Central Information Commission
S Aruldoss vs United India Insurance Co. Ltd. on 21 February, 2025
के ीय सूचना आयोग
Central Information Commission
बाबा गंगनाथ माग, मुिनरका
Baba Gangnath Marg, Munirka
नई िद ी, New Delhi - 110067
File No: CIC/UIICL/C/2023/145815
CIC/UIICL/A/2024/101075
S Aruldoss ....िशकायतकता /Complainant
.....अपीलकता/Appellant
VERSUS
बनाम
CPIO,
United India Insurance Co.
Ltd, PLA Rathna Towers, 5th
Floor, 212, Anna Salai,
Chennai - 600006 .... ितवादीगण /Respondent
Date of Hearing : 17.02.2025
Date of Decision : 20.02.2025
INFORMATION COMMISSIONER : Vinod Kumar Tiwari
The abovementioned Complaint and Second Appeal have been clubbed
together for disposal through common order as these are based on same RTI
application.
CIC/UIICL/C/2023/145815
CIC/UIICL/A/2024/101075
Relevant facts emerging from complaint/Second Appeal:
RTI application filed on : 29.09.2023
CPIO replied on : Not on record
First appeal filed on : 16.11.2023
First Appellate Authority's order : Not on record
2nd Appeal/Complaint dated : Nil, 03.01.2024
Page 1 of 5
Information sought:
The Complainant/Appellant filed an RTI application dated 29.09.2023 (offline) seeking the following information:
"In the letter cited, the Chairman, Medical Board has addressed the Regional Officer, United India Insurance Company Ltd., Chennai 6 for the Medical -Reimbursement in respect of mine, for the operation of Bilateral Inguinal Hernia. After the Period exceeds eight months, the medical reimbursement has not been given to me.
2) Therefore the under mentioned details may be furnished under RTI Act 2005.
i. How much time prescribed for Medical Reimbursement Claim?
ii. Whether any disciplinary action against the staff who is responsible for the eight months delay?
The copies of files, in which actions have been taken related to my Medical reimbursement, may be furnished."
Not having received any response from the CPIO, the complainant/appellant filed a First Appeal dated 16.11.2023. The FAA order is not on record.
Feeling aggrieved and dissatisfied, complainant approached the Commission with the instant Complaint and Second Appeal.
A written submission dated 13.02.2025 has been filed by Shri R Balu, CPIO is taken on record. Contents of the same are reproduced below:
".....
Query dated 29/09/2023. CPIO reply dated
01/02/2024:
1.With references to the treatment taken by Mr. Arul doss Reply to Query. We
was admitted in MCV Hospital, 1) How much time regret for the delay in
prescribed for reimbursement, 2) whether any action responding due to
against the staff for delay in reimbursement, 3) please search of documents by
furnish the action taken as information after submitting the holder of the
the medical documents. information (Govt of
Query dated 16/11/2023 Tamil Nadu) For RTI
1. With reference to the cited above I request the public Query 1) & 2) requested
information officer to furnish the information as per Right to kindly refer G.O. Ms. to information Act 2005. Request to furnish the information No. 160, Dated as requested from the PIΟ. 29/06/2021.Page 2 of 5
FAA reply: The appeal was not received by FAA till date. From the CLC complaint only we understand that appeal was not received us.
Query dated 03/01/2024 to the CIC:
1. The CPIO and Appellate authority did not furnish the information which is requested in RTI so far. So request you to furnish the information as requested from the PIO.
REPLY FOR THIS APPEAL: The appeal is pertaining to the claim is for the treatment taken by Mr. Arul doss was admitted in MCV Memorial ENT Trust Hospital from 18/10/2022 to 19/10/2022, with diagnosis of Poly P. The said procedure is non- emergency and not covered, as per G.O.160 dt 29/06/2021. Hence the claim got rejected and the letter has been sent to the beneficiary. Hence we pray that we have replied for the RTI query requested by the applicant."
Relevant Facts emerged during Hearing:
The following were present:-
Complainant/Appellant: Present through video-conference. Respondent: Shri P M Soundira Ranjan, Manager/CPIO present through video- conference.
The Complainant/Appellant stated that no reply has ever been received by him from the respondent till date.
The respondent by inviting attention of the Commission towards the contents of his written submission stated that reply has already been given to the appellant vide letter dated 01.02.2024. He tendered his unconditional apology for delay in reply by stating that it was unintentional and may be condoned in the interest of justice.
At the behest of the Commission, the respondent has agreed to resend a copy of his written submission with enclosures and postal receipt vide which initial reply was dispatched, to the appellant. He further stated that the Company will review the insurance claim of the appellant, if he files a representation in this regard.Page 3 of 5
Decision The Commission after adverting to the facts and circumstances of the case, hearing both the parties and perusal of the records observes that the main premise of instant Complaint and Second Appeal was non-receipt of any reply from the respondent. To which, the respondent claimed that he has already given reply to this RTI application vide letter dated 01.02.2024 and he tendered his apology for delay in giving reply which is taken on record.
The Commission finds no infirmity in the reply and as a sequel to it further clarification tendered by the respondent during the hearing to assist the complainant/appellant, as the same was found to be in consonance with the provisions of the RTI Act. Further, no mala fide is established on the part of CPIO which may attract any action in this matter.
Nonetheless, as per hearing proceedings, the respondent is directed to resend a copy of his written submission along with enclosures and postal receipt, free of cost to the complainant/appellant within 2 weeks of the date of receipt of this order.
Lastly, the respondent is strictly cautioned to exercise due diligence and follow timeline mandates while responding to RTI applications, failing which action may be initiated against him as per the RTI Act. The Complainant/Appellant is advised to file before the Respondent Public Authority, a representation regarding settlement of his claim supported by requisite documents as suggested by the respondent during the hearing.
The Complaint/Appeal is disposed of accordingly.
Vinod Kumar Tiwari (िवनोद कुमार ितवारी) Information Commissioner (सूचना आयु ) Authenticated true copy (अिभ मािणत स"ािपत ित) (S. Anantharaman) Dy. Registrar 011- 26181927 Date Page 4 of 5 Copy To:
The FAA, United India Insurance Co. Ltd, PLA Rathna Towers, 5th Floor, 212, Anna Salai, Chennai - 600006 Page 5 of 5 Recomendation(s) to PA under section 25(5) of the RTI Act, 2005:-
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