Source: https://iclg.com/practice-areas/insurance-and-reinsurance-laws-and-regulations/india
Timestamp: 2019-04-23 16:28:50+00:00

Document:
The Insurance Regulatory and Development Authority of India (IRDAI) governs all insurance and reinsurance companies in India.
Insurance business in India can only be undertaken by an Indian insurance company or a reinsurance company/reinsurance branch office that is registered with the IRDAI. Insurers registered in India can undertake life insurance business, general insurance business, and/or health insurance business in accordance with the terms of their registration. Reinsurance companies/reinsurance branches can undertake reinsurance business in accordance with the terms of their registration.
In order to secure registration, an applicant must, along with other formalities, have a minimum paid-up equity capital of Rs.1 billion (circa US$13.6 million) in the case of life, general and health insurers, Rs.2 billion (circa US$27.3 million) in the case of a reinsurer and a minimum assigned capital of Rs.1 billion (circa US$13.6 million) in the case of a reinsurance branch. Moreover, foreign investment in the Indian insurance sector is permitted up to 49%.
Overseas, non-admitted insurers cannot write direct insurance business in India. As a general rule, the purchasing of insurance from overseas insurers by Indian residents is prohibited in India, unless the purchase falls within the general or specific approval of the Reserve Bank of India (RBI).
However, Indian residents are permitted to purchase health insurance policies from overseas insurers provided the aggregate remittance (including premium) does not exceed the prescribed limit. Indian residents are also permitted to purchase insurance policies in respect of any property in India or any ship, vessel or aircraft registered in India with an insurer whose principal place of business is outside India only with IRDAI’s permission.
Non-admitted insurers who have registered with IRDAI as Cross Border Reinsurers can write reinsurance of Indian risks from overseas in accordance with the IRDAI’s regulations on the reinsurance of life and general insurance business.
Indian insurers are given the liberty to decide their own policy terms and conditions, but insurance products can only be offered if the terms and conditions have been approved by the IRDAI and/or filed with the IRDAI under the applicable product filing procedures.
Further, the extraneous rules that will impact policy terms are: (a) the Insurance Act 1938 which gives policyholders a right to override contrary policy terms in favour of Indian law and jurisdiction; and (b) Indian policyholders cannot be stopped from approaching Consumer Courts.
Under the Companies Act 2013, there is no ban on companies indemnifying directors and officers. The premium paid on such insurance is not to be treated as the remuneration payable to the officer. However, if such a person is proved to be guilty of negligence, default, misfeasance, breach of duty or breach in relation to the company, the premium paid on insurance will be treated as part of the remuneration.
Carriage by Air Act 1972: requires parties to maintain adequate insurance covering any liabilities that may arise.
Companies Act 2013: insurance of deposits accepted by companies.
Deposit Insurance and Credit Guarantee Corporation Act 1961: insurance taken by the banks functioning in India (DICGC is an RBI subsidiary).
Employees State Insurance Act 1948: for insurance to employees in case of sickness, maternity and employment injury.
Inland Vessels Act 1917: insurance of mechanically propelled vessels.
IRDAI (Insurance Brokers) Regulations 2018, IRDA (Registration of Corporate Agents) Regulations 2015, IRDA (Revised Guidelines on Insurance Repositories and Electronic Issuance of Insurance Policies) 2015, IRDA (Registration of Insurance Marketing Firm) Regulations 2015 and IRDA (Insurance Web Aggregators) Regulations 2017: professional indemnity insurance covering errors and omission, dishonesty and fraudulent acts by employees and liability arising from loss of documents or property.
Marine Insurance Act 1963: for marine adventures.
Merchant Shipping Act 1958: on the lives of crew members.
Motor Vehicles Act 1988: compulsory third-party liability insurance.
Payment of Gratuity Act 1972: insurance for gratuity payments to employees.
Personal Injuries (Compensation Insurance) Act 1963: employer’s liability for workers sustaining injuries.
Persons with Disabilities (Equal Opportunities, Protection of Rights and full participation) Act 1995: insurance scheme for employees with disabilities.
Public Liability Insurance Act 1991: accidental cover for those handling hazardous substances and environmental issues.
War Injuries (Compensation Insurance) Act 1943: for workmen sustaining injury in war.
