Shyam Advani vs The Oriental Insurance Co. Ltd. on 11 April, 2025

[Cites 7, Cited by 0]

Central Information Commission

Shyam Advani vs The Oriental Insurance Co. Ltd. on 11 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/OICOL/A/2023/655769, CIC/OICOL/C/2023/656240,
          CIC/OICOL/C/2024/600367,CIC/OICOL/C/2024/600380,
          CIC/OICOL/C/2024/621779, CIC/OICOL/A/2023/655814,
          CIC/OICOL/C/2024/600414, CIC/OICOL/C/2024/600420,
          CIC/OICOL/C/2024/600431, CIC/OICOL/C/2024/600436,
          CIC/OICOL/C/2024/600443


SHYAM ADVANI                                     ....िशकायतकता /Complainant &
                                                 .....अपीलकता/Appellant


                                        VERSUS
                                         बनाम


The PIO
The Oriental Insurance Co. Ltd.,
56 L, Mahatma Gandhi Road,
Near Regal Square, Nehru Park 2,
Chhoti Gwaltoli, Indore - 452001

The Oriental Insurance Co. Ltd.,
20, Vikram Tower, Shradhanand
Marg Main Road, Snehnagar,
Indore - 452001                                       .... ितवादीगण /Respondent


Date of Hearing                     :    03.04.2025
Date of Decision                    :    09.04.2025

INFORMATION COMMISSIONER :               Vinod Kumar Tiwari



                                                                     Page 1 of 35
 The above-mentioned Complaints and Appeals are clubbed together as the
Applicant is common and subject-matter is similar in nature and hence are
being disposed of through a common order.

                            1. CIC/OICOL/A/2023/655769

Relevant facts emerging from appeal:
RTI application filed on          : 20.09.2023
CPIO replied on                   : 18.10.2023
First appeal filed on             : 02.11.2023
First Appellate Authority's order : not on record
2nd Appeal/Complaint dated        : 20.12.2023

Information sought

The Appellant filed an RTI application (online) dated 20.09.2023 seeking the following information:

"Under the RTI act, please provide copies of surveyor report, including final survey report and all the addendum reports, for fire claim of my firm VISHNU COATERS, with claim id 153501/11/2022/00000001"

The CPIO furnished a reply to the Appellant on 18.10.2023 stating as under:

"Reason for Rejection: Duplicate Entry"

Being dissatisfied, the appellant filed a First Appeal dated 02.11.2023. The FAA order is not on record.

Feeling aggrieved and dissatisfied, appellant approached the Commission with the instant Second Appeal.

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"(1) That the appellant is a client of the respondent and had bought a fire insurance policy for his factory from the respondent. There was a fire incident in this factory, after which the claim was illegally processed by the respondent. The respondent broke all the rules and regulations laid down by IRDAI for claim settlement. (2) To hide its wrong doing in claim settlement, the respondent has broken its obligation under the RTI act, by not providing documents asked by the appellant under the RTI act.

Page 2 of 35

(3) It is worth mentioning here that as per IRDAI regulations on claim settlement, it is mandatory for the insurance companies to provide copy of the survey report to the insured if he so desires. In this instant case of RTI, the appellant had asked for copy of the survey report, which as per IRDAI norms, was right of the appellant, but to hide their wrong doings, the respondent rejected this RTI application, saying "duplicate entry".

(4) While rejecting this RTI application, the CPIO has not mentioned the clause of RTI act, under which he is rejecting this RTI, which would mean that the CPIO also knew that there is no clause in the RTI act by which he could have rejected this application, still to hide his wrong doing, the CPIO chose to reject it. (5) After the RTI being rejected, the applicant filed for first appeal, which was not responded by the FAA within stipulated time period of 45 days. This again shows that the CPIO and the FAA wanted to illegally withhold the information, so that their wrong doings don't come out in the open.

(6) It is worth mentioning here that the offices of both the CPIO and the FAA were directly involved in this illegal claim settlement of the appellant, and thus to save themselves from getting exposed, they chose not to provide information under the RTI act.

(7) On not getting any reply from the FAA within 45 days, the appellant was forced to do second appeal with the CIC. After this second appeal, the FAA rejected the first appeal, saying the case is subjudice in court.

(8) It is worth mentioning here that the honourable court has not stopped the respondent from sharing any information under the RTI act. And that there have been many judgements in the past of the CIC and High Courts, where they have made it clear that until and unless the courts direct a party not to release information under the RTI act, they cannot deny the asked information. Thus, this clearly shows that this RTI and First appeal has been deliberately rejected by the CPIO and FAA with malafide intention against the provisons of the RTI act. (9) It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good.

(10) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(11) A copy of this written submission is being sent to the respondent by email."

A written submission has been received from Shri RK Raman, CPIO-cum- Regional Manager, vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

Page 3 of 35

"Our submission to the honorable CIC are the following:-

Al The claim has been settled on 20.03.2023.Full & Final Discharge Voucher received from insured on 25.3.2023 for Rs.8267814/-, and the payment amount has been accepted by the insured.

