Revival of a lapsed cancer policy triggers its contractual 180-day waiting period.

The petitioner held a Future Generali Cancer Protect Plan with a sum assured of ₹20 lakh. The annual premium due on 15 June 2024 was not paid within the 30-day grace period, and the policy lapsed on 16 July 2024.

The petitioner paid the premium and the policy was reinstated on 20 August 2024. He was diagnosed with colon cancer in December 2024 and his claim was repudiated because the diagnosis occurred within the policy’s 180-day waiting period following reinstatement.

The insurer’s review committee and the Insurance Ombudsman upheld the repudiation. The petitioner then sought relief under Article 226, challenging the repudiation, the Ombudsman’s award and the waiting-period clause.

Whether a writ petition under Article 226 was maintainable and could be entertained against the private insurer in the circumstances of the case.

Whether the insurer correctly repudiated the claim because the cancer was diagnosed within 180 days of the policy’s reinstatement, and whether the insurer’s communications or conduct waived that waiting period.

Under Article 226, a private body may be amenable to writ jurisdiction where it discharges a public function and the challenged action has a public-law element; however, maintainability is distinct from whether the court should entertain the petition. S. Shobha v. Muthoot Finance Ltd., (2025) 11 SCC 335, and LIC of India v. Asha Goel, (2001) 2 SCC 160, require the court to consider the nature of the dispute and whether factual inquiry is needed before entertaining a contractual insurance claim.

Insurance policies are construed according to their terms, without rewriting the contract: Vikram Greentech India Ltd. v. New India Assurance Co. Ltd., (2009) 5 SCC 599. Exclusion clauses must be strictly construed, but an insurer cannot be made liable for a risk outside the policy’s cover: United India Insurance Co. Ltd. v. Hyundai Engineering and Construction Co. Ltd., (2024) 6 SCC 310.

A policy clause expressly restarting a time period on reinstatement must be given effect: Reliance Life Insurance Co. Ltd. v. Jaya Wadhwani, (2024) 2 SCC 427. Mere conduct or administrative communications do not, without a clear basis for waiver, nullify an express policy condition; the Court also considered Saurashtra Chemicals Ltd. v. National Insurance Co. Ltd., (2019) 19 SCC 70.

The material facts were undisputed, and the dispute turned on interpreting the policy. The Court held that the lapse clause had to be read together with the revival provisions, which expressly imposed a 180-day waiting period from reinstatement.

The petitioner’s policy was reinstated on 20 August 2024, while his cancer was diagnosed within the ensuing 180 days; the policy therefore excluded the claim.

The insurer’s reminders and invitation to revive the policy did not waive the waiting period: the communications stated that revival was subject to the company’s norms and directed the petitioner to the policy terms.

Because no disputed factual inquiry was required, the Court considered the petition entertainable, but found no basis to disturb the contractual outcome.

It found no infirmity in the claim repudiation, the review decision or the Insurance Ombudsman’s award. The writ petition was dismissed, with no order as to costs.