filed within two years of the cause of action, the Bench turned to the explanation offered for the delay. It accepted the medical prescription annexed to the appeal, which showed that treatment for depression began after the husband’s death.
“the Appellant has given sufficient cause, being that she was seeking treatment for clinical depression”
Having found that, the Commission concluded that condoning the delay would serve the interest of justice.
“it would be in the interest of justice to condone the delay in filing the Complaint”
Back to the District Commission
The District Commission’s order of February 2, 2026 stands set aside and the 250-day delay is condoned. The complaint goes to the District Commission (West), Pankha Road, Janak Puri, which must decide it on merits within three months of the judgment. The parties have been directed to appear there on November 17, 2026.
The Commission expressed no view on the waiting-period exclusion or on the insurer’s reasons for repudiation. Both remain open for the District Commission.
A policy, an illness and a repudiated claim
The appellant, Priya Mehrotra of Rajouri Garden, and her late husband, Saurabh Mehrotra, were insured under a Tata AIG Medicare policy bought in June 2019 and renewed each year, the last renewal running from June 8, 2021 to June 7, 2022, with a sum assured of Rs 20 lakh. Mr. Mehrotra, a dentist, fell ill on August 16, 2021. He was admitted to Sir Ganga Ram Hospital the next day, shifted to the Institute of Liver and Biliary Sciences on September 14, 2021, and died there on October 27, 2021.
Ms. Mehrotra claimed Rs 25,73,529 on cashless and reimbursement heads. The insurer repudiated the claim on January 14, 2022, taking the stand that the treatment for cirrhosis fell within the policy’s two-year waiting period under its exclusion clause. A grievance cell rejected her representation on December 17, 2022, and the Insurance Ombudsman’s order followed on January 31, 2023.
Dismissed at the threshold
Her complaint before the District Commission-III, New Delhi (Janak Puri) was filed late. On February 2, 2026, that Commission dismissed it in limine as barred by Section 69 of the Consumer Protection Act, 2019, observing that no reason for the delay, and no application for condonation, had been placed on record. It held that limitation had expired in December 2024.
The appellant’s case
The appeal was filed on June 2, 2026 and heard on August 19, 2026. Ms. Mehrotra, represented by Neha Gund & Associates, argued that the waiting-period exclusion was unsustainable in law and that her husband’s liver condition was an acute, sudden onset and not a pre-existing disease. She also contended that the District Commission had misread the meaning of “sufficient cause” under Section 5 of the Limitation Act, 1963, and that her prolonged treatment for clinical depression explained the delay. No counsel is recorded for the insurer.
What the statute allows
Under Section 69(1) of the Consumer Protection Act, 2019, a Commission cannot admit a complaint filed more than two years after the cause of action arises. Section 69(2) lets it entertain a late complaint if the complainant shows sufficient cause, so long as the Commission records its reasons for condoning the delay. Section 5 of the Limitation Act, 1963 carries the same idea of sufficient cause into appeals and applications.
What the order signals
A complainant’s health, backed by medical records, can supply the sufficient cause that Section 69(2) asks for. The order also indicates that a consumer complaint should not be closed at the threshold as time-barred without giving the complainant a chance to explain the delay.
For policyholders’ families, the ruling keeps open a hearing on the merits of a repudiated claim, while leaving the insurer free to defend its reliance on the waiting-period clause before the District Commission.
Case Title: Ms. Priya Mehrotra v. M/s Tata AIG General Insurance Co. Ltd. [FA/360/2026]
Bench: Justice Sangita Dhingra Sehgal (President) and Bimla Kumari (Member), Delhi State Consumer Disputes Redressal Commission
Date of Judgment: October 7, 2026
Appearances: Neha Gund & Associates for the appellant. No counsel recorded for the respondent.