The Insurance Act 1938 restricts the ability of insurers to call a life insurance policy into question after three years on any grounds (including fraud).
The IRDAI (Protection of Policyholders’ Interests) Regulations 2017 provide, amongst other obligations, that insurers follow certain practices at the point of sale of the policy so that: the insured can understand its terms properly; they have proper procedures and mechanisms to hear any grievances of the insured; they clearly state the policy terms (such as warranties, conditions, insured’s obligations, cancellation provisions, etc.); they follow certain claims procedures to expeditiously process claims; and pay interest at the rate of 2% above the bank rate fixed by the RBI at the beginning of the financial year in which claim has fallen due, in cases of delayed payment, etc.
This payment of penal interest has been recently extended from delay in settlement of claims to delay in settlement of other payments made to the policyholders, including payments with respect to maturity, survival benefit and annuities, free look cancellation, surrender, withdrawal, request for refund of proposal deposit, and refund of outstanding proposal deposit.
The IRDAI (Health Insurance) Regulations 2016 permit general insurers and health insurers to decline the renewal of a health insurance policy only on grounds of fraud, moral hazard, misrepresentation or non-cooperation by the insured. Renewal cannot be denied on other grounds; namely, an adverse claims history.
On 20 September 2011, the IRDAI issued certain guidelines for condoning delay in claim intimation and submission of documents in relation to certain types of policies and policyholders to the effect that insurers should not reject claims on the basis of delayed notification if the delay was unavoidable, unless the insurer is satisfied that the claim would have been rejected in any event.
The IRDAI (Health Insurance) Regulations 2016 have also stipulated that all health insurance policies offer portability benefits whereby policyholders are given credit for the waiting period already served under previous health insurance policies with that insurer or any other Indian insurer.
The IRDAI has issued standard form definitions for health insurance and critical illness policies.
The IRDAI has directed insurers to introduce provisions for covering treatment of mental illness on the same basis as is available for the treatment of physical illness.
The IRDAI has issued a Circular of 8 October 2018, in harmony with the provisions of the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act 2017, directing insurers to not discriminate against the insured on account of HIV/AIDS.
There is one other feature of the Indian insurance sector that is worth mentioning. This concerns the government-owned insurers, who are considered an instrument of the State and are thus expected to act justly, fairly, and reasonably.
So far as the Court’s interpretation of the policy terms and conditions is concerned, we have seen a trend towards strict interpretation. The Supreme Court has held that the terms of the policy have to be construed and applied strictly, without altering the nature of the contract as the same may adversely affect the interests of the parties. The clauses of an insurance policy have to be read as they are and consequently the terms of the policy that fix the responsibility of the Insurance Company must also be read strictly.
It is common practice for third parties to name the defendant’s insurer in motor accident-related proceedings.
The Motor Vehicles Act 1988 makes it mandatory for all vehicles to have third-party insurance or third-party liability cover and provides that the rights of an insured under a policy are transferred to a third party claiming against the insured in the event of the insured’s insolvency.
The Motor Vehicles Act empowers the Motor Accident Claims Tribunal to seek the insurers’ involvement in a third-party action against the insured if the tribunal believes the claim is collusive or if the insured fails to contest the claim.
We do not believe that a direct action can be brought against a reinsurer because, amongst other things, there is no privity of contract. However, attempts to sue a reinsurer may be made. The other exception where an insured may bring a direct action against a reinsurer would be if the contractual arrangements permitted it, for example, through a “cut through” clause, although no such clause has been tested before the Indian Courts so far.
Indian law mandates that a contract of insurance be one of utmost good faith. Insurers are therefore entitled to a fair presentation of the risk prior to inception and if there has been a misrepresentation or non-disclosure of a material fact, the insurer can avoid the policy ab initio. Unless the misrepresentation or non-disclosure was fraudulent, the premium must be returned to the policyholder. For life insurance policies, however, the policy cannot be called into question on any grounds (including fraud) after the completion of three years from the date of the issuance or the revival of the policy.
The insured is required to disclose all material facts whether or not a specific question is asked, but often what is material is guided by the information and documents sought in the proposal form. The Marine Insurance Act 1963 requires that the insured makes a full and frank disclosure prior to inception. The Supreme Court has said that this is to be done through the proposal form. The IRDAI (Protection of Policyholders’ Interests) Regulations 2017 also imposes an obligation on the insured to disclose all material information.
