Central Information Commission
Amit Kumar Maihan vs Office Of The Insurance Ombudsman, New ... on 3 April, 2025
के ीय सूचना आयोग
Central Information Commission
बाबा गंगनाथ माग, मुिनरका
Baba Gangnath Marg, Munirka
नई िद ी, New Delhi - 110067
File No: CIC/INSON/A/2023/656481
Amit Kumar Maihan .....अपीलकता/Appellant
VERSUS
बनाम
CPIO,
Office of the Insurance Ombudsman,
2/2 A, Universal Insurance Building,
Asaf Ali Road, New Delhi - 110002 .... ितवादीगण /Respondent
Date of Hearing : 25.03.2025
Date of Decision : 02.04.2025
INFORMATION COMMISSIONER : Vinod Kumar Tiwari
Relevant facts emerging from appeal:
RTI application filed on : 26.08.2023
CPIO replied on : 05.10.2023
First appeal filed on : 10.10.2023
First Appellate Authority's order : 03.11.2023
2nd Appeal/Complaint dated : 26.12.2023
Information sought:
The Appellant filed an RTI application dated 26.08.2023 (offline) seeking the following information:
"1. Please provide certified copies of Awards passed by the Hon'ble Ombudsman for the Month of June, July & August 2023."
The CPIO furnished a reply to the Appellant on 05.10.2023 stating as under:
Page 1 of 13"Information sought can not be provided as per section 8 (1) (j) of RTI Act 2005 i.e. 'information which relates to personal information the disclosure of which has no relationship to any public activity or interest, or which would cause unwarranted invasion of the privacy of the individual unless the Central Public Information Officer or the State Public Information Officer or the Appellate Authority, as the case may be, is satisfied that the larger public interest justifies the disclosure of such information.
This disposes off your application."
Being dissatisfied, the appellant filed a First Appeal dated 10.10.2023. The FAA vide its order dated 03.11.2023, upheld the reply of CPIO with the following observations:
"...3. Orders passed by the Insurance Ombudsman have been made available in the website under the link https://www.cioins.co.in/ which can be accessed by the complainant only to protect the personal information of the complainant.
4. The funds for running the Office of Insurance Ombudsman is granted by the Council of Insurance Ombudsman.
5. Orders passed by the Insurance Ombudsman have been made available in the website under the link https://www.cioins.co.in/ which can be accessed by the complainant only to protect the personal information of the complainants.
6. Insurance ombudsman performs quasi judicial functions. Both public and private Insurance Company come under the jurisdiction of the Insurance Ombudsman. There is no fee to be paid for filing complaint before Insurance Ombudsman. Only individual aggrieved insured can file the complaint against insurer to the Insurance Ombudsman. The quasi- judicial acts don't bound anybody but give decisions without the proceedings of the court.
7. The orders passed by the Insurance Ombudsman involve financial implications and hence it is available only to the individual affected.
8. The discretion cited by the PIO is well within the rules of RTI Act 2005.
9. The Office of Insurance Ombudsman, Delhi has not published awards in booklet form.
10. The IRDAI is a Statutory body whereas Insurance Ombudsman is an alternate Grievance Redressal platform. Hence comparison between the two is not Justified.
11. The copies of orders are available in this office. As the office has limited staff. Collation and compilation of such information is not possible.Page 2 of 13
However you may personally visit this office to obtain the available information/documents..."
Feeling aggrieved and dissatisfied, appellant approached the Commission with the instant Second Appeal on the following grounds:
"...The office of the Hon'ble Ombudsman is under statuary obligation to publish the records held by it, especially when decisions rendered by it affects public at large. Therefore, compliance is required and cannot be discounted citing any flimsy reason.
4.2 Orders passed are Public Document - Please refer to Ombudsman scheme, the Order passed by the Ombudsman falls within the ambit of quasi-judicial orders. Once the adjudication has taken place, it falls within the scope of Public document and cannot be termed as private information. Therefore, assumption drawn by PIO in his reply is fundamentally incorrect. No information which has public interest and especially when the issue raised by an individual has been adjudicated upon under a statutory scheme can be withheld from public view unless National Security issue is involved. Attention is drawn towards section 74 of Evidence Act as under:
74. Public documents.--The following documents are public documents-- (1) documents forming the acts or records of the acts--
(i) of the sovereign authority,
(ii) of official bodies and tribunals, and
(iii) of public officers, legislative, judicial and executive, 105[of any part of India or of the Commonwealth], or of a foreign country; (2) public records kept 106[in any State] of private documents.
