DR. SADHNA SHANKER, MEMBER 1. These two cross appeals have been filed under Section 19 of the Consumer Protection Act, 1986 (hereinafter referred to as “the Act”) in challenge to the Order dated 19.12.2017 passed by the State Consumer Disputes Redressal Commission, Delhi (hereinafter to be referred to as ‘State Commission’) in complaint No. 84 of 2009 whereby the complaint was allowed. 2. Heard learned counsel for the complainants (hereinafter referred to as the ‘complainants’), the learned counsel for the insurance company (hereinafter referred to as the ‘insurance company’) and the learned counsel for the bank (hereinafter referred to as the ‘bank’) and perused the record including the State Commission’s impugned Order dated 19.12.2017 and the memorandum of appeal. First appeal no. 459 of 2018 has been filed by the complainants seeking refund of Rs. 5,29,863/- being EMIs collected after the death of complainant no.1’s husband, with interest. First appeal no. 1670 of 2018 has been filed by the insurance company seeking setting aside of the Order dated 19.12.2017 of the State Commission. 3. In first appeal no. 1670 of 2018, there is a delay of 95 days in filing the present appeal. In the interest of justice and considering the reasons mentioned in the application for condonation of delay, the delay in filing the appeal is condoned. 4. The relevant brief facts of the case are that the complainant no. 1 along with her husband applied for loan to the ICICI Bank Limited and finally loan of Rs. 34,00,000/- was sanctioned in their favour. To secure the repayment of loan, the ICICI Bank got the loan applicants insured through its sister concern i.e. the insurance company. The complainant no. 1 and her husband regularly paid the EMI/calculated insurance premium payable to the insurance company. On 18.01.2008, unfortunately, the husband of complainant no. 1 died in a car accident at Bilaspur (HP) leaving behind complainant no. 1 as his widow, complainant no. 2 & 3 as his minor children. The complainant no. 1 informed the insurance company and claimed the insurance amount to clear up the outstanding loan amount. The insurance company repudiated the claim on the ground that the claim was inadmissible as the policy provides coverage only to the Primary Loan Applicant. It is alleged that since the demise of her husband, the complainant no. 1 paid EMI to the bank from the sources generated by her husband. It is further alleged that inspite of complying with request of complainant no. 1 to send copy of insurance policy, the ICICI bank sent fresh repayment schedule dated 15.12.2008 whereby not only the amount of EMI was increased but even the number of instalments were unauthorisedly and illegally increased. As per said repayment schedule, complainant no. 1 has paid EMI upto 10.02.2009 and out of loan amount of Rs. 34,00,000/-, a sum of Rs. 33,42,306/- towards principal amount was shown as due whereas commencing from 10.12.2006, the bank had been paid a sum of Rs.10,77,268/-. It is alleged that the insurance company was duty bound to pay principal sum due as on 18.01.2008/date of death of husband of complainant no. 1 to the bank. It is alleged that the bank had collected Rs. 5,29,563/- towards EMI from 10.02.2008 to 10.02.2009, which amount is liable to be refunded to the complainants. The complainants filed a complaint before the State Commission praying for a direction to the insurance company to pay the principal amount with interest as it became due immediately after date of death of husband of complainant no. 1 i.e. 18.01.2008 to the bank and discharge the complainants of any liability on account of loan with further directions to the bank to return the title deed of flat No. M-305, Habitat Apptt., B-19, Vasundhara Enclave, New Delhi. 5. The insurance company contested the complaint by filing reply stating that the complaint was not maintainable as the same had been filed with malafides and the complainants have no cause of action to prosecute the instant complaint and that Clause 9(v) attached to this policy provided that “this policy covers only primary loan applicant as mentioned in ICICI Bank’s Books” and Dr. Narinder Singh was not the primary loan applicant and was not insured by the insurance company and that there is no deficiency in service on the part of the insurance company and the complaint was liable to be dismissed. 6. The State Commission, vide its Order dated 19.12.2017, allowed the complaint and directed the insurance company to pay the entire principal amount with interest to the bank and discharge the complainants of their liability on account of loan. The bank was directed to return the title deeds of flat no. M-5, Habitat Apartmment, B-19, Vasundhara Enclave, New Delhi to the complainant no. 1. 7. Being aggrieved by the impugned order dated 19.12.2017, both the parties have filed the instant appeals before this Commission. 