The right to subrogation is recognised under law. No separate contractual clause is required to trigger the right to subrogation, but as a matter of practice, policies do contain subrogation clauses and insurers will frequently obtain “subrogation letters” and an “assignment” of the third-party claim from the insured. The IRDAI (Protection of Policyholders’ Interests) Regulations 2017 also obligate an insured to assist its insurer in recovery proceedings, if the insurer so requires.
The insured has an option to approach (i) a Court of Civil Jurisdiction or (if the dispute qualifies), (ii) a Consumer Court, or (iii) a Commercial Court, whereas the insurer can only approach a Civil Court or a Commercial Court for recourse. All the three Courts have pecuniary and territorial jurisdiction, so actions brought before them need to be initiated keeping in mind the geographical location of the defendant/cause of action and also the value of the claim.
The Civil Court and Consumer Courts have a three-tiered hierarchy. The Consumer Courts usually follow (in ascending order) District, State and National Consumer Dispute Redressal Commission. There are 629 District Consumer Dispute Redressal Commissions, which can accept claims up to a value of Rs.2 million (circa US$27,000) and 35 State Consumer Dispute Redressal Commission that can accept claims over Rs.2 million (circa US$27,000) and up to a value of Rs.10 million (circa US$137,500) and also appeals against the order of the District Commissions. At the apex lies the National Consumer Dispute Redressal Commission which accepts matters with a value exceeding Rs.10 million (circa US$137,500) and appeals against the decisions of the State Commissions. An appeal from the decision of the National Commission lies before the Supreme Court of India.
The broad ascending hierarchy of the Civil Courts too is similar. This comprises circa 600 District Courts, 24 High Courts and the Supreme Court (highest court in India). Amongst 24 High Courts, four are termed Charter High Courts (i.e. Calcutta, Madras, Bombay and Delhi High Courts) which have original jurisdiction to accept and hear matters which fall above certain pecuniary thresholds, exempting the District Courts from hearing these matters due to a higher pecuniary limit. The rest of the District Courts have unlimited pecuniary jurisdiction, as do the competent Courts of first instance to hear any insurance dispute falling under their territorial jurisdiction. There is no right to a hearing before a jury in India, as the jury system has been abolished and the cases are heard and decided by the judges.
Pursuant to the passing of the Commercial Courts Act 2015, most of the state governments and/or the Chief Justices of various High Courts have designated judges at the District Court and the High Court respectively to adjudicate commercial disputes. The recent amendment to the Commercial Courts Act 2015 has reduced and fixed the minimum pecuniary threshold of commercial disputes at Rs.300,000 (circa US$4,125). The amendment also mandates compulsory mediation before a suit is instituted, save such cases where urgent relief is required to be obtained. Proper mechanisms facilitating mediation, however, are yet to be set up. Appeals against the orders of the Commercial Courts of first instance lie before the Commercial Appellate Courts or the Commercial Appellate Division of the concerned High Court (as the case may be), and the Commercial Courts Act 2015 does not allow for any further appeals from the orders of either the Commercial Appellate Court or the Commercial Appellate Division of a High Court.
Indian litigation is slow and time-consuming. This is attributed to the reported pendency of around 30 million cases presently in Courts across India. Usually it would take the Court of first instance a minimum of four to six years to reach a decision if both the parties are cooperative. In the case of a strongly contested litigation, the period may exceed eight to 10 years. An appeal from such order would take another five years or so to resolve.
The Commercial Courts Act 2015 requires the Commercial Courts to hold a Case Management Hearing where it may pass orders to, inter alia, fix the schedule for filing of evidence, filing written arguments and oral arguments. The Commercial Courts are required to ensure that the arguments are closed not later than six months from the date of the Case Management Hearing. The Commercial Court has to pronounce its judgment within 90 days from the conclusion of arguments.
The Commercial Courts Act 2015 also states that the appellate Courts must endeavour to dispose of appeals filed before it within a period of six months. Of late, the Courts have increasingly mandated strict compliance with statutory timelines in commercial litigation and have even forfeited rights of the non-compliant parties. Our experience regarding the time taken by a Commercial Court to adjudicate upon a dispute has not been uniform. In some instances, disputes have been adjudicated quickly whereas in other instances matters have progressed at the usual pace seen in the jurisdiction.