4.3 The funds for running the office of the Ombudsman are through public money, it is not a charitable or philanthropic venture but the office derives its authority from public money, under a statutory scheme. Therefore, the public at large has the authority to check, read & verify acts done by it.
4.4The Order passed by the Courts, Tribunals, Forums, etc. are published regularly. All these orders fall within definition of public documents as provided under Evidence Act, by no stretch or no authority the judicial and Page 3 of 13 quasi-judicial authority can deny sharing of the same on the grounds of it being private information, unless the orders are already published on its site - like order of other Tribunals, District Court, Consumer Courts, High and Supreme Court.
4.5 Whenever a hearing takes place, parties and members of public have right to witness the same. There is no bar to witness such proceedings (except in camera proceedings). The right of public to witness derives is enshrined in constitution and brings transparency in every sphere. No person can be denied to witness right to witness judicial or quasi-judicial proceedings on the pretext of private matter. Nothing remains private once an individual comes at a door of any public authority to seek relief against corporate bodies. Chances of individual being misguided in the name of privacy are writ large and needs to be checked, hence openness is one step towards it.
4.6 The orders passed by the Ombudsman involves financial implications and pertains to individual well-being, etc. In such circumstances if public is not allowed or witness or read or write about adjudication then certainly it would lead to arbitrary and corrupt practice.
4.7 The discretion cited by the PIO is not absolute and cannot be exercised arbitrarily.
4.8 Earlier also it has remained a practice to publish awards on site or share copies in booklet form. Sudden departure from the established practice without any reason citing the privacy is totally unwarranted and against the statute. The IRDAI regularly puts up penalty orders against Insurers, Individual Surveyors & Brokers etc. on its site. Going by the logic extended by the PIO, the Regulator must not publish information on its site - citing privacy.
5. It is not that required information has to be collected - as per Rule 17 of the scheme same is maintained in soft form on a software complaints management system. Therefore, no extra burden would be there on any of the staff."
Page 4 of 13A written submission dated 18.03.2025 filed by the respondent is taken on record. Contents of the same are reproduced below for reference:
4. As per communication dated 15.12.2023 sent by FAA, RTI applicant was informed that he may personally visit the office to obtain any information/document pertaining to him and there was no request of hearing from the RTI applicant in his first appeal. However when he visited on 26.12.2023 he could not provide the Award number pertaining to him. 4.1 The statutory obligation of publishing the records is done by the Council for Insurance Ombudsman and Office of Honourable Ombudsman, Delhi does not have separate website Moreover as per section 4(1)(d) of RTI Act also, every public authority shall provide reasons for its administrative or quasi judicial decisions to affected persons.
4.2.As per rule 17(5) of Insurance Ombudsman Rules, 2017, the Order passed by the Insurance Ombudsman shall be sent to the complainant and the Insurance Company named in the complaint.
4.3 The funds for running the office of Insurance Ombudsman are granted by the Council for Insurance Ombudsman.
4.4 Orders passed by the Insurance Ombudsman have been made available in the website under the link https://www.cioins.co.in/which can be accessed by the complainant only, to protect the personal information of the complainants.
4.5 Honourable Insurance Ombudsman performs quasi judicial functions.
Both public and private Insurance Companies come under the purview of the Office of the Insurance Ombudsman. There is no fee to be paid for filing complaint in the Office of the Insurance Ombudsman. Only individual aggrieved insured can file the complaint against insurer to the Insurance Ombudsman. The quasi-judicial acts don't bound anybody but give decisions without the proceedings of the court.
Furthermore, as per response available under general FAQs on the website of CIO-' As per the Insurance Ombudsman Rules 2017, there is no provision to engage a lawyer'.
4.6. The awards passed by the Insurance Ombudsman involve financial implications & contains personal information of the complainants hence same are available only to the individual affected(complainants) & Insurance Company.
4.7. The discretion cited by the PIO is well within the rules of RTI Act 2005. 4.8. The Office of Insurance Ombudsman, Delhi has not published awards in booklet form.
Page 5 of 134.9. The IRDAI is a Statutory body whereas Office of Insurance Ombudsman is an alternate Grievance Redressal platform. Hence comparison between the two is not justified.