B] The subject case is under arbitration at HC Jabalpur therefore being sub judice the details could not be provided. Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case is listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal.

The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

2. CIC/OICOL/C/2023/656240 Relevant facts emerging from complaint:

RTI application filed on          : 13.11.2022
CPIO replied on                   : 28.12.2022
First appeal filed on             : Nil
First Appellate Authority's order : 25.08.2023
2nd Appeal/Complaint dated        : 25.12.2023
Information sought:

The Complainant filed an RTI application (online) dated 13.11.2022 seeking the following information:

"Under the RTI act, please provide me the soft copies and certified hard copies of all the note sheets prepared by the Burhanpur branch office, Khandwa divisional office and Indore regional office of oriental insurance company regarding fire claim of my firm Vishnu Coaters with claim id 153501/11/2022/00000001 Please let me know the amount that is to be paid for the certified hard copies, which I will pay"

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Reply/Remarks:-Reply Information: Partially rejected. Rejected information-As the claim is still under process for want of some clarifications from surveyor, we are unable to provide you the required information.

Rejected reason:- Section 8/1)(e)."

Page 4 of 35

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim has been already paid and accepted by the applicant (Discharge voucher received)."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"The complainant has already provided the complaint matter in detail in its complaint. Through this written submission, the complainant would like to produce some additional documents/information, that would prove that the CPIO and the FAA acted with malafide Intention while responding to the RTI application and the First Appeal. Those details are as follows:

(1) After filing RTI on 13/November/2022, and on not receiving any reply, the complainant sent first reminder email on 30/November/2022, to the senior officers of the respondent insurance company, including the CPIO, regarding the pending RTI application. Copy of that email is being attached below as Attachment 1. (2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. A copy of the same is being attached below as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022, addressed to the CPIO and other senior officials, but to no avail. Copy of this 3 reminder is being attached below as ATTACHMENT 3.

(4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days, thus proving his malafide intention.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 15/December/2022.

(6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. In this RTI, the complainant had asked for copies of note sheets prepared by the respondent's Burhanpur office, Khandwa office and Indore office related to complainant's claim.

The complainant believes that these offices had given a positive view on the complainant's claim and based on these note sheets, the complainants claim should have been settled much earlier. But even after getting such positive inputs from their offices, the respondent company delayed the claim settlement of the complainant. By not providing the asked information, the respondent is trying to hide his wrong doing in claim settlement of the complainant. Thus, it is clear that the respondent has Page 5 of 35 committed unlawful act on 2 instances here, firstly, he did not answer the RTI within stipulated time period of 30 days, and secondly, he illegally rejected the same after about 40-45 days (8) That after filing the first appeal, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals and that multiple RTIs are not being answered by their CPIOs on time, but to no avail. Copy of those emails are being attached below as Attachment 4,5 and 6. (9) As per the RTI act, the FAA has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim said "The claim has already been paid.....". By giving such a reply, the FAA is implying that once the claim is paid, then they don't have to follow the regulations laid down in the RTI act, which is not true. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not. Thus, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months. This shows his malafide intention. (10)It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good. Also, worth mentioning here is that as per complainant's knowledge, the CPIO and the FAA were both directly involved in illegal handling of the said claim, and thus they have used all illegal tactics to not provide asked information in this RTI application, so that they can hide their wrongdoing. (11) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(12)That this copy of written submission is being forwarded to the respondent through email by the complainant."

"Our submission to the honorable CIC are the following:-

Al These are our internal process of claim, and cannot be given under section 8(1)(d).

Page 6 of 35

B) The claim has been settled on 20.03.2023. Full & Final Discharge Voucher received from Insured on 25.3.2023 for Rs.8267814/-, and the payment amount has been accepted by the insured...

C) The subject case is under arbitration at HC Jabalpur Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case is listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal.

The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

3. CIC/OICOL/C/2024/600367 Relevant facts emerging from complaint:

RTI application filed on             :   16.11.2022
CPIO replied on                      :   28.12.2022
First appeal filed on                :   Nil
First Appellate Authority's order    :   25.08.2023
2nd Appeal/Complaint dated           :   03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 16.11.2022 seeking the following information:

"In my claim no 153501/11/3022/00000001, of my finiri Vishnu Coaters, I had hled two grievances with the PMO CPGRAMS with registration id PMOPG/E/2021/0464719 and PMOPG/E/2021/0594079 and also tried subsequent appeals to both these grievances. Under the RTI Act, please provide me the following (1) soft coples and certified hard copies of all the communication that your insurance company had within its various offices and officials regarding both these grievances and their subsequent appeals (2)soft copies and certified hard copies of communnamon that insurance company had with the PMO CPGRAMS officials regarding both my grievances and their subsequent appeals"

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Reply/Remarks Reply Information: Partially Reject Rejected information: No such information is available with us. Rejected reason: Section 8(1)(e) Page 7 of 35 Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim has been already paid and accepted by the insured. The grievance details uploaded."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"The complainant has already provided the complaint matter in detail in its complaint. Through this written submission, the complainant would like to produce some additional documents/information, that would prove that the CPIO and the FAA acted with malafide intention while responding to the RTI application and the First Appeal. Those details are as follows:

(1) After filing RTI on 16/November/2022, and not getting any response, the complainant sent first reminder email on 30/November/2022, to the senior officers of the respondent insurance company, regarding the pending RTI application. This email is being attached below as Attachment 1.