The power of discovery or summoning of documents is governed by the Code of Civil Procedure 1908 (CPC), as amended by the Commercial Courts Act 2015. The Courts, on a motion by either of the parties to a litigation or of its own accord, direct the parties to summon documents which relate to any matter in the dispute at hand. The relevance of the documents sought under the discovery would depend on the issue at hand. On a motion made for discovery of documents, the Court would direct the party who has made reference to produce the document, to give the same for inspection to the requested party or to answer its inability to produce such document. The Court can also impose costs against a party refusing to produce such documents or for not giving sufficient reasons for non-production of the document.
Non-compliance with an order for discovery of documents can lead to an adverse inference or even dismissal of the action or defence as may be.
The CPC allows any party who would be in possession of documents to produce documents that are material to the dispute even if the person is not arrayed as a party to the ongoing litigation.
The provisions under the Indian Evidence Act 1872 protect communications between a lawyer and his client. Unless an express permission is given by the client, the lawyer is estopped from disclosing such communications unless the same is in furtherance of an illegal purpose. The Indian Evidence Act also specifies that a person cannot be compelled to reveal information between that person and his/her lawyer unless the same is produced with his/her consent and is required to establish his/her testimony.
The Supreme Court and various High Courts in India have issued guidelines recognising the privilege of communications between a lawyer and his clients over documents made in furtherance of litigation. The privilege attributed to these documents is similar to the position in English law.
In terms of documents prepared in the course of settlement negotiations/attempts, it is common for the parties to mark them “without prejudice”, but these are not expressly protected as privileged documents under the Indian Evidence Act and as a matter of practice, are commonly produced before Courts.
Yes, the Courts have the power to call for witnesses within their jurisdiction to give evidence during the litigation before the final orders are reserved. Any non-compliance with the Court summons can even lead to arrest of the person evading such direction from the Court. The Court may not compel a person who is not a resident within its jurisdiction to be present for giving evidence. In such cases, the CPC recognises the Court’s power to issue commissions or interrogatories to the parties whose evidence cannot be obtained easily to determine the issue at hand.
As per the CPC, the examination-in-chief of a witness is required to be on an affidavit, but his attendance is necessary for the purposes of cross-examination. In the case that the witness is unable to appear before the Court, the Court may, in compliance with the provisions of the CPC, issue commissions or interrogatories to address this. The Supreme Court has even permitted cross-examinations to be conducted through video conferencing in cases where witnesses, for reasons beyond their control, are unable to appear before the Court; for example, an infirm person residing outside India.
The Indian Evidence Act allows the Court to hear expert evidence on matters of foreign law, science or art. Appointment of an expert is usually on an application filed by a party asking the Court to permit that party to call an expert to give evidence, or the Court may also decide to appoint its own expert. The report/statement filed by the expert will not automatically become evidence and an expert must be examined as a witness. The contesting party will then have the opportunity to controvert his findings during cross-examination, or even file the evidence of its own expert witness.
The CPC provides for a wide variety of discretionary interim remedies which may be substantive or procedural. In terms of substantive remedies, temporary injunctions and interlocutory orders allow the Court to stop the commission of an act. Further, mandatory injunctions, available under the Specific Relief Act 1963, allow the Court to ask a party to carry out a positive and overt act. In other words, a Court may use an injunction to direct a party to act or restrain it from acting or omitting to act to the detriment of the contesting party. The amended Commercial Courts Act 2015 allows a party seeking an urgent interim relief to bypass the mandatory ‘pre-institution mediation’ and approach the Court directly.
In addition, a Court may also pass directions for a party to direct a deposit of an amount of money or provide surety in the Court in order to secure the interests of the contesting party, especially where that defaulting party is attempting to defeat a possible award or decree against it. This can be done by way of, inter alia, fixed deposits, bank guarantees, demand drafts or a simple direction that a party shall not dispose of its assets during the pendency of the litigation.
These remedies are obviously discretionary and a grant of such a remedy is based on various factors which need to be satisfied and proved before the Court.
The Commercial Courts Act 2015 allows an appeal only in specified circumstances. This right will not be available when the decision of the Court is with the consent of the parties. The first appeal can be made on any ground of error either legally, factually or procedurally, by the Court of first instance. However, no appeal is allowed from any interlocutory order of the Commercial Court and this may be taken as grounds while appealing against the final decree of the Court.
A subsequent appeal from a first appeal is only available in specific cases where there is a substantial question of law involved. Further, no second appeal is available in suits for recovery of an amount which is less than Rs.25,000 (circa US$340). There are some High Courts in the country which are the Courts of first instance where the subject matter of the proceedings is more than a fixed amount. These are the Calcutta High Court, Madras High Court, Bombay High Court and the Delhi High Court. No second appeal is available from a decision of these Courts. The first appeal from a decision of a single judge of these Courts lies to a division bench of the same Court. In cases where an Appeal is not provided for and is not specifically barred by any statute, a Letters Patent Appeal is available.
In civil disputes, the usual sequence is that the decision of a District Court is appealable before a single judge of the High Court. The single judge’s decision can be appealed before a division bench of the High Court. In both these cases, a final stage of appeal is provided under the constitution to the Supreme Court for which prior leave of the Supreme Court is required.
A Court has the discretion to award interest from the date when the cause of action arose to the date of actual payment of the claim. A rate of 9% to 12% is currently applied by the Courts. However, an arbitral award will carry interest at a rate which is 2% higher than the highest prevailing rate of interest on deposits, unless the Tribunal says otherwise.
The Supreme Court has, in the recent case of Vedanta v. Shenzen Shandong, laid out guidelines to ensure reasonable exercise of the discretion of arbitral tribunals to award interest on claims.
The Court may award the successful party its costs of pursuing litigation, but such an award is entirely at the Court’s discretion. It is common for costs awards to be made in favour of a successful party, but the principles of awarding costs are archaic and the level of costs awarded is rarely sufficient to cover the actual costs incurred. In a recent decision, while referring to a statutory upper limit of Rs.3,000 (circa US$40) for costs awards in cases of vexatious litigation, the Supreme Court suggested that the Parliament should consider raising the limit to Rs.100,000 (circa US$1,375). In view of the low level of costs awarded, there are, as yet, no material advantages in making a pre-trial offer in civil litigation and Calderbank letters are hardly, if ever, used.
The Commercial Courts Act 2015 has expanded the definition of costs and the factors to be taken into account by the Court while awarding costs. Costs would now include the fees and expenses of the witnesses, the legal fees and any other expenses incurred in connection with the proceedings. Further, the Commercial Courts are not bound by the aforesaid statutory upper limit for costs awards in cases of vexatious litigation.
Section 89 of the CPC sets out the provision for settlement of disputes outside the Court, keeping in mind the delay in legal procedures and the limited number of judges available. It has now become imperative for the Courts to encourage, though not compel, parties to explore the possibilities of an out-of-court settlement with a view to end litigation between the parties at an early date. The Courts usually have an in-house mediation centre where experienced senior lawyers are appointed on a confidential basis and parties involved in contentious complex cases, which have the potential for an extremely delayed decision, are compelled to explore settlement at the mediation centre with the neutral experienced lawyers acting as mediators. All proceedings at the mediation centre and settlement discussions are kept confidential from the Court and do not prejudice either party in case mediation fails. In certain circumstances, however, the mediator may file a report before the Court if directed to do so. Parties are of course free to return to the Court process.
However, the amended Commercial Courts Act 2015 now requires a plaintiff (to a suit) to mandatorily exhaust the remedy of ‘pre-institution mediation’ before it can institute the suit, provided that urgent interim relief(s) are not sought.
Generally, consent of the parties is a condition precedent to be referred to the mediation. There are no formal sanctions if proceedings are not followed through to their logical end. However, a dispute falling under the Commercial Courts Act 2015 will not be entertained by the Court if the statutorily required mediation has not been exhausted.
The Indian Arbitration and Conciliation Act 1996 (ACA) is based on the UNCITRAL Model Law and was recently amended in 2015. The amended ACA applies to arbitrations which have been instituted after 23 October 2015, while the arbitrations instituted prior to this date continue to be governed by the unamended ACA.
