CWP-21332-2025 (O&M) IN THE HIGH COURT The New India Yogesh Goyal & others CORAM: Present: GURVINDER SINGH GILL, 1. The petitioner this Court seeking by the National Consumer Disputes Redressal Commission revision petition filed by the petitioner assailing order dated passed by the State Consumer Disputes Redressal Commission dismissing the first appeal preferred by the petitioner, has been dismissed. 2. The matter arises o Goyal, who had purchased a Health Insurance Policy from the petitioner Insurance Company, expenditure said claim was declined (Annexure P “Patient admitted and diagnosed bypass surgery done. falls out of the scope of the policy conditions as per Clause 4.4.6 of the (O&M) ( 1 ) IN THE HIGH COURT FOR THE STATES AT CHANDIGARH CWP Date of Decision: The New India Assurance Company Limited Versus Yogesh Goyal & others HON'BLE MR. JUSTICE GURVINDER SINGH GILL HON'BLE MRS. JUSTICE RAMESH KUMARI Mr. R.C.Gupta, Advocate, for the petitioner. GURVINDER SINGH GILL, J. petitioner – The New India Assurance Company Limited this Court seeking quashing of order dated 23.04.2025 National Consumer Disputes Redressal Commission revision petition filed by the petitioner assailing order dated passed by the State Consumer Disputes Redressal Commission dismissing the first appeal preferred by the petitioner, has been dismissed. The matter arises out of a complaint filed by respondent No.1 , who had purchased a Health Insurance Policy from the petitioner Insurance Company, against turning down his claim for reimbursement of the expenditure incurred by him for taking treatment for mor said claim was declined being non-payable (Annexure P-3). The relevant portion of the said letter reads as under: Patient admitted and diagnosed Morbid bypass surgery done. Since, treatment for obesity & its complications falls out of the scope of the policy conditions as per Clause 4.4.6 of the FOR THE STATES OF PUNJAB & HARYANA AT CHANDIGARH WP-21332-2025 (O&M) ate of Decision: 12.01.2026 Assurance Company Limited … Petitioner ... Respondents HON'BLE MR. JUSTICE GURVINDER SINGH GILL RAMESH KUMARI Advocate, for the petitioner. The New India Assurance Company Limited has approached 23.04.2025 (Annexure P-1) passed National Consumer Disputes Redressal Commission vide which a revision petition filed by the petitioner assailing order dated 06.04.2016 passed by the State Consumer Disputes Redressal Commission, Punjab dismissing the first appeal preferred by the petitioner, has been dismissed. ut of a complaint filed by respondent No.1 – Yogesh , who had purchased a Health Insurance Policy from the petitioner against turning down his claim for reimbursement of the incurred by him for taking treatment for morbid obesity. The payable vide letter dated 18.10.2010 . The relevant portion of the said letter reads as under: orbid Obesity. Laparoscopic gastric treatment for obesity & its complications falls out of the scope of the policy conditions as per Clause 4.4.6 of the has approached 1) passed vide which a 06.04.2016 , Punjab Yogesh , who had purchased a Health Insurance Policy from the petitioner – against turning down his claim for reimbursement of the . The 18.10.2010 VIMAL KUMAR 2026.01.16 12:46 I attest to the accuracy and integrity of this document CWP-21332-2025 (O&M) policy conditions hence, Lap Gastric Bypass. 3. The learned District Consumer Di 23.12.2014 (Annexure P while relying upon judgment dated 13.12.2013 Consumer Disputes Redressal Commission, Punjab in New India Assurance Company Limited etc. not fall under cosmetic surgery so as to exclude medical reimbursement. 23.12.2014 is reproduced herein “12. However, the repudiation of the claim made by the opposite parties is not legal and valid. Similar proposition arose in appeal titled as Ashwani Goyal appellant Vs. New India Assurance Company Limited etc. respondents Consumer Disputes Redressal Commission, Punjab, Chandigarh, wherein the Hon’ble Commission went on to hold that morbid obesity does not fall under cosmetic surgery. There being no evidence on record that Cl of the insured, therefore, it had no binding effect on the insured. 