(2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of that letter is being attached below as Attachment 2.

(3) A third reminder email was sent on 05/December/2022, but to no avail. This email copy is being attached below as Attachment 3.

(4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days. Which proves the malafide intention of the CPIO.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022.

(6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) That after filing the first appeal, and not getting any reply, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals and illegal handling of the RTI applications by the CPIOs, but to no avail. Copy of those emails are attached below as Attachment 4,5 and 6. (8) It is worth mentioning here, that when the respondent insurance company was not settling the insurance claim of the complainant, as per the laid down procedures, the complaint was forced to file a grievance with the Prime Minsiter's Office.

Surprisingly, the respondent insurance company were not afraid to give false commitments to even the Prime Minister's office and based on those false commitments, the PMO closed the grievance. Through this RTI the complainant asked for copies of communication between the insurance company and the PMO with Page 8 of 35 regard to my grievance. If the respondent would have provided those copies, then it would have been proven that false promises were made by the insurance company to the PMO, so that grievance can be closed. Thus, to hide its wrong doing, the CPIO rejected my RTI. The PMO's website clearly mentions that they have had communication with the respondent company, whereas while rejecting the RTI, the CPIO mentions that "No such information is available with us". CLEARLY THE CPIO IS LYING HERE. I am attaching a copy of the grievance page of the PMO's website, to substantiate my claim in Attachment 7 and B. (9) As per the RTI act, the FAA has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim said "The claim has been settled....". The FAA here does not provide the asked information and by what he says, he implles that once he has paid the claim, then they don't have any obligation to provide the asked information under the RTI act, which is untrue. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not. Thus, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months.

(11)

With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(12)

It is staggering to know that the respondent in this case have no regard for the RTI act, or for the regulations laid down by the IRDAI or for that matter they are not even afraid of making false promises to the PMO. Thus, an exemplary punishment should be given in this matter so that government officials are afraid of repeating such mis conducts in future.

(13) A copy of this written submission is being sent to the respondent by email."

Page 9 of 35

"Our submission to the honorable CIC are the following:-

A] The claim has been settled on 20.03.2023.Full & Final Discharge Voucher received from Insured on 25.3.2023 for Rs.8267814/- and the payment amount has been accepted by the insured. The grievance details Uploaded B] At present the subject case is under arbitration at HC Jabalpur. Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case was listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal. The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

4. CIC/OICOL/C/2024/600380 Relevant facts emerging from complaint:

RTI application filed on             :   15.11.2022
CPIO replied on                      :   28.12.2022
First appeal filed on                :   Nil
First Appellate Authority's order    :   25.08.2023
2nd Appeal/Complaint dated           :   03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 15.11.2022 seeking the following information:

"Under the RTI act, please provide me the DAILY PROGRESS REPORT for my firm (VISHNU COATERS) fire claim with claim id 153501/11/2022/00000001 from the date of fire 1 April 2021 till 14 November 2022"

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Reply/Remarks-Reply Information-Partially Reject Rejected information: There will not be any daily progress report. After receiving the provisional survey report any the process starts, and we have raised some queries. Some have been replied, but a few are still to he replied.

Rejected reason:-Section 8(1)(e)"

Page 10 of 35

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim stands paid and the amount has been accepted by the insured (clear discharger voucher received)."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"The complainant has already provided the complaint matter in detail in its complaint. Through this written submission, the complainant would like to produce some additional documents/information, that would prove that the CPIO and the FAA acted with malafide intention while responding to the RTI application and the First Appeal. Those details are as follows:

(1) After filing RTI on 15/November/2022, and on not getting any reply, the complainant sent reminder email on 30/November/2022, to the senior officers of the respondent insurance company, regarding the pending RTI application. Copy of that email is being attached below as Attachment 1.

(2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of that letter is being attached below as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022, but to no avail. Copy of this third reminder is being attached below as Attachment 3. (4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days, thus proving malafide intention. (5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022.

(6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. It's worth mentioning here, that the respondent is an Insurance Company and as per the law, is governed by rules and regulations laid out by IRDAI (Insurance Regulatory and Development Authority of India). The IRDAI, in its gazetted notification titled "Protection of Policyholder's Interest 2017", has clearly laid out a time line for the insurance companies. This time line by IRDAI includes the maximum time within which the surveyor has to give his report, the maximum time that insurance company has to ask for any clarifications from the surveyor, and many such similar timelines. In complainant's claim the claim should have been settled within 6-8 months, but the insurance company took more then 2 years to settle it, thus it clearly did not follow the guidelines issued by the IRDAI, thus in this RTI the complainant asked for the daily progress report of his claim, which was rejected by the CPIO under section 8(1)(e).