5. The matter mentioned in point 5 of second appeal is not clear however there is no mention of any kind of maintenance in soft form on a software Complaint Management System in rule 17 of Insurance Ombudsman Rules, 2017.
Rule 17 of Insurance Ombudsman Rules, 2017 is as under- "17. Award.-(1) Where the complaint is not settled by way of mediation under rule 16, the Ombudsman shall pass an award, based on the pleadings and evidence brought on record. 2 ((2) The award passed under the sub-rule (1) shall be in writing, duly signed in person or digitally by the Insurance Ombudsman with reasons for passing such award.) (3)Where the award is in favour of the complainant, it shall state the amount of compensation granted to the complainant after deducting the amount already paid, if any, from the award: Provided that the Ombudsman shall, (i) not award any compensation in excess of the loss suffered by the complainant as a direct consequence of the cause of action; or (ii) not award compensation exceeding rupees 3 [fifty] lakhs (including relevant expenses, if any). (4) The Ombudsman shall finalise its findings and pass an award within a period of three months of the receipt of all requirements from the complainant. (5) A copy of the award shall be sent to the complainant and the insurer 1 (or insurance broker, as the case may be,] named in the complaint. (6) The insurer 1 [or insurance broker, as the case may be,] shall comply with the award within thirty days of the receipt of the award and intimate compliance of the same to the Ombudsman 2 (and upload the details in the complaints management system.] (7) The complainant shall be entitled to such interest at a rate per annum as specified in the regulations, framed under the Insurance Regulatory and Development Authority of India Act, 1999, from the date the claim ought to have been settled under the regulations, till the date of payment of the amount awarded by the Ombudsman. (8) The award of Insurance Ombudsman shall be binding on the insurers 1 [or insurance broker, as the case may be]".
It is pertinent to note that many points raised in the first appeal were not related to the information sought in the original RTI application by the applicant however same were duly replied by the FAA to maintain the transparency."
Page 6 of 13Relevant Facts emerged during Hearing:
The following were present:-
Appellant: Present in person.
Respondent: Ms. Anita Chawla, Assistant Secretary/CPIO along with Ms. Supriya Sharma, Assistant Secretary/Nodal Officer present in person.
The appellant stated that Insurance Ombudsman pass their award under the aegis of being a quasi-judicial body. Therefore, its award be deemed as public documents and should be made public as per Section 4 of the RTI Act. However, in contravention of the RTI provisions, the respondent did not make their awards easily accessible to the public. In this regard, he sought time to file written submission in support of their arguments which was granted by the Commission.
The respondent by inviting attention of the Commission stated that since the award passed by the Insurance Ombudsman contain the personal details and financial implications of the complainant and insurance company concerned which may be public or private company. Therefore, it is not made public as such. Only the affected parties have right to access the same after logging in on their website. Even otherwise, such administrative decisions are taken by their principal body which is Council for Insurance Ombudsmen (CIO).
Post hearing, the appellant has filed a written submission dated 25.03.2025 which is taken on record. Contents of the same are reproduced below:
"1. It is during the hearing today i.e. 25.03.2025, the Ld. PIO could not come up with any other ground to deny information except as cited in the reply to RTI application.
2. It is during the course of the hearing-need was felt and both the parties were directed to file written submissions. The appellant makes the submissions under distinct heads as under:
A. Set Up of Ombudsman
3. Attention is straight away drawn towards Ombudsman Rules 2017-
Updated on 09.11.2023 relied and cited by the Respondent with their written submissions dated 18.03.2025, the relevant para is cited as under:
The Insurance Ombudsman Rules, 2017 updated as on 9.11.2021 Page 7 of 13 In exercise of the powers conferred by section 24 of the Insurance Regulatory and Development Authority Act, 1999 (41 of 1999) and in supersession of the Redressal of Public Grievances Rules, 1998, except as respects things done or omitted to be done before such supersession the Central Government hereby makes the following rules, namely Perusal of the above makes it clear that the office of Insurance Ombudsman has been set up under the statutory provision of the afore mentioned Act. Hence, performing public functions/duties.
