Five years after the 26/7 deluge, the consumer forum has ordered an insurance firm to pay compensation to an Andheri shop owner, who suffered major losses in the floods. The forum said the insurance firm repudiated the claim with “a mala fide intention and merely on a technical ground”. The insurance company will now pay the policy holder Rs 1.92 lakh together with an interest of 9% from March 2006 till the realisation of the entire amount and Rs 5,000 towards costs.
The policy holder, Nishat Enterprises, is a partnership firm that owns GKB Eyecare, an optical shop in Andheri (W). In the complaint filed by one of the partners, Ali Hussain Khan, the firm said it had taken an insurance policy from Oriental Insurance Company in respect of goods and property at the shop premises, valid from December 2004 to December 2005. On July 26, 2005, flood water entered the shop and all furniture and optical stock were totally destroyed.
The insurance company was intimated about the loss. When a surveyor visited the shop, the complainant said that the policy had wrongly mentioned the shop number as 18 when it was actually 10. However, the insurance company rejected the claim, saying that as per the survey report, the policy was taken for shop number 18, whereas the complainant’s shop was 10. Khan then filed a complaint with the Mumbai Suburban District Consumer Disputes Redressal Forum.
In their defence, the insurance company contested that the alleged loss occurred at shop 10, whereas shop 18 was insured, and it was not liable for any loss occurred at shop number 10. The forum presided by J L Deshpande and members D S Bidnurkar and V G Joshi said that the firm had requested the insurance company to make the correction. The forum observed that there were only 12 shops and there was no shop 18.
The insurance firm also argued that the policy was taken for commercial purpose and so, the firm is not a consumer within the meaning of the provisions of the Consumer Protection Act. The consumer said it had wrongly applied to the provisions of the Consumer Protection Act. “The firm had not taken the insurance policy to acquire and sell it…it was not the subject of its commercial activity or business.”
Source: http://timesofindia.indiatimes.com/city/mumbai/Insurance-co-told-to-pay-for-26/7-loss/articleshow/6267705.cms

The apex consumer court in Maharashtra has shown insurance firms their place, directing that it is the doctor — and not the insurer — who
can decide whether a case requires emergency medical attention or not. It has also fined the insurer Rs 5,000 for rejecting a claim on this ground lodged by a Versova resident.
The order — coming at a time when insurance firms are desperately trying to whittle down expenses on claims — will spread cheer among the insured, feel consumers’ organizations.
“An insurance company’s officials are not experts who can decide whether a particular case is of medical emergency or not,” the Maharashtra State Consumer Disputes Redressal Commission observed while ordering an insurance company to pay mediclaim to a Versova resident. “It is for the expert doctor in the field to give an opinion if this is a case of medical emergency or not,” the commission stated in its order.
The case dates back to 2000. Shamim Khan was working as a schoolteacher in Jeddah, Saudi Arabia. It was during a visit to India in July 2000 that she suffered unbearable stomach pain that led to severe bleeding.
She also experienced breathing problems and her haemoglobin levels began to drop considerably. Khan was admitted to Bombay Hospital immediately where an emergency surgery was conducted. She was discharged after eight days of stay in the hospital and, after incurring a total expenditure of Rs 41,158, Khan lodged a claim for insurance with the New India Assurance Company Limited from whom she had taken a policy. The policy was in force from April 2000 to March 2001.
Khan’s claim was, however, rejected on the ground that there was “no emergency need to undergo the operation”. Aggrieved by the the repudiation letter she filed a complaint in a district consumer forum, where the insurance company argued that “she (Khan) knew of the illness even before she came to India and had purchased the policy by suppressing material facts of her illness”; so it had the right to repudiate the claim, the insurer pleaded.
Khan had, however, procured a doctor’s certificate to the effect that there was an emergency situation and the doctor was required to operate on her to save her life.
Based on this document, the district forum on July 7, 2007, directed the insurance company to pay the medical claim and also Rs 5000 for causing mental harassment to Khan.
source: Economic Times

The South Goa consumer disputes redressal forum on Monday, held that it had no jurisdiction over a telecom service dispute against Bharat Sanchar Nigam Limited (BSNL) in view of a supreme court judgment.
However, complaints against private telecom service providers can be filed before the forum, it stated.
While stating that the apex court judgment applies to all pending consumer complaints against BSNL, the forum disposed of six cases against the government telecom service provider pending since 2002.
The forum also granted liberty to the parties to refer their disputes against BSNL, subject to the provisions of law, to arbitrators as contemplated under the supreme court judgment.
The Supreme Court in 2009, in the General Manager, Telecom, versus M Krishnan case, involving BSNL as a party, had ended the jurisdiction of consumer courts to entertain disputes relating to the telecom service provider.
It ordered that these disputes be resolved through arbitration provided under Section 7B of the Indian Telegraph Act, 1885.
In view of the judgment of the apex court, the forum had on April 15, 2010, heard final arguments to decide its jurisdiction in telecom matters.
The lawyers of BSNL, private telecom service providers and consumers had submitted their views in the matter before the forum.
Twenty-two telecom cases were pending before the forum which pertained to issues ranging from dropped calls and over-charging of customers to unwanted value-added charges and false calls. The complaints were against mobile service providers, internet service providers, broadband service providers, DTH operators, cable TV operators and landline service providers.
Relying on the Punjab State Commission judgment in the Spice Communication Pvt Ltd case, the forum held that private service providers, operators and companies are beyond the scope of the apex court judgment and as such, all such cases shall continue to be heard on merits by the forum.
Around 16 cases against various private operators are lying before this forum
The commission had also noted in its order that “the private service providers are the licencees to operate mobile lines under section 4 (1) of the Indian Telegraph Act, 1885, and therefore they cannot be equated with the director general of posts and telegraphs nor can they be termed as officers appointed by the director general of posts and telegraphs to discharge the functions of the telegraph authority.
“They are only the licencees, therefore any dispute between the licencee and their consumer is not covered by provisions of section 7B of the Indian Telegraph Act, 1885,” the Punjab State Commission had observed.
Before parting with the judgment, forum president Jagdish Prabhudessai and member Kala Dalal observed that they were aware of the general anxiety and apparent dissatisfaction in the minds of consumers and NGOs after the apex court judgment.
“A submission was made before us that upon the representations received from various NGOs, the central government is seriously thinking of making suitable amendments to the Indian Telegraph Act of 1885,” said the forum.
This is to bring the consumer disputes alternatively within the purview of the Consumer Protection Act, 1986., the forum further said.
“With utmost respect we heard the submission that Parliament is seriously thinking of making necessary amendments to the existing laws concerned so as to best protect the interests of the consumers at large.
“However, the consumer forum cannot wait till then. We do justice in accordance with the law as it stands today,” stated the forum in its order on Monday.
Times of India