Page 11 of 35

This was clearly done by the CPIO to hide the fact that they have not followed the mandatory regulations laid down by IRDAI. Thus, it is clear that the respondent firstly, did not answer the RTI within stipulated time period of 30 days, but also rejected the same after about 40-45 days on illegal grounds.

(8) That after filing the first appeal, and not getting any reply, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals, and that CPIOs of their company are not answering RTIs as per the RTI act, but to no avail. Copy of those emails are attached below as Attachment 4,5 and 6 (9) As per the RTI act, the FAA has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim said "The claim stands paid....". This reply of the FAA implies that if a claim is paid by the insurance company, then they are not liable to provide any information if a cliam is paid, which is untrue. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not. Thus, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months.

(10)It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good. Also, worth mentioning here is that as per complainant's knowledge, the CPIO and the FAA were both directly involved in illegal handling of the said claim, and thus they have used all illegal tactics to not provide asked information in this RTI application, so that they can hide their wrongdoing. (11) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(12) A copy of this written submission is being mailed to the respondent as well."

"Our submission to the honorable CIC are the following:-

A) No such daily progress report is available with us as mentioned in our reply.

The claim stands paid and the amount has been accepted by the insured (clear discharge voucher received from Kirti Advani -Claimant/Insured on 25.3.2023).

Page 12 of 35

B] The subject case is under arbitration at HC Jabalpur. Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case was listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal.

5. CIC/OICOL/C/2024/621779 Relevant facts emerging from complaint:

RTI application filed on             :   26.02.2024
CPIO replied on                      :   Not on record
First appeal filed on                :   Nil
First Appellate Authority's order    :   26.04.2024
2nd Appeal/Complaint dated           :   22.05.2024

Information sought:

The Complainant filed an RTI application (online) dated 26.02.2024 seeking the following information:

"Under the provisions of the RTI act, I would like to inspect all documents in physical form and digital form (including, all communications through email), related to my fire claim no 153501/11/2022/00000001.

During this inspection, I would also like to take copies of all relevant documents. "

Having not received any response from CPIO, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 26.04.2024, held as under.

"The subject case is under arbitration at HC Jabalpur, therefore being sub judice details could not be provided."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

Page 13 of 35

"With my following written submission, I want to put forward the reasons why I believe that the CPIO and the FAA have behaved with a malafide motive by rejecting my RTI application:

(1) That the complainant is a client of the respondent and had bought a fire insurance policy for his factory from the respondent. There was a fire incident in this factory, after which the claim was illegally processed by the respondent. The respondent broke all the rules and regulations laid down by IRDAI for claim settlement. (2) To hide its wrong doing in claim settlement, the respondent has broken its obligation under the RTI act, by not providing documents asked by the appellant under the RTI act.

(3) That the complainant believes that while settling his insurance claim, gross irregularities have been carried out by the respondent, and many IRDAI regulations on claim settlement have been broken, which now the respondent company is trying to hide.

(4) In this instant case also, the CPIO and the FAA both did not reply to the complainant within the stipulated time frame as per the RTI act, which clearly shows that they are trying to hide the information.

(5) That the complainant filed this RTI application, but did not receive any reply from the CPIO within 30 days, proving malafide intention of the CPIO. (6) After which the complainant filed First Appeal, which too was not replied to within 45 days. The FAA took more then 45 days to reject this first appeal and did not provide any reason for this delay.

(7) While rejecting the First appeal (much after stipulated time limit of 45 days), the FAA mentioned that since the matter is in court, thus he cannot provide the asked information.

(8) It is worth mentioning here that the honourable court has not stopped the respondent from providing any information under the RTI act related to this matter. And in the past there have been many decisions by CIC and honourable courts, which clearly state that only because a matter is sub judice, information under the RTI act cannot be denied.

Even after such clear guidelines in this matter, the FAA illegally rejected the information asked, thus proving his malafide intention. (9) That in this RTI, the complainant had asked for inspection of his claim file of all documents in physical form and digital form, which would have uncovered many illegal acts of the respondent while settling complainant's claim and therefore to save themselves, the CPIO and the FAA have not allowed for file inspection, going against provisions of the RTI act.

(10) It is worth mentioning here that in this case the offices of the CPIO and the FAA were directly involved in appellant's illegal claim settlement, in which many regulations of the IRDAI were broken. Thus, to hide their wrong doings in this case, the CPIO and FAA both did everything at their disposal, to reject the information asked for in the RTI application.

(11) It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this Page 14 of 35 case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good.

(12) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(13) A copy of this written submission is being sent to the respondent by email."

