The Insurer had a duty to inform the appellants that a change regarding the limitation on its liability was being introduced

by admin | Apr 17, 2023 | Legal

The Insurer had a duty to inform the appellants that a change regarding the limitation on its liability was being introduced

Case Title: Jacob Punnen and another versus United India Insurance Co Ltd

Decided on 9 Dec 2021

“The Insurer had a duty to inform the appellants that a change regarding the limitation on its liability was being introduced”

In this case Jacob Punnen and another versus United India Insurance Co Ltd, a bench comprising Justices S Ravindra Bhat and KM Joseph was considering an appeal against an order of the National Consumer Disputes Redressal Commission, which denied relief to the appellants.

The appellants, two senior citizens, had availed a mediclaim policy from United India Insurance in 1982, which was renewed on yearly basis. In 2008, the second appellant had to undergo angioplasty surgery. A claim of Rupees 3.82 lakhs was submitted by the appellants to the insurer with respect to the angioplasty surgery. The coverage at the relevant time was Rs 8 lakhs. However, the insurer accepted the claim for only Rupees 2 lakhs, saying that the renewed agreement had a clause which limited the liability with respect to surgeries like angioplasty to an amount of Rs.2 lakhs.

The policy holder is under the impression that the existing conditions are being renewed.
“If the renewed contract is agreed, in all respects, by both parties, undoubtedly the fresh terms (with restrictions) would be binding. However, that would not be the case when a new term is introduced unilaterally about which the policy holder is in the dark. Further, the allusion to continuation of the terms of the Gold policy in respect of senior citizens (who were not to be compelled to migrate to another policy) but were to be subject to the same terms, upon payment of a different rate of premia, reinforces the conclusion that there was in fact, a renewal of the existing terms”.

Duty of insurers

The Court noted that a striking feature of the insurance contract is the principle of uberrima fide (duty of utmost good faith). In this backdrop, the insurer cannot plead that it is the duty of the policyholders to satisfy themselves about the terms and conditions. The Court took note of two particular facts – (1) the appellants are in need of health insurance due to advanced age; (2) the insurance policies are in standard form which offers no space for bargain or negotiation.
“In the present case, the standard form contract, renewed year after year, left the appellants only with the choice of raising the insurance cover”. That being the situation, the “informational blackout” by the insurer was a crucial omission, held the Court.
Justice Joseph held :

“‘The Insurer had a duty to inform the appellants that a change regarding the limitation on its liability was being introduced. there was unjustifiable non-disclosure by the Insurer about the introduction of clause of limitation and, in this case, it constituted a deficiency in service and resultantly the appellants are entitled to relief”.

Pecuniary Jurisdiction under Consumer Protection Act, 2019

by admin | Sep 27, 2020 | Consumer Rights and Laws

Pecuniary Jurisdiction under Consumer Protection Act, 2019

The National Consumer Disputes Redressal Commission (NCDRC) in M/S Pyaridevi Chabiraj Steels Pvt. Ltd. V. National Insurance Company Ltd. & Ors. [Consumer Case No. 833 of 2020] held that for determining the pecuniary jurisdiction of the Consumer for a and the value of the goods “paid” as consideration has to be taken and not the value of goods or services “purchased”. It was observed by the court that the case being governed under the Consumer Protection Act, 1986, NCDRC would have jurisdiction in the matter since pecuniary jurisdiction thereunder was determined by taking the “value of the goods or services and compensation”. Meaning thereby that the value of the goods or services as also the compensation would be added to arrive at a conclusion as to whether the National Commission has the jurisdiction or not. It was further observed by the court that under the new law, the NCDRC has jurisdiction to entertain complaints where the “value of the goods or services paid” as consideration exceeds R. 10,00,00,000.

It was held that, “It appears that the Parliament, while enacting the Act of 2019 was conscious of this fact and to ensure that Consumer should approach the appropriate Consumer Disputes Redressal Commission whether it is District, State or National only the value of the consideration paid should be taken into consideration while determining the pecuniary jurisdiction and not value of the goods or services and compensation, and that is why a specific provision has been made in Sections 34 (1), 47 (1) (a) (i) and 58 (1) (a) (i) providing for the pecuniary jurisdiction of the District Consumer Disputes Redressal Commission, State Consumer Disputes Redressal Commission and the National Commission respectively.”

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NCDRC asks Yash Raj Films to compensate for excluding song from movie ”Fan”

by admin | Apr 26, 2020 | Consumer Rights and Laws

NCDRC asks Yash Raj Films to compensate for excluding song from movie ”Fan”

National Consumer Disputes Redressal Commission or NCDRC directed Yash Raj Films (YRF) to pay Rs 10,000 as compensation to a teacher in Maharashtra”s Aurangabad, who was disappointed by exclusion of a song from Shah Rukh Khan-starrer ‘’Fan”.

The decision of the NCDRC was made after a complaint was registered by a consumer against YRF for promoting the movie ‘Fan’ starring Shahrukh Khan with the song ‘Jabra Fan’ in its promotional campaign, which then never appeared in the actual screening of the movie. The complainant felt cheated as she and her family decided to watch the movie on the basis of the song in the promos but the song did not appear in the movie.

YRF argument that the complainant was not a consumer as defined under CPA 1986 was rejected by the NCDRC. It argued that though the money paid by the teacher was not going directly to the producer, yet the producer, exhibitor and distributor all share the final revenue from ticket sales. Therefore, the NCDRC held that the complainant was in law and infactis a consumer of YRF when the teacher purchased the ticket to watch the movie.

The NCDRC alsodelved into the interpretation of “deficiency” and “unfair trade practice” under the CPA 1986. The Commission noted that the obvious purpose behind such an unfair trade practice is to draw potential viewers to cinema halls by luring them with the song and thereby making a profit at the cost of the viewer.

The presiding member V K Jain stated that he failed to understand the logic behind including the song in the promo but excluding it while exhibiting the movie. He stressed that the intention of the producer was to deceive the viewers by making them believe that the song would form part of the movie while knowing it very well that the said song would not be a part of the movie when it is screened in the cinema halls.

The NCDRC rejected the contention of the YRF that the producer and the actor of the movie had publicly declared the song which forms part of the promo would not be a part of the movie. The commission called it insufficient since it was not necessary that a person who watched the promo would have also seen the said interview.

The NCDRC observed that “When the producer of a movie shows the promos of the said movie on TV Channels, etc. and such promos include a song, any person watching the promo would be justified in believing that the movie would contain the song shown in the said promos, unless the promo itself contains a disclaimer that the song will not be a part of the movie. If a person likes the song shown in the promo and based upon such liking decides to visit a cinema hall for watching the said movie for a consideration, he is bound to feel deceived, disappointed and dejected if the song shown in the promo is not found in the film.” On this basis the NCDRC was of the opinion that the practice of using a song on TV channels to promote a movie and then not showing the song in the actual movie constitutes an unfair trade practice.

The National Consumer Disputes Redressal Commission (NCDRC) held the exclusion of song ”Jabra Fan” as “unfair trade practice” and said the person who decides to watch the movie after seeing the song in promotion is bound to feel “deceived, disappointed and dejected”.