13. In the case in hand also, the facts of the case are quite similar to the authority cited above. In the case in hand also, no pointed attention of the complainant was drawn to Cl issuing the insurance policy in dispute nor there are any complicated diseases like high blood pressure, heart disease, osteoarthritis of wei SA/respiratory problem, gastro esophage and infertility etc. allegedly suffered by the complainant from the treatment history adduced on record. Therefore, surgery conducted on the complainant cannot be termed to be cos of imagination clause as stated by the counsel for the opposite parties. (O&M) ( 2 ) policy conditions hence, claim stands non Lap Gastric Bypass.” The learned District Consumer Disputes Redressal Forum, vide order dated 23.12.2014 (Annexure P-4), while considering the evidence on record and while relying upon judgment dated 13.12.2013 Consumer Disputes Redressal Commission, Punjab in a Assurance Company Limited etc. not fall under cosmetic surgery so as to exclude medical reimbursement. The relevant extract from the order dated 23.12.2014 is reproduced herein under: However, the repudiation of the claim made by the opposite parties is not legal and valid. Similar proposition arose in appeal titled as Ashwani Goyal appellant Vs. New India Assurance Company Limited etc. respondents decided on 13.12.2013 by the Hon’ble Consumer Disputes Redressal Commission, Punjab, Chandigarh, wherein the Hon’ble Commission went on to hold that morbid obesity does not fall under cosmetic surgery. There being no evidence on record that Clause 4.4.6. of the policy was brought to the pointed notice of the insured, therefore, it had no binding effect on the insured. In the case in hand also, the facts of the case are quite similar to the authority cited above. In the case in hand also, no pointed attention of the complainant was drawn to Clause 4.4.6 of the policy at the issuing the insurance policy in dispute nor there are any complicated diseases like high blood pressure, heart disease, osteoarthritis of wei SA/respiratory problem, gastro esophage and infertility etc. allegedly suffered by the complainant from the treatment history adduced on record. Therefore, surgery conducted on the complainant cannot be termed to be cos of imagination and the same cannot be said to fall under the exclusion clause as stated by the counsel for the opposite parties. claim stands non-payable. Morbid Obesity for sputes Redressal Forum, vide order dated hile considering the evidence on record and while relying upon judgment dated 13.12.2013 rendered by the State Consumer Disputes Redressal Commission, Punjab in Ashwani Goyal Vs. a Assurance Company Limited etc., held that “morbid obesity” does not fall under cosmetic surgery so as to exclude the claim of the claimant for The relevant extract from the order dated However, the repudiation of the claim made by the opposite parties is not legal and valid. Similar proposition arose in appeal titled as Ashwani Goyal appellant Vs. New India Assurance Company 13.12.2013 by the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh, wherein the Hon’ble Commission went on to hold that morbid obesity does not fall under cosmetic surgery. There being no evidence on was brought to the pointed notice of the insured, therefore, it had no binding effect on the insured. In the case in hand also, the facts of the case are quite similar to the authority cited above. In the case in hand also, no pointed attention of use 4.4.6 of the policy at the time of issuing the insurance policy in dispute nor there are any complicated diseases like high blood pressure, heart disease, osteoarthritis of weight, SA/respiratory problem, gastro esophageal reflux/heart burn depression and infertility etc. allegedly suffered by the complainant from the treatment history adduced on record. Therefore, surgery conducted on the complainant cannot be termed to be cosmetic surgery by any stretch and the same cannot be said to fall under the exclusion clause as stated by the counsel for the opposite parties.” sputes Redressal Forum, vide order dated hile considering the evidence on record and rendered by the State Ashwani Goyal Vs. does the claim of the claimant for The relevant extract from the order dated VIMAL KUMAR 2026.01.16 12:46 I attest to the accuracy and integrity of this document CWP-21332-2025 (O&M) 4. Aggrieved by the aforesaid order, the petitioner preferred an appeal before the Commission, 06.04.2016 (Annexure P to be considered as a disease and is not extract from the order dated 06.04.2016 passed by the State Consumer Disputes Redressal Commission is reproduced herein “12. xxx As per the discharge summary Ex.C24, the chief complaints were Morbid Obesity with BMI of 40.0 sleep apnoea, appendectomy 20 years back” Morbid obesity is a medical term describing people who have a Body Mass Index (BMI) 40, or of 35 to 40 with significant medical problems caused by or made worse by their weig pounds above ideal weight. Severly overweight, health risks. High blood pressure. Diabetes. “Morbid Obesity is a serious disease that has been linked to shortened life expectancy. condition, but ‘Morbid Obesity’ is considered as a disease which leads to many ailments. There is no evidence on record to prove that the treatment undergone by the complainant was in the nature of cosmetic surgery various serious health problems like cancer, syndrome, diabetes etc. and the diseases which are the result of Morbid Obesity. Morbid obesity is not cosmetic surgery been taken by this Commission in First Appeal No. District Forum rightly observed that Morbid Obesity is not cosmetic surgery, therefore, the claim of the complainant did not fall under the exclusion clause of the policy 5. The petitioner petition before the National Consumer Disputes Redressal Commission, (O&M) ( 3 ) Aggrieved by the aforesaid order, the petitioner preferred an appeal before the State Consumer Disputes Redressal mission, Punjab, which came to be dismissed 06.04.2016 (Annexure P-5) wherein it was observed that to be considered as a disease and is not obesity extract from the order dated 06.04.2016 passed by the State Consumer Disputes Redressal Commission is reproduced herein xxx xxx As per the discharge summary Ex.C24, the chief complaints were Morbid Obesity with BMI of 40.0 kg/m.sq, breathlessness on exertion, sleep apnoea, appendectomy 20 years back” Morbid obesity is a medical term describing people who have a Body Mass Index (BMI) 40, or of 35 to 40 with significant medical problems caused by or made worse by their weight. BMI of 40 amounts to approximately 100 pounds above ideal weight. Severly overweight, health risks. High blood pressure. Diabetes. Morbid Obesity is a serious disease that has been linked to shortened life expectancy.” It is clear that ‘Obesity’ is a common medical condition, but ‘Morbid Obesity’ is considered as a disease which leads to many ailments. There is no evidence on record to prove that the treatment undergone by the complainant was in the nature of cosmetic surgery. As per medical jurisprudence, Morbid Obesity leads to various serious health problems like cancer, syndrome, diabetes etc. and the diseases which are the result of Morbid Obesity. Morbid obesity is not cosmetic surgery been taken by this Commission in First Appeal No. District Forum rightly observed that Morbid Obesity is not cosmetic surgery, therefore, the claim of the complainant did not fall under the exclusion clause of the policy.” he petitioner – Insurance Company, still dissatisfied petition before the National Consumer Disputes Redressal Commission, Aggrieved by the aforesaid order, the petitioner – Insurance Company State Consumer Disputes Redressal which came to be dismissed vide order dated wherein it was observed that “morbid obesity” obesity simplicitor. The relevant extract from the order dated 06.04.2016 passed by the State Consumer Disputes Redressal Commission is reproduced herein under: As per the discharge summary Ex.C24, the chief complaints were kg/m.sq, breathlessness on exertion, sleep apnoea, appendectomy 20 years back” Morbid obesity is a medical term describing people who have a Body Mass Index (BMI) of 40, or of 35 to 40 with significant medical problems caused by or made ht. BMI of 40 amounts to approximately 100 pounds above ideal weight. Severly overweight, health risks. High Morbid Obesity is a serious disease that has been linked to shortened It is clear that ‘Obesity’ is a common medical condition, but ‘Morbid Obesity’ is considered as a disease which leads to many ailments. There is no evidence on record to prove that the treatment undergone by the complainant was in the nature of cosmetic . As per medical jurisprudence, Morbid Obesity leads to various serious health problems like cancer, heart disease, metabolic syndrome, diabetes etc. and the diseases which are the result of Morbid Obesity. Morbid obesity is not cosmetic surgery and same view has been taken by this Commission in First Appeal No.1687 of 2010. The District Forum rightly observed that Morbid Obesity is not cosmetic surgery, therefore, the claim of the complainant did not fall under the still dissatisfied, preferred a revision petition before the National Consumer Disputes Redressal Commission, Insurance Company State Consumer Disputes Redressal vide order dated ” is The relevant extract from the order dated 06.04.2016 passed by the State Consumer a revision petition before the National Consumer Disputes Redressal Commission, VIMAL KUMAR 2026.01.16 12:46 I attest to the accuracy and integrity of this document CWP-21332-2025 (O&M) which also came to be dismissed vide impugned order dated (Annexure P Redressal Commission. 