PER SUBHASH CHANDRA This First Appeal under section 19 of the Consumer Protection Act, 1986 (for short “the Act”) challenges the order dated 25.03.2013 of the Punjab State Consumer Disputes Redressal Commission (for short “the State Commission”) allowing Complaint No.100 of 2011 and directing the Appellant/Opposite Party to pay the Respondent No.1/Complainant US Dollars 50,000, the insurance amount, along with ₹50,000/- as compensation for harassment and agony and ₹10,000/- as litigation expenses within 45 days. MA 1635 of 2013 filed before the State Commission seeking review has been disallowed vide order dated 11.11.2013 on the grounds that it did not have the powers to amend its orders. The Appellant has prayed for setting aside of the impugned order on the grounds that the insured had expired due to a pre-existing disease of hypertension which resulted in the myocardial infarction while he was travelling overseas under the terms of the policy. 2. There is a delay of 233 days in filing of this Appeal. In the interest of justice and for the reasons mentioned in IA No.495 of 2014, the delay is condoned. 3. Since none appeared on behalf of the Respondents No.1, 3 and 4, they were proceeded ex parte vide order dated 24.04.2015. Respondent No.2 was also proceeded ex parte vide order dated 27.09.2023 since none appeared on their behalf. Heard arguments of learned Counsel for the Appellant and perused the material on record and the short synopsis filed by the Appellant and the Respondent No.1/Complainant. 4. The short issue before us is whether the insured/Respondent expired on account of a pre-existing disease which had not been disclosed to the Appellant at the time of obtaining the policy. The Appellant has relied on condition no.10(a) of the policy which makes it specific that the policy is intended for use by the insured in the event of a sudden and unexpected sickness outside the Republic of India. Clause 10(b) of the policy also excludes indemnity in respect of the medical services, the need for which arises out of a pre-existing condition as per condition 10(c). Clause 10(c) provides for pre-existing condition to mean “any sickness or illness” which existed prior to the effective date of insurance whether or not the insured had symptoms related to it and includes allegations arising out of such a pre-existing condition. 5. From the facts of this case, it is clear that the Respondent/Complainant suffered a precocious myocardial infarction complicated by acute pulmonary edema while in transit in Paris. According to the Appellant, complication from hypertension was one of the proximate causes of myocardial infarction and it is, therefore, contended that the State Commission erred in allowing the Complaint No.100 of 2011. 6. Per contra, Respondent No.1/Complainant has contended that overseas mediclaim insurance policy for US$ 50,000 had been obtained to cover any sudden or unforeseen illness while on travel abroad and the cause of death, precocious myocardial infarction which means a “pre-mature heart attack” with swelling of lungs with water constitutes a sudden and unforeseen illness. As per the Death Certificate dated 23.12.2010 issued by the treating Hospital, the death was on account of sudden medical condition and not a pre-existing illness and therefore, the Respondent/Complainant was entitled to the insurance amount as assured. 7. From the foregoing, it is apparent that the State Commission has relied upon the Medical Certificate issued following the admission of the insured in the Craniological Intensive Care Unit on 22.12.2010 and has relied upon the judgment of the Hon’ble Supreme Court in Biman Krishna Bose vs. United India Insurance Co., Civil Appeal No.3438 of 1995 which held that an insurance claim cannot be repudiated if the insured was suffering from hypertension since hypertension is not a material disease which is fatal in itself. 8. The order of the State Commission is a reasoned and a detailed order which sets out clearly that hypertension per se is not a fatal disease and that the insured in the instant case had suffered a sudden heart attack as per the report of the treating Hospital in Paris. We, therefore, find no reason to interfere with this order since the objective of the policy was to cover any such sudden incident relating to the health of the insured. The fact that the insured was suffering from hypertension cannot be held against the insured since hypertension itself is not a life threatening disease and has been widely recognized as a lifestyle disease. It has not been disputed that expenditure of Euros 10,899.51 was the cost incurred by the Respondent/Complainant which is within the insurance cover of US$ 50,000. 9. In view of the discussion above, the Appeal is partly allowed. The order of the State Commission is affirmed with the following modifications. (i) Appellant shall pay to the Respondent/Complainant an amount equivalent to Euros 10,899.51 with costs awarded which is within the insured amount of US$50,000 along with interest @ 9% from the date of rejection of claim till the date of filing of this Complaint within six weeks. Failure to do so will entail penal interest @ 12% from the date of rejection of claim till realization. (ii) Appellant shall also pay litigation costs of ₹50,000/- to the Respondent. 10. Pending IAs, if any, stand disposed of with this order. | 
