Impact of Upholding pecuniary jurisdiction bar by APEX COURT on Medical Profession ?

 

• Will the Apex Court's stance on pecuniary jurisdiction lead to more equitable justice for medical professionals, or simply shift the burden elsewhere?

On29th.April,2025, The Supreme Court of India's decision to uphold the constitutional validity of provisions in the Consumer Protection Act, 2019 (CPA 2019), specifically Sections 34, 47, and 58, which prescribe pecuniary jurisdiction based on the consideration paid for goods or services, has significant implications. 

Below, I am analyzing the alignment with the Indian Constitution &It's impact on medical profession and precautions medical professionals should take.

 Impact on the Medical Profession in India

 The CPA 2019’s pecuniary jurisdiction provisions and their affirmation by the Supreme Court significantly affect the medical profession, as medical services are explicitly covered under the Act following the 1995 *Indian Medical Association v. V.P. Shantha* ruling. Key impacts include:

 # Positive Impacts

- Clarity in Jurisdiction: Doctors and hospitals benefit from a clear jurisdictional framework based on the fees paid by patients. This prevents patients from inflating compensation claims to access higher forums like the NCDRC, reducing frivolous litigation.

- Reduced NCDRC Burden: High-value compensation claims for low-fee services (e.g., consultations costing ₹1,000) are now directed to District Commissions, easing the NCDRC’s workload and allowing it to focus on complex cases.

- Judicial Safeguards: The Court’s reliance on mechanisms to reassess overvalued claims protects doctors from manipulative litigation tactics.

 # Negative Impacts

- Increased Litigation at Lower Forums: District Commissions, with jurisdiction up to ₹1 crore, may see a surge in medical negligence cases, even for high-compensation claims, if the consideration (e.g., hospital fees) is low. These forums often lack the expertise to adjudicate complex medical cases, potentially leading to inconsistent rulings

- Uncertainty in Application: Despite the 1995 ruling, there is ongoing debate within the medical community about whether medical services should fall under the CPA, given the unique nature of the doctor-patient relationship. The omission of “medical services” from the explicit list in Section 2(42) of the CPA 2019, coupled with the phrase “but not limited to,” creates ambiguity, though courts continue to include doctors- Potential Reconsideration: In 2024, the Supreme Court signaled a possible reconsideration of the 1995 *V.P. Shantha* ruling in *Bar of Indian Lawyers v. D.K. Gandhi*, suggesting that professionals (like doctors and lawyers) may not be fully subject to the CPA. 

If revisited, this could exclude doctors, reducing their liability under consumer forums but leaving patients to seek redress under tort law or medical councils- Higher Scrutiny: The CPA 2019’s expanded definition of “consumer” (including telemedicine and e-commerce) and mandatory billing requirements increase doctors’ exposure to consumer complaints, especially for teleconsultations

Conclusion: The CPA 2019’s jurisdiction rules streamline litigation but place a heavier burden on lower forums, which may struggle with medical negligence cases. The potential reconsideration of doctors’ inclusion under the CPA adds uncertainty, but for now, medical professionals remain liable.

                                Precautions Medical Professionals Should Take. 

Given the CPA 2019’s applicability and the pecuniary jurisdiction framework, medical professionals in India should adopt the following precautions to mitigate risks: 

# Legal and Documentation Precautions

- Maintain Detailed Records: Keep comprehensive patient records, including consent forms, treatment plans, and communication logs, to defend against allegations of negligence. The Supreme Court has emphasized that doctors are not liable for adverse outcomes if reasonable care and skill are exercised- Issue Receipts/Bills: The CPA 2019 mandates issuing receipts for all services, including consultations (in-person and telemedicine). Failure to do so is an unfair trade practice, inviting penalties.[](- Obtain Informed Consent: Clearly explain risks, benefits, and alternatives before procedures, and document consent to counter claims of vitiated consent- Transparent Billing: Ensure bills reflect the actual consideration paid, as this determines jurisdiction. Avoid discrepancies that could be construed as misleading practices.

 # Professional Conduct

- Adhere to Standards of Care: Follow the Bolam Test (standard of care expected of an ordinary competent practitioner), as endorsed by the Supreme Court, to minimize negligence claims- Exercise Due Diligence: Even in telemedicine, verify patient details and provide evidence-based advice to avoid liability for deficient service- Avoid Guarantees: Refrain from promising specific outcomes, as unfulfilled expectations can lead to consumer complaints

# Insurance and Legal Support

- Secure Professional Indemnity Insurance: Obtain robust malpractice insurance to cover potential compensation claims, especially given high awards like ₹11 crore in *Balram Prasad v. Kunal Saha* (2013- Engage Legal Counsel: Consult lawyers specializing in consumer law to navigate complaints filed under the CPA, particularly in District Commissions where expertise may be limited.

 # Training and Awareness

- Stay Updated on CPA: Attend workshops on the CPA 2019 and its implications, especially regarding jurisdiction and liability for telemedicine- Ethical Practice: Uphold high ethical standards to reduce complaints, as the Supreme Court has noted rising professional misconduct

# Advocacy by IMA HBI

- Lobby for Exclusion: Engage with other stakeholders like speciality medical associations to advocate for excluding medical services from the CPA, as suggested by the 2024 Supreme Court deliberations. This could shift negligence cases to medical councils or tort law, potentially reducing litigation risks

Conclusion: Medical professionals must prioritize documentation, transparency, and adherence to standards while securing insurance and legal support to navigate the CPA 2019’s framework effectively.

  Final Answer

The Supreme Court’s decision to uphold the CPA 2019’s pecuniary jurisdiction provisions is constitutionally valid, aligning with Article 14 by providing a rational, non-arbitrary classification based on consideration paid. It is reasonable for its clarity and efficiency but raises concerns about overburdening lower forums and limiting access to higher forums for high-compensation claims. 

For the medical profession, the decision increases litigation at District Commissions, which may lack expertise, and sustains liability under the CPA, though future reconsideration could exclude doctors. Medical professionals should maintain detailed records, issue receipts, obtain informed consent, adhere to care standards, secure insurance, and engage legal support to mitigate risks.