B. Quasi-Judicial Function
4. Attention is drawn towards Rule 13 of the afore mentioned scheme; relevant para is reproduced hereunder:
13. Duties and functions of Insurance Ombudsman. (1) The Ombudsman shall receive and consider complaints [alleging deficiency in performance required of an insurer (including its agents and intermediaries) or an insurance broker, on any of the following grounds]:-
(a) delay in settlement of claims, beyond the time specified in the regulations, framed under the Insurance Regulatory and Development Authority of India Act, 1999;
(b) any partial or total repudiation of claims by the life insurer, General insurer or the health insurer,
(c) disputes over premium paid or payable in terms of insurance policy,
(d) misrepresentation of policy terms and conditions at any time in the policy document or policy contract;
(e) legal construction of insurance policies in so far as the dispute relates to claim;
(1) policy servicing related grievances against insurers and their agents and intermediaries;
(g) issuance of life insurance policy, general insurance policy including health insurance policy which is not in conformity with the proposal form submitted by the proposer,
(h) non-issuance of insurance policy after receipt of premium in life insurance and general insurance including health insurance; and
(i) any other matter arising from non-observance of or non-adherence to the provisions of any regulations made by the Authority with regard to Page 8 of 13 protection of policyholders' interests or otherwise, or of any circular, guideline or instruction issued by the Authority, or of the terms and conditions of the policy contract, insofar as such matter relates to issues referred to in clauses (a) to (h).
[Explanation. For the purposes of this sub-rule, the term "deficiency" shall have the meaning as assigned to it in clause (11) of section 2 of the Consumer Protection Act, 2019 (35 of 2019).] as can be seen in cases related to Women Sexual Crime, POSCO and JJA etc. Except those excluded by law, cannot be suppressed citing any flimsy reason in order to avoid public scrutiny and accountability. The Ombudsman adjudicates upon issues involving 50 lakh, in order to protect the office from any suspicion or chances of any malpractice publication of final adjudication is must.
Orders of Ombudsman are Challenged/distinguished - Amenable to the Jurisdiction of the Hon'ble 7. The Insurance companies relies upon the orders of the Ombudsman while before other adjudication authorities such as National Commission and Challenges the same before High Court under Article 227 of the Constitution. A case is cited herein where order passed by the National commission was discussed and differed. The relevant para is under:
2019 SCC OnLine NCDRC 1133-Ravi Kumar... Petitioner(s); Versus United India Insurance Company Ltd. Rep By Its Branch Manager,
2. The first point that falls for consideration in the instant case is whether the State Commission has rightly adjudicated that when the Complainant had already participated in the proceedings before the Insurance Ombudsmen and received an award, he can still file a Complaint before the Consumer Forum. In the instant case the District Forum has dismissed the Complaint on the ground that the Complaint was not maintainable as the Complainant had already availed the remedy by approaching the Insurance Ombudsmen. Having regard to the catena of judgements of the Hon'ble Supreme Court, we are of the considered view that the decision of the Ombudsmen is not binding on the Complainant and therefore the Complaint preferred is maintainable under Section 2(1)(d) of the Act. 3. The State Commission has rightly observed that under Section 3 of the Act, the reliefs available to the Page 9 of 13 Consumer are in addition to and not in derogation of any other law for the time being in force.
4. Now we address ourselves to whether the State Commission was night in exception at their own. A single page orders from Consumer Commission, MACT etc. are enclosed herewith for ready reference.
8. The IRDAI regularly puts up penalty orders against Insurers, Individual Surveyors & Brokers etc. on its site. Going by the logic extended by the PIO, the Regulator must not publish information on its site citing privacy.
9. The Insurer were not complying with the Awards at their whims, the IRDA had to intervene and had to issue circular seeking compliance. In the name of private party, the public at large was left at the mercy and kept on guessing about compliance without any clue at all.
10. The information i.e. Awards are not required to be collected as per Rule 17 of the scheme same is maintained in soft form on a software complaints management system. Therefore, no extra burden would be there on any of the staff.
Therefore, PIO may be directed to furnish, publish and supply the desired information."
Decision:
The Commission adverting to facts and circumstance of the case, perusal of records and after hearing submissions of the parties notes the replies and as a sequel to it further clarifications tendered by the Respondents vide written submission are appropriate in terms of the RTI Act.
The Commission agrees with the stand taken by the CPIO in denial of information as the details of awards granted by the Insurance Ombudsman contain the details of the complainant and financial implication of the concerned insurance companies disclosure of which would apparently invade the privacy of third parties and thus, it cannot be made public in terms of Section 8 (1)(j) of the RTI Act.