"Our submission to the honorable CIC are the following:-

Al The claim has been settled on 20.03.2023 Full & Final Discharge Voucher received from Insured on 25.3.2023 for Rs. 8267814/-, and the payment amount has been accepted by the insured.

B) The subject case is under arbitration at HC Jabalpur therefore being sub judice the details could not be provided. Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case is listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal.

The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

6. CIC/OICOL/A/2023/655814 Relevant facts emerging from complaint:

RTI application filed on             :   20.09.2023
CPIO replied on                      :   18.10.2023
First appeal filed on                :   02.11.2023
First Appellate Authority's order    :   Not on record
2nd Appeal/Complaint dated           :   20.12.2023

Information sought:

The Complainant filed an RTI application (online) dated 20.09.2023 seeking the following information:

Page 15 of 35

"Please provide the following information, related to fire claim of my firm VISHNU COATERS, with claim id 153501/11/2022/00000001 (1) what amount was paid to the surveyor for the above mentioned claim number ?

(2) on which date was this amount paid to the surveyor?"

The CPIO furnished a reply to the complainant on 18.10.2023 stating as under:

"The information sought is not clear, hence unable to address."

Being dissatisfied, the complainant filed a First Appeal dated 02.11.2023. The FAA order is Not on record.

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"Following is my written submission in my above mentioned second appeal:

(1) That the appellant is a client of the respondent and had bought a fire insurance policy for his factory from the respondent. There was a fire incident in this factory, after which the claim was illegally processed by the respondent. The respondent broke all the rules and regulations laid down by IRDAI for claim settlement. (2) To hide its wrong doing in claim settlement, the respondent has broken its obligation under the RTI act, by not providing documents asked by the appellant under the RTI act.

(3) It is worth mentioning here that as per Surveyor Management policy of the respondent, they have to do fees payment of the surveyor within 48 hours of him submitting the first survey report. The purpose of this surveyor fees payment rule is that no undue pressure to lower the loss assessed amount can be exercised on surveyor by the insurance company, by delaying his fees, and the surveyor remains neutral as per IRDAI guidelines. But in appellant's case, the surveyor's fees was delayed by more then one and half years after him submitting his first survey report, and he was made to reduce the loss assessed amount of the appellant by around 40 percent, thus causing great loss to the appellant.

(4) To get a documentary proof of this illegal act committed by the respondent, the appellant filed a RTI asking for the date of payment to the surveyor and the amount paid to the surveyor.

(5) Surprisingly, the CPIO rejected this RTI application without providing details of any section under which he was rejecting it. The CPIO just mentioned that "the information sought is not clear..." It clearly shows the malafide intention of the CPIO, while replying to this RTI application.

(6) Aggrieved by this RTI rejection, the appellant filed first appeal in this matter.

Page 16 of 35

(7) The FAA also did not want to share the asked information, and did not reply to the First appeal within stipulated time period of 45 days.

(8) After which the appellant filed second appeal, and after this second appeal, the FAA rejected the first appeal, stating that the asked information cannot be provided as the matter is subjudice.

(9) It is worth mentioning here that in this case the CPIO and the FAA both were directly/indirectly involved in appellant's illegal claim settlement, in which many regulations of the IRDAI were broken. Thus to hide their wrong doings in this case, the CPIO and FAA both did everything at their disposal, to reject the information asked for in the RTI application.

(10)

It is worth mentioning here that the honourable court has not stopped the respondent from sharing any information under the RTI act. And that there have been many judgements in the past of the CIC and High Courts, where they have made it clear that until and unless the courts direct a party not to release information under the RTI act, they cannot deny the asked information. Thus, FAA's decision to not provide information becase a matter is subjuice, is clearly against clear cut past judgements of the CIC and many high courts. This clearly shows that this RTI and First appeal has been deliberately rejected by the CPIO and FAA with malafide intention against the provisons of the RTI act.

(11)

(13) A copy of this written submission is being sent to the respondent by email."

"Our submission to the honorable CIC are the following:-

A) Information asked under RTI regarding Amount paid to Surveyor & date of payment is not related to applicant, Complainant's RTI falls under Third party Information under section 11 of RTI Act.

Page 17 of 35

B] The subject case is under arbitration at HC Jabalpur therefore being sub judice the details could not be provided. Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd. As per Company Advocate Mr Som Mishra, the subject case is listed on 12/02/2025 before court, but the matter could not reach for hearing. Revised date is not uploaded on Court Portal.

7. CIC/OICOL/C/2024/600414 Relevant facts emerging from complaint:

RTI application filed on             :   15.11.2022
CPIO replied on                      :   28.12.2022
First appeal filed on                :   Nil
First Appellate Authority's order    :   25.08.2023
2nd Appeal/Complaint dated           :   03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 15.11.2022 seeking the following information:

"In fire claim of my firm VISHNU COATERS, with claim id no 153501/11/2022/00000001, a DISCHARGE VOUCHER was offered to the insured by the oriental insurance company branch office on 7th October 2021, which the insured had signed and submitted on the same day. Under the RTI Act, please provide me soft copy and certified hard copy of this DISCHARGE VOUCHER."