6. Learned counsel for the petitioner that the treatment “obesity” and that “obesi such, the petitioner is not respondent No.1 for the same. 7. We have considered the aforesaid submission and have also gone through the impugned orders 8. We are unable to agree with the submission raised on behalf of the petitioner – Insurance Company to the effect that of “obesity” nature of a disease, whi assigned by the by the State Consumer Disputes Redressal Commission in appeal and National Consumer Disputes Redressal Commission in revision founded. In any case, the scope of interference in writ jurisdiction assail the said orders would be very limited i.e. if there is some sheer perversity in the impugned orders or evidence, which is no in M/s Garment Craft Vs. Prakash Chand Goel, AIR 2022 SC 422 defining the scope of interference under Article 227 of the Constitution, held as under: (O&M) ( 4 ) which also came to be dismissed vide impugned order dated (Annexure P-1) reiterating the findings of the State Consumer Disputes Redressal Commission. Learned counsel for the petitioner – Insurance Company vehemently argued that the treatment undertaken for “morbid obesity and that “obesity” is excluded as per the terms of the policy and as such, the petitioner is not bound to reimburse the expenditure incurred by respondent No.1 for the same. We have considered the aforesaid submission and have also gone through the orders. are unable to agree with the submission raised on behalf of the petitioner Insurance Company to the effect that “morbid obesity ” would fall under the excluded clause. Morbid obesity is in the nature of a disease, which can be life threatening. We assigned by the District Consumer Disputes Redressal Commission as well as by the State Consumer Disputes Redressal Commission in appeal and National Consumer Disputes Redressal Commission in revision founded. In any case, the scope of interference in writ jurisdiction assail the said orders would be very limited i.e. if there is some sheer perversity in the impugned orders or if there is some sheer misreading of evidence, which is not there in the instant case. M/s Garment Craft Vs. Prakash Chand Goel, AIR 2022 SC 422 defining the scope of interference under Article 227 of the Constitution, held which also came to be dismissed vide impugned order dated 23.04.2025 reiterating the findings of the State Consumer Disputes Insurance Company vehemently argued morbid obesity” is one of the types of excluded as per the terms of the policy and as to reimburse the expenditure incurred by We have considered the aforesaid submission and have also gone through the are unable to agree with the submission raised on behalf of the petitioner morbid obesity” being in the nature would fall under the excluded clause. Morbid obesity is in the ch can be life threatening. We find that the reasoning Disputes Redressal Commission as well as by the State Consumer Disputes Redressal Commission in appeal and National Consumer Disputes Redressal Commission in revision is well founded. In any case, the scope of interference in writ jurisdiction so as to assail the said orders would be very limited i.e. if there is some sheer there is some sheer misreading of t there in the instant case. The Hon’ble Supreme Court M/s Garment Craft Vs. Prakash Chand Goel, AIR 2022 SC 422, while defining the scope of interference under Article 227 of the Constitution, held 23.04.2025 reiterating the findings of the State Consumer Disputes Insurance Company vehemently argued one of the types of excluded as per the terms of the policy and as to reimburse the expenditure incurred by We have considered the aforesaid submission and have also gone through the are unable to agree with the submission raised on behalf of the petitioner ure would fall under the excluded clause. Morbid obesity is in the reasoning Disputes Redressal Commission as well as by the State Consumer Disputes Redressal Commission in appeal and well so as to assail the said orders would be very limited i.e. if there is some sheer there is some sheer misreading of The Hon’ble Supreme Court , while defining the scope of interference under Article 227 of the Constitution, held VIMAL KUMAR 2026.01.16 12:46 I attest to the accuracy and integrity of this document CWP-21332-2025 (O&M) “18. Having heard the counsel for the parties, we