Further, the Commission is not inclined to accept the vague contention of the Appellant of a larger public interest subsisting in the matter keeping in view of Page 10 of 13 catena of judgments of the superior Courts as under with respect to the aspect of larger public interest:
The Hon'ble Supreme Court in the matter of Bihar Public Service Commission vs. Saiyed Hussain Abbas Rizwi & Anr. [CIVIL APPEAL NO.9052 OF 2012] observed as under:
"23. The expression 'public interest' has to be understood in its true connotation so as to give complete meaning to the relevant provisions of the Act. The expression 'public interest' must be viewed in its strict sense with all its exceptions so as to justify denial of a statutory exemption in terms of the Act. In its common parlance, the expression 'public interest', like 'public purpose', is not capable of any precise definition. It does not have a rigid meaning, is elastic and takes its colour from the statute in which it occurs, the concept varying with time and state of society and its needs. [State of Bihar v. Kameshwar Singh (AIR 1952 SC 252)]. It also means the general welfare of the public that warrants recommendation and protection; something in which the public as a whole has a stake [Black's Law Dictionary (Eighth Edition)]. Emphasis Supplied "24. The satisfaction has to be arrived at by the authorities objectively and the consequences of such disclosure have to be weighed with regard to circumstances of a given case. The decision has to be based on objective satisfaction recorded for ensuring that larger public interest outweighs unwarranted invasion of privacy or other factors stated in the provision.
Certain matters, particularly in relation to appointment, are required to be dealt with great confidentiality."
".... Similarly, there may be cases where the disclosure has no relationship to any public activity or interest or it may even cause unwarranted invasion of privacy of the individual. All these protections have to be given their due implementation as they spring from statutory exemptions. It is not a decision simpliciter between private interest and public interest. It is a matter where a constitutional protection is available to a person with regard to the right to privacy. Thus, the public interest has to be construed while keeping in mind the balance factor between right to privacy and right to information with the purpose sought to be achieved and the Page 11 of 13 purpose that would be served in the larger public interest, particularly when both these rights emerge from the constitutional values under the Constitution of India." Emphasis Supplied Similarly, in another judgment of the Hon'ble Supreme Court in the matter of S. P. Gupta v President of India, [AIR 1982 SC 149], with reference to 'public interest' it has been maintained that:
"Redressing public injury, enforcing public duty, protecting social, collective, 'diffused' rights and interests vindicate public interest... [in the enforcement of which] the public or a class of the community have pecuniary interest or some interest by which their legal rights or liabilities are affected." Emphasis Supplied And, in the matter of State of Gujarat vs. Mirzapur Moti Kureshi Kasab Jamat & others [Appeal (Civil) 4937-4940 of 1998], the Hon'ble Supreme Court has held that:
"the interest of general public (public interest) is of a wide importance covering public order, public health, public security, morals, economic welfare of the community, and the objects mentioned in Part IV of the Constitution [i.e. Directive Principles of State Policy]". Emphasis Supplied Nonetheless, in the spirit of the RTI Act, the Commission deems it fit to direct Respondent, to search and locate the relevant records pertaining to the instant RTI Applications within four weeks from the date of receipt of this order and thereafter, to provide an opportunity to the Appellant to inspect the relevant records on a mutually decided date and time duly intimated to the Appellant telephonically and in writing. Copy of documents, if not exempted from disclosure under the RTI Act, should be provided to the Appellant free of cost up to 25 pages, and beyond that prescribed fees shall be charged as per the RTI Rules, 2012. The said direction should be complied within six weeks from the date of receipt of this order and a compliance report of the same be duly sent to the Commission, enumerating the details of documents inspected and copy of documents provided.
FAA to ensure compliance of the direction.Page 12 of 13
Notwithstanding the aforesaid, the public interest will be best served if the Respondent Public Authority would explore the possibility of making disclosure of list of cases/awards heard and disposed date-wise and party-wise with the case title under suo-moto disclosure in lines of Section 4 of the RTI Act while downloading of decision/award may remain protected as per current practice.
In pursuance of the aforesaid advisory, the FAA is directed to place a copy of this order before their competent authority for appropriate action.
The 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 Copy To:
The FAA, Office of the Insurance Ombudsman, 2/2 A, Universal Insurance Building, Asaf Ali Road, New Delhi- 110002 Page 13 of 13 Recomendation(s) to PA under section 25(5) of the RTI Act, 2005:-
Nil Powered by TCPDF (www.tcpdf.org)