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Rejected Information:-Unable to provide the same as the claim in under process and the final assessed amount has not been arrived. Rejected reason:- Section 8(1)(e)"

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The discharge voucher has already given to insured."

Page 18 of 35

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"(1) After filing RTI on 15/November/2022, and not getting reply, the complainant sent reminder email on 30/November/2022, to the senior officers of the respondent insurance company, regarding the pending RTI application. Copy of the same is being attached below as Attachment1.

(2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of the same is being attached below as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022, addressed to the CPIO and other senior company officials, reminding them about the pending RTI application, but to no avail. A copy of this email is being attached below as Attachment 3.

(4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days, thus proving his malafide intentions.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022. (6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. It's worth mentioning here, that in RTI application, the complainant had asked for a copy of the "Discharge Voucher" that was offered by the respondent's office to the complainant.

This document has got nothing to do with any third party involved with the respondent in a Fiduciary relationship. Still, the CPIO chose to reject the RTI application because he wanted to hide his wrong doing of not paying the claim amount as per the first discharge voucher, which I had asked for in this RTI. Thus, it is clear that the respondent here committed 2 unlawful acts, firstly, he did not answer the RTI within stipulated time period of 30 days, and secondly, he rejected the same after about 40-45 days arbitrarily.

(8) After having filed the First Appeal, and not getting any reply, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals and CPIOs not responding to RTIs, but to no avail. Copy of those emails are attached below as Attachment 4,5 and 6.

(9) As per the RTI act, the FAA has to dispose of the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim did not provide the asked information and said "The discharge voucher has already been given to insured" 1 want to categorically state here that after having filed this RTI on Page 19 of 35 13/November/2022, the respondent company has not given me any copy of the discharge voucher signed on 07/October/2021, which I had asked for in this RTI. THUS, THE FAA IS CLEARLY LYING OVER HERE. Thus, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months.

(10)It is worth mentioning here that the CPIO in this case denied the RTI under section 8(1)(e), and says this information cannot be provided and the FAA contradicts the CPIO by saying that the document has already been provided, thus proving that the document does not come under information banned under section 8(1)(e). Thus, further implying that the CPIO was wrong in denying the information asked for. But he took no action against the CPIO, nor did he provide the asked document (11) It is worth mentioning here, that the complainant's claim was earlier settled for a much higher amount of Rs 1.38 crores, and a discharge voucher of this amount was offered to the complainant, but later on the respondent went back on its promise and paid only Rs 83 lacks to the complaint by offering a second discharge voucher. This is the reason why the respondent did not want to provide the first discharge voucher copy (signed on 7/October/2021), asked for in this RTI (12) It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good. Also, worth mentioning here is that as per complainant's knowledge, the CPIO and the FAA were both directly involved in illegal handling of the complainant's claim, and thus they have used all illegal tactics to not provide asked information in this RTI application, so that they can hide their wrongdoing. (13) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(14) That copy of this written submission is also being forwarded by the complainant to the respondent through email."

"Our submission to the honorable CIC are the following:-

A] Discharge Voucher Dt. 7.10.2021 desired in relevant RTI, which was before approval of fire claim. Hence we have replied unable to provide as claim is under Page 20 of 35 process. Invalid Discharge Voucher cannot be acknowledged as valid information and hence not disclosed.

The claim has been settled on 20.03.2023. Full & Final Discharge Voucher received from Insured on 25.3.2023 for Rs.8267814/,same is attached. B] The subject case is under arbitration at HC Jabalpur Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

8. CIC/OICOL/C/2024/600420 Relevant facts emerging from complaint:

RTI application filed on          : 16.11.2022
CPIO replied on                   : 28.12.2022
First appeal filed on             : Nil
First Appellate Authority's order : 25.08.2023
2nd Appeal/Complaint dated        : 03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 16.11.2022 seeking the following information:

"In claim id no 153501/11/2022/00000001 of my firm Vishnu Coaters, the Insurance Company in reply to PMO CPGRAMS grievance no PMOPG/E/2021/0464719 had replied that a meeting would be arranged to decide the quantum between the Insurance company officials, the surveyor and the insured. This meeting took place on 24 September 2021 and some points were agreed to between all present parties regarding the quantum of the claim, and a MINUTES OF MEETING was prepared for these mutually agreed points which was signed by the then senior divisional manager and the then branch manager of the insurance company and the surveyor along with the insured.

Under the RTI act, please provide me a soft copy and certified hard copy of this MINUTES OF THE MEETING"

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"No such minutes of meeting was recorded, hence we are unable to provide the same.

Rejected reason: Section 8(1)(e)"

Page 21 of 35

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"Details have been provided and accordingly the claim has been paid. Discharge voucher has already been received."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"(1) After filing RTI on 16/November/2022, and not getting any reply, the complainant sent first reminder email on 30/November/2022, to the CPIO and senior officers of the respondent insurance company, regarding the pending RTI application. Copy of that email is being attached below as Attachment 1. (2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of the same is being attached below as Attachment 2.

(3) A third reminder was sent on email on 05/December/2022, addressed to the CPIO and other senior officials, reminding them about pending RTI applications, but to no avail. Copy of that email is being attached below as Attachment 3. (4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days, thus proving his malafide intentions.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022. (6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) That after filing the first appeal, and not getting any reply from the FAA, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals, and also informing these seniors that many RTIs are not being answered by their CPIOS, but to no avail. Copy of those emails are attached below as Attachment 4,5 and 6.

(8) In this RTI, the complainant had mentioned that a meeting to settle the complainant's claim was held and some points were agreed to in this meeting related to the claim settlement, these points were then written down in a "Minutes of Meeting" and this document was signed by the Surveyor, 2 officials of the insurance company and the insured. The complainant asked for a copy of this document "Minutes of Meeting", under this RTI. While rejecting this RTI application, the CPIO mentions that "no such minutes of meeting was recorded..." THIS IS A COMPLETELY FALSE AND MALAFIDE ASSERTION MADE BY THE CPIO. A Minutes of Meeting was signed in this said meeting and I am attaching a copy of the same below in attachment 7 and 8. The CPIO is giving a false reply because he is trying to hide his colleagues wrong doing, as after having agreed to the points in this Minutes of Page 22 of 35 Meeting the insurance company went back on its word and did not honour what was mutually decided in this meeting, (9) As per the RTI act, the FAA has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim said "The claim has been paid....".

Thus, the FAA is implying here that once they pay a claim, they are not bound to provide any information under the RTI act, which is untrue. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not. Thus, the FAA has done 2 illegal acts here, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, he did not provide the asked information even after 8 months.

(12) A copy of this written submission is being mailed to the respondent as well."

"Our submission to the honorable CIC are the following:-

A) As per record available with us on 28/12/22 no meeting was conducted on 24.09.2021 at RO Indore and same was mentioned in RTI reply sent by CPIO. After receipt of complete claim file & discussion with the then Sr. Divisional Manager (now retired) informed that for speedy disposal of claim Surveyor, Insured representative, and the then BM and himself had attended that meeting at surveyor's office.

B] The claim has been settled on 20.03.2023 as Full & Final settlement after Discharge Voucher received from Insured on 25.3.2023 for Rs.8267814/-, and the payment amount has been accepted by the insured.

C] The subject case is under arbitration at HC Jabalpur Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd Page 23 of 35 The delay in serving replies to the applicant must be due to office exigencies for which apology is requested. Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

9. CIC/OICOL/C/2024/600431 Relevant facts emerging from complaint:

RTI application filed on          : 18.11.2022
CPIO replied on                   : 28.12.2022
First appeal filed on             : Nil
First Appellate Authority's order : 25.08.2023
2nd Appeal/Complaint dated        : 03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 18.11.2022 seeking the following information:

"Please provide soft copy and certified hard copy of my policy no. 153501/11/2021/89 and 153501/11/2021/90"

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"The policy can be obtained from Policy Issuing Office, by payment of required fees for duplicate policy.

Rejected reason: Section 8(1)(e )"

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim has been settled , hence the appeal is being dropped."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"The complainant has already provided the complaint matter in detail in its complaint. Through this written submission, the complainant would like to produce some additional documents/information, that would prove that the CPIO and the FAA acted with malafide intention while responding to the RTI application and the First Appeal. Those details are as follows:

Page 24 of 35

(2) After filing RTI on 18/November/2022, and not getting any response, the complainant sent first reminder email on 30/November/2022, to the senior officers of the respondent insurance company, regarding the pending RTI application. Copy of this email is being attached below as Attachment 1.

(2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of this reminder is being attached below as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022. Copy of this reminder email is attached below and marked as Attachment 3.

(4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022.

(6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) In this RTI, the complainant had asked for his insurance policy copy, which he had misplaced somewhere, and without these policy copies it would have been difficult for the complainant to understand the terms and conditions of the policy. Before filing this RTI, the complainant had requested the insurance company office to issue a duplicate policy document, but to no avail, after which the complainant file this RTI to get a copy, but firstly the CPIO did not reply within 30 days (even after 3 reminders) and secondly, when he replied he rejected my RTI asking me to get it from the office, which was not issuing me the duplicate policy copy. The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. It is a clear violation of the RTI act to deny a insurance policy copy, to the insured himself, under section 8(1)(e). Although, the complainant was able to find the misplaced original insurance policy copy later on, but this denial by the CPIO under section 8(1)(e), clearly shows his malafide intention. (8) That after filing the first appeal, and on not getting any reply from FAA, the complainant sent multiple mails to senior officers of the respondent company including the FAA, reminding them of pending First Appeals, and illegal acts being conducted by their CPIOs by not answering the RTis, but to no avail. Copy of those mails is being attached below with Attachment no 4,5 and 6. (9) As per the RTI act, the FAA has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more then 8 months (despite multiple reminders), to dispose it off and even after such a long period, did not provide the asked information. The FAA while disposing off the claim did not provide the asked information and said "The claim has already been settled...", thus implying that once an insurance claim has been paid, then they are not liable to provide any information under the RTI act, which is not true. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not.

Thus, firstly, the FAA took more than the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months.

Page 25 of 35

"Our submission to the honorable CIC are the following:-

Al Our reply is "The Policy can be obtained from policy issuing office by payment of required fees for duplicate policy." For getting duplicate policy nominal fee is to be deposited as per norms.

B] The subject case is under arbitration at HC Jabalpur- Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd.

The delay in serving replies to the applicant must be due to office exigencies for which apology is requested.

Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

10.CIC/OICOL/C/2024/600436 Relevant facts emerging from complaint:

RTI application filed on          : 18.11.2022
CPIO replied on                   : 28.12.2022
First appeal filed on             : Nil
First Appellate Authority's order : 25.08.2023
2nd Appeal/Complaint dated        : 03.01.2024
Information sought:

                                                                            Page 26 of 35

The Complainant filed an RTI application (online) dated 18.11.2022 seeking the following information:

"Please provide the preliminary surveyor report for fire incident in my policy no. 153501/11/2021/89 and 153501/11/2021/90""

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Even in preliminary report, there are many mistakes and corrections are to be made, hence we are unable to provide at this stage. Rejected reason: Section 8(1)(e)"

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim has been settled and the survey details has already been informed to the applicant."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"(1) After filing RTI on 18/November/2022, and on not getting any reply, the complainant sent first reminder email on 30/November/2022, to the senior officers of the respondent insurance company including the CPIO, regarding the pending RTI application. This email is being attached below as Attachment 1. (2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. A copy of the same is being attached below as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022, addressed to the CPIO and other senior officers of the respondent company, reminding them about pending RTI applications, but to no avail. Copy of this 3rd reminder is being attached below as Attachment 3.

(4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days. This clearly proves the malafide intention of the CPIO.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 20/December/2022, (6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. It's worth Page 27 of 35 mentioning here, that the respondent is an Insurance Company and as per the law, is governed by rules and regulations laid out by IRDAI (Insurance Regulatory and Development Authority of India). The IRDAI, in its gazetted notification titled "Protection of Policyholder's Interest 2017", has clearly mandated the insurance companies to share the survey report with the insured, if the insured so desires. Thus, as per IRDAI regulations, it is mandatory for the respondent to share survey report with the insured, if the insured requests for it. Through this RTI, the complainant asked for copy of preliminary survey report, which in no way can be treated some information related to the Fiduciary relationship of the respondent, but on the other hand IRDAI norms make it obligatory for the respondent to provide it if the insured asks for It. Thus, it is clear that the respondent firstly, did not answer the RTI within stipulated time period of 30 days, but also rejected the same after about 40-45 days going against IRDAI norms and provisions of the RTI act. (8) That after filing the first appeal, and not getting any reply, the complainant sent multiple mails to senior officers of the respondent company, reminding them of pending First Appeals and the CPIOs not responding to the RTIs being filed., but to no avail. Copy of those emails are being attached below as Attachment 4,5 and 6. (9) As per the RTI act, the FAA has committed 2 illegal acts here, firstly he has to dispose of the first appeal within 30-45 days, whereas in this case, the FAA took more than 8 months (despite multiple reminders), to dispose it off and secondly, even after such a long period, he did not provide the asked information. The FAA while disposing off the claim said "The claim has been settled......... The FAA by answering such, is implying that if a claim has been settled, he is not bound to provide information under the RTI act. Whereas, as per the provisions of the RTI act, the complainant should have received the asked information irrespective of whether the claim was settled or not. Thus, firstly, the FAA took more than the stipulated time to dispose of the First Appeal and secondly, did not provide the asked information even after 8 months.

(10)It is worth mentioning here that the complainant in his claim was given amount much below the amount mentioned by the preliminary surveyor in his report. And thus, the CPIO and the FAA were trying to hide their wrongdoing in claim settlement by not sharing the Preliminary Survey Report.

(11)

It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good. Also, worth mentioning here is that as per complainant's knowledge, the CPIO and the FAA were both directly involved in illegal handling of the said claim, and thus they have used all illegal tactics to not provide asked information in this RTI application, so that they can hide their wrongdoing. (12) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby Page 28 of 35 requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide compensation to the complainant for his financial losses and mental agony faced by him.

(13) That Copy of this written submission is also being forwarded to the respondent through email."

"Our submission to the honorable CIC are the following:-

A] Reply submitted "Even in preliminary report, there are many mistakes and corrections are to be made, hence we are unