Good News! Delayed In Filing An Insurance Claim? Your Claim Still Cannot Be Denied!

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Posted on January 15, 2013 by Runjhun

complaint against oriental insurance consumer forum says claims are not timebound

Insurance and good news is an oxymoron in more ways than one. Yet this is one of those rare times when tidings from the insurance industry are favorable for the average consumers.

Predictably, insurance industry is hardly responsible for the good stuff. It flows from the Maharashtra State Consumer Dispute Resolution Commission.

In a landmark verdict that has the potential of fundamentally changing the way the claims are rejected by the insurers in this country, the Maharashtra State Commission has held that insurance claims are not timebound. The ‘deadline’ for filing a claim is not mandatory but only directory and the insurers cannot reject any claim simply because it was filed after the expiry of this ‘deadline’.

This remarkable verdict was delivered by the State Commission while deciding upon a complaint filed by a widow against the Oriental Insurance Company Ltd. The forum directed The Oriental Insurance Company Ltd to pay the widow of a man who died in a 2006 accident the entire claim of Rs 1 lakh plus a compensation of Rs 46,000 even though the claim had been filed well past the one-month ‘deadline’.

The Commission further stated that it has constantly held that giving intimation within specified period or within one month is not a ‘mandatory condition’, but it is a ‘directory’ in nature and breach of this condition does not empower appellant insurance company to forfeit or foreclose the insurance claim required to be duly settled.

And thus, the insurers in the country were duly snatched of one of their favorite grounds for repudiation of valid claims–delay in filing!

Kudos State Commission!

Insurance claims not time-bound: Panel (Times Of India)

Consumer Horror! Diagnostic Center In Delhi Wrongly Diagnoses A Person As HIV+, To Pay 2 Lakhs.

Posted on January 14, 2013 by Runjhun

complaint against diagnostic center for wrongly diagnosing a patient as HIV+, to pay 2L as compensation

Diagnosing someone as HIV+ is bad.

Diagnosing someone as HIV+ wrongly is…you tell me!

One of the worst instances of medical negligence surfaced in New Delhi where a diagnostic laboratory misdiagnosed a person as HIV+.

Horrifying ? You bet.

But this is just the beginning of the story.

As if the horror of the misdiagnosis and trauma of being an HIV+, however briefly was not enough, this particular consumer also lost an employment opportunity abroad because of the diagnosis. The mis-diagnosis had happened when the consumer underwent mandatory fitness tests for a job in Saudi Arabia.

A complaint was filed with the consumer forum and the South West District Consumer Dispute Redressal Forum held that if the test conducted by Paramount Diagnostic Center had to be re-run after four to six weeks to confirm it then the lab could not have reported him unfit on the basis of their (initial) findings… Their haste in declaring him unfit immediately after the test is not only negligent but also rash on their part.

The forum also noted that Paramount`s report had been proved “false” by all subsequent tests including one by the All India Institute of Medical Sciences (AIIMS) which was conducted within two weeks of the “faulty” report. The forum ordered the diagnostic center to pay Rs 2.05 lakh as damages along with Rs.5000 as litigation cost to a 25-year-old youth for wrongly diagnosing him as HIV positive and depriving him of an employment opportunity abroad.

City lab to pay Rs 2.05 lakh for wrongly diagnosing youth as HIV+ (Zee News)

Wedding Woes! Wedding Hall Troubles Or Faulty Banquet Management, Consumer Forum Redresses All!

Posted on January 14, 2013 by Runjhun

complaint against wedding hall owner, banquet management, to pay compensation

Did you know? If you book a wedding hall, you are a consumer!

Marriage season is back and back are the garish decors, blaring music and unarguably, the most shameless magnum opus of wealth, opulence and everything else that the the upper middle class in this country swears by.

Steering clear of the ideological, sociological and psychological debates that are triggered by the Indian marriage extravaganzas, Tadka brings forth two tales that are an uncanny mix of weddings, troubles and consumer forums.

India being India, nothing is sacrosanct and everything, every person and every event is bound to be plagued by troubles–specifically consumer troubles. Weddings are no exceptions and as anyone who have had the (mis)fortune of organizing a wedding in India would vouch, troubles fly faster than the wedding confetti. From troublesome tent owners to unsavory banquet arrangements to problematic wedding hall owners, the range of troubles is as diverse as the wedding rituals.

But fear not. Consumer forums have rose up to the occasion and have undertaken the herculean tasks of actually addressing the wedding troubles.

Case in point is consumer forum verdict from Mumbai.

This was a case where a tax consultant had booked the Imperial banquet hall in Vashi, managed by Kambala Hospitality pvt ltd for hosting the wedding of his daughter Harsha in April 2009. At the time of booking the hall, Kalra had made an advance payment of Rs 50,000 to the proprietor of the banquet hall confirming his booking. Unfortunately, the marriage ceremony had to be cancelled. Kalra promptly informed the banquet management about the cancellation much in advance so that they could lease out their premises to other parties eager on the same date. He sought a refund of his advance.

The proprietor refused the refund but agreed to adjust the amount in any future booking. However, even later, during a fresh booking, the proprietor refused the adjustment. A complaint was filed with the consume forum which held the owner liable and ordered that the aggrieved party be immediately returned the Rs 50,000 advance money besides paying a Rs 10,000 fine and another Rs 2,000 toward legal expenses.