are clearly of the view that the impugned order is contrary to law and cannot be sustained for several reasons, but primarily for deviation from the limited jurisdiction exercised by the High Court under Article Constitution of India. The High Court exercising supervisory jurisdiction does not act as a court of first appeal to reappreciate, reweigh the evidence or facts upon which the determination under challenge is based. error of fact or even a legal flaw when the final finding is justified or can be supported. The High Court is not to substitute its own decision on facts and conclusion, for that of the inferior court or tribunal. jurisdiction exe right grave dereliction of duty or flagrant abuse, violation of fundamental principles of law or justice. is exercised sparingly in appropriate cases, like when there evidence at all to justify, or the finding is so perverse that no reasonable person can possibly come to such a conclusion that the court or tribunal has come to. It is axiomatic that such discretionary relief must be exercised to ensure there is no 9. Examining the impugned orders in the light of ratio of law Garment Craft’s case (supra) impugned orders jurisdiction. dismissed. 12.01.2026 Vimal (O&M) ( 5 ) Having heard the counsel for the parties, we are clearly of the view that the impugned order is contrary to law and cannot be sustained for several reasons, but primarily for deviation from the limited jurisdiction exercised by the High Court under Article Constitution of India. The High Court exercising supervisory jurisdiction does not act as a court of first appeal to reappreciate, reweigh the evidence or facts upon which the determination under challenge is based. Supervisory jurisdiction is error of fact or even a legal flaw when the final finding is justified or can be supported. The High Court is not to substitute its own decision on facts and conclusion, for that of the inferior court or tribunal. jurisdiction exercised is in the nature of correctional jurisdiction to set right grave dereliction of duty or flagrant abuse, violation of fundamental principles of law or justice. is exercised sparingly in appropriate cases, like when there evidence at all to justify, or the finding is so perverse that no reasonable person can possibly come to such a conclusion that the court or tribunal has come to. It is axiomatic that such discretionary relief must be exercised to ensure there is no Examining the impugned orders in the light of ratio of law Garment Craft’s case (supra), we do not find any perversity or illegality in the impugned orders so as to warrant any interference jurisdiction. Finding no merit in the instant petition, the same is hereby dismissed. (GURVINDER SINGH GILL Whether speaking/reasoned: Whether reportable: Having heard the counsel for the parties, we are clearly of the view that the impugned order is contrary to law and cannot be sustained for several reasons, but primarily for deviation from the limited jurisdiction exercised by the High Court under Article 227 of the Constitution of India. The High Court exercising supervisory jurisdiction does not act as a court of first appeal to reappreciate, reweigh the evidence or facts upon which the determination under Supervisory jurisdiction is not to correct every error of fact or even a legal flaw when the final finding is justified or can be supported. The High Court is not to substitute its own decision on facts and conclusion, for that of the inferior court or tribunal. The rcised is in the nature of correctional jurisdiction to set right grave dereliction of duty or flagrant abuse, violation of fundamental principles of law or justice. The power under Article 227 is exercised sparingly in appropriate cases, like when there is no evidence at all to justify, or the finding is so perverse that no reasonable person can possibly come to such a conclusion that the court or tribunal has come to. It is axiomatic that such discretionary relief must be exercised to ensure there is no miscarriage of justice.” Examining the impugned orders in the light of ratio of law laid down in M/s e do not find any perversity or illegality in the any interference in exercise of writ Finding no merit in the instant petition, the same is hereby GURVINDER SINGH GILL) JUDGE (RAMESH KUMARI) JUDGE Yes/No Yes/No M/s e do not find any perversity or illegality in the in exercise of writ Finding no merit in the instant petition, the same is hereby VIMAL KUMAR 2026.01.16 12:46 I attest to the accuracy and integrity of this document