The ACA preserves party autonomy in relation to most aspects of arbitration, such as the freedom to agree upon the qualification, nationality, number of arbitrators (provided it is not an even number), the place of arbitration and the procedure to be followed by the arbitration tribunal. The principle of party autonomy was confirmed by the Constitutional Bench of the Supreme Court of India in Bharat Aluminium Co v. Kaiser and the same was followed in its subsequent decisions.
Where a party files an action before a Court in spite of an arbitration agreement, the other party can apply to that Court to refer the dispute to arbitration instead.
A party can apply to a Court for interim remedies (please see the response to question 5.4 below for further details).
A party may also seek Court’s assistance in taking evidence and summoning a witness.
A party can seek the Court’s assistance for the appointment of an arbitrator if the other party refuses to cooperate in the process.
An arbitration agreement, as per the ACA, must be in writing and signed by the parties. The agreement should reflect the intention of the parties to submit their dispute(s) to arbitration. There is no prescribed form required for the purpose of an arbitration agreement. In fact, it is not necessary for an arbitration agreement to be incorporated into an insurance/reinsurance contract at all. An arbitration agreement can also come into existence if it is contained in a subsequent exchange of letters, telex, telegrams or other means of telecommunications (including by electronic means) which provide a record of the agreement.
The reference in a contract to another document which contains an arbitration clause also constitutes an arbitration agreement if the contract is in writing and the reference is such that it makes the arbitration clause part of the contract.
In relation to domestic arbitration, the ACA bars the intervention from the Courts except for some specific instances wherein the Courts are allowed to intervene – for example, for interim relief, reference to arbitration when an action has been instituted before the Court and for the appointment of arbitrators, where parties have failed to nominate arbitrators within the stipulated timeframe.
In relation to international commercial arbitration, the tendency of the Indian judiciary to intervene is now declining. The decision of the Supreme Court in Bharat Aluminium Co v. Kaiser has reversed the earlier authority which endorsed an interventionist approach under certain circumstances.
However, there are exceptions to the non-interventionist approach. For example, in N Radhakrishnan v. Maestro Engineering, the Supreme Court has held that cases involving allegations of fraud and misrepresentation which go to the root of the agreement, involve adjudication upon substantial questions of law and complicated facts, or that require detailed evidence ought to be decided by the Courts. Nonetheless judgments of the Supreme Court in World Sports Group (Mauritius) Ltd v. MSM Satellite, Swiss Timing Ltd v. Organising Committee, and Commonwealth and A Ayyasamy v. A Paramasivam have diluted the effect of the judgment in Radhakrishnan and demonstrate a growing inclination towards a pro-arbitration and non-interventionist approach in the context of Indian as well as foreign-seated arbitrations.
In addition to the above, the Courts have recognised a few additional categories of matters, such as cases involving disputes relating to: criminal offences; matrimonial disputes; guardianship disputes; insolvency; disputes under the Indian Trusts Act 1882; and winding up and testamentary disputes, which ought not to be arbitrated. Further, the National Consumer Dispute Redressal Commission, in its recent judgment in Aftab Singh v. Emaar MGF Land Limited & Anr, held that disputes under the Consumer Protection Act 1986 cannot be referred to arbitration and an arbitration clause cannot oust the jurisdiction of the consumer courts.
■ an interim injunction or the appointment of a receiver; and such other interim measure of protection as a Court may find just and convenient.
However, pursuant to the amendment to the ACA in 2015, in the event that the Court grants interim relief prior to commencement of the arbitration, the arbitral proceedings have to commence within 90 days of such order by the Court, unless extended by the Court.
Further, once the arbitral proceedings commence, the Court shall not entertain any application for interim relief unless it is satisfied that the arbitration tribunal will not be able to provide an efficacious remedy.
As per the ACA, an arbitral award must state the reasons upon which it is based unless: (a) the parties have expressly agreed that no reasons are to be given; or (b) the award is made upon terms agreed between the parties.
The ACA lays down the grounds on which an award can be challenged before a Court. These grounds are narrow and limited and a Court is not allowed to reassess or re-appreciate the quality of evidence produced before the arbitrator. The Court cannot substitute the tribunal’s findings with its own findings or conclusions and will set aside an arbitral award only if it is shown that a party was under some incapacity, the tribunal lacked jurisdiction, there was a failure to follow principles of natural justice, illegal composition of the tribunal and/or if the award is in conflict with public policy.
is in conflict with the basic notions of morality or justice.

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