The respondent approached the National Consumer Disputes Redressal Commission (NCDRC). Vide the impugned order, the Commission held in favor of the respondent and directed the appellant to pay the insured sum.
“When the fact of a knee injury is established through evidence such a X-Rays, MRI reports and expert opinion of doctors, the repudiation on the basis of a pre-existing toe injury, that has not been established to have occurred/recurred during the period of insurance cover, makes the repudiation a deficiency in service”, the Commission opined.