8. Learned counsel for the insurance company has argued that as is evident from the loan application form, the complainant no. 1 was the applicant for the loan while her deceased husband was the co-applicant. He further drew our attention to the loan sanction letter dated 12.10.2006, which was addressed to both the applicants and which clearly stated in the last para “Further on final disbursement, the first applicant of this loan will also benefit from a free personal accident insurance cover, to the extent of principal amount outstanding for the term of the loan as per the applicable conditions.” Further, it was argued that this being a group insurance matter, the insurance policy was taken by the bank from the insurer and that the insurance policy dated 27.09.2007 clearly provides in clause 9 under special condition at serial (v) that “this policy covers only the primary loan applicant as mentioned in ICICI Bank books”. After the unfortunate death of the husband of the complainant no. 1, through the letter dated 17.04.2008, the claim of the appellant under said group insurance policy, was repudiated stating the following: “With respect to the captioned claim we would like to inform you that on processing the documents as submitted by you in support of the above Personal Accident claim of Mr. Narendra Singh we have arrived at the following conclusion that the captioned claim is not admissible under the policy as the policy provides coverage only to the Primary Loan Applicant.” It was submitted that the assertion of the complainants that she did not have the policy conditions with her and was not aware of this condition is not acceptable because firstly the loan sanction letter referred to above stated the same very clearly which has not been denied. Further the special condition was referred to in the policy itself and seeking of the policy’s terms and conditions after the repudiation of the claim was merely done to substantiate her case. 9. Reliance was placed on the judgment in the case of Export Credit Guarantee Corp. of India vs. Garg Sons International (2013) (1) Scale 410 wherein the Hon’ble Supreme Court has held that it is not permissible for a court to substitute the terms of the contract itself, under the garb of construing terms incorporated in the agreement of insurance. No exception can be made on the ground of equity. Reliance was also placed on the decision of this Commission in the case of Liberty Videocon General Insurance Co. Ltd. Vs. Shivbhajan Sahu & Anr., Revision Petition No. 1871 of 2016 decided on 20.03.2018 for the proposition that it is the insured bank that obtains the policy to take care of the documentation etc. in the event of any lapse the bank could be responsible and not the insurer. 10. Before us, it was argued by the learned counsel for the complainants that different terms were being used for the loan applicant by the insurance company in various documents. Somewhere, they are called applicant and co-applicant elsewhere they are called borrower or co-borrower. It was argued that both had applied for loan and had submitted title deed of the house where they were both living, as security and the EMI for the loan, including insurance premium, were paid by Dr. Narendra Singh to the bank during his lifetime. It is submitted that creating this distinction of a primary loan applicant being the only eligible person for the insurance is incorrect and is being done to escape liability. It was also argued that terms of the insurance were never provided to the complainants and they were not aware of any such special condition in the policy. Reliance was placed on Anju Kalsi vs. HDFC Ergo General Insurance Company Limited & Anr. (2022) 6 SCC 394 for the proposition that if the special conditions of the group insurance policy are not brought to the notice of the beneficiary, the policy holder, the repudiation on the ground of the same cannot be said to be justified. 11. Reliance was placed on D. Srinivas vs. SBI Life Insurance Company Limited & Ors. (2018) 3 SCC 653 and Sulakshna vs. Oriental Insurance Co. Ltd. & Anr. 2022 SCC Online SC 1287 for the proposition that once the insured had done all that was required in their part then the insurance policy had come into force. 12. The question that arises before us is whether the repudiation of the claim is correct or not. 13. In this case, from the record it emerges that the loan applicant was the complainant no. 1 and the co-applicant of the loan was her husband. The loan sanction letter, which is not disputed, clearly states that it will be the primary loan applicant who will be eligible for the insurance cover with respect to the loan obtained and not all the applicant. In view of the same, the complainant no. 1 had been put to notice at the time of sanction of the loan itself that the insurance cover was only for one applicant whose name appears first and did not cover other joint applicant or applicants. 14. In view of the above, whether the insurance detailed terms and conditions were communicated or not become irrelevant because the loan sanction letter is dated 12th October 2006 while the insurance began on 27.09.2007. It is an admitted positon that the name of the wife is the first name in the loan documents, and the husband is the co-applicant / co-borrower. As the applicant was aware at the time of sanction of the loan itself that the insurance was in respect of only the primary loan applicant and she is admittedly the first applicant in the loan application, we are of the view that the repudiation by the insurance company in the circumstances is just and reasonable. 15. In the result, the appeal no. 1670 of 2018 filed by the insurance company is allowed. The order of the State Commission dated 19.12.2017 is set aside. The appeal no. 459 of 2018 filed by the complainants is dismissed. Consequently, the complaint is dismissed. There shall be no order as to costs. | 