Thane consumer forum fines banquet management (Times of India)

Investor Using A Share Broking Firm? You Are Not A Consumer, Says Consumer Forum.

Posted on January 11, 2013 by Runjhun

investor trading in shares not a consumer says consumer forum

One of the issues that keeps recurring in the complaints filed with Akosha is whether an investor treated as a consumer?

Addressing this question yet again, Thane District Consumer Forum has held that an investor cannot be considered as a consumer because he is indulging in trading in shares for commercial purposes.

This issue was addressed by the forum in response to a complaint filed by an investor using the services of a share broking company, India Infoline Ltd.

As per the complaint, the consumer had opened a Demat account with India Infoline for selling and purchase of share. She deposited Rs 60,555 with the company and Rs 0.05 paise was to be taken as brokerage for trading. It was noticed by the complainant that instead of charging Rs 0.05 paise, they charged Rs 0.10 paise as brokerage. Also, despite a request to stop the transactions from the investor, the company continued the transactions.

However, when the matter was filed with the consumer forum, the forum dismissed the complaint stating that the complainant being an investor trading for commercial purposes was did not fall within the purview of the definition of ‘consumer’ and hence cannot file a complaint with the forum.

Investor trading in shares is not a consumer: Consumer Disputes Redressal Forum (Indian Express)

Consumers Alert! Insurers Can’t Alter The Terms Of Your Policy Unilaterally At The Time Of Renewal.

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Posted on December 26, 2012 by Runjhun

complaint against united india insurance, to pay for altering terms unilaterally

Ever been in a situation where your policy regulations said something when you bought them and suddenly at the time of redemption, you are told that terms were ‘changed’?

Unbelievable as it sounds, this is surprisingly common. Hidden in indecipherable fine print of most policy terms is the insurer’s right to change the policy regulations. Insurers surreptitiously change the policy terms at the time of the renewal and the result more often than not is a very surprised..scratch that..shocked consumer!

This is what precisely happened to a consumer in Mumbai who was admitted in Ashwini Ayurvedic Hospital at Borivali from May 3, 2007 to May 24, 2007, for which she was billed Rs 77,050. In addition, she had spent Rs 3,432 for medicines. She claimed these amounts under her mediclaim policy issued by United India Insurance, but the company rejected it, stating ayurvedic treatment was not covered under the policy. This despite the fact that similar claims had been honoured in the past by the Company.

The aggrieved consumer filed a complaint with the Mumbai Suburban District Consumer Forum which held this conduct of the insurance company was arbitrary. The Forum also observed the policy excluded only claims in respect of naturopathy treatment. There was no clause which excluded claims for ayurvedic treatment. The Forum directed the insurance company to pay the entire claim amount of Rs 84,491 along with nine per cent interest and Rs 5,000 as costs.

The most crucial aspect of this verdict was the fact that the consumer had challenged the change in the terms and conditions and claimed that the policy ought to be renewed on identical terms contracted when the insurance first came into existence. On the other hand, the insurance company claimed it was yearly contract and it had a right to change the policy conditions.

The forum, relying on the judgment of the Supreme Court, in the case of Biman Krishna Bose v. United India Insurance held the terms and conditions of the policy could not be unilaterally changed at the time of renewal and that renewal would have to be on identical terms and conditions as embodied in the original policy when it was first issued.

A commendable verdict and a crucial one with respect to curbing the surreptitious practice of unilaterally altering the terms and conditions of the policy without the consent or knowledge of the policy holder.

Insurers have to inform policy holders about change in terms (Business Standard)

And Now, Complaining Against Your Local Kirana Store Shall Pay–Quickly And Conveniently!

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Posted on December 24, 2012 by Runjhun

complaint against neighborhood kirana stores made easy by consumer affairs ministry

If we were to tell you that you should sue your neighborhood kirane waale bhaiya for cheating you, you would laugh,hysterically…or deem us to be delusional!

Who cares for petty cheating when serious issues are not resolved in time? Go to a consumer court for those 100 rupees that were fleeced…we must be really kidding you!

But no, we are not. We solemnly suggest that you would soon start considering filing a complaint every time your neighbourhood store cheats you.

Or so Consumer Affairs Ministry wants us to believe.

We had reported that a Parliamentary Standing Committee had proposed certain amendments to the existing law to the Ministry (see the article here Online Shopping Troubles? Filing A Complaint Set To Get Easier As Ministry Proposes Changes). If these materialize, they will enable the smaller complaints to be resolved quickly and effectively without getting stuck into the rut of pendency.

In addition to the facility of filing complaint online which is to be introduced very soon, the consumer affairs ministry has decided to set up a mediation centre, similar to a Lok Adalat, in each district of India under direct supervision of the district consumer forum. This measure is also expected to reduce burden on the consumer courts and help in faster disposal of cases.

It is expected that once this amendments are in place and operational, things will improve dramatically for the consumers, especially with respect to the issues faced by them on day to day basis.

For the sake of consumers, we really hope that this turns out to be true!

Soon, sue neighbourhood traders sans the legal rut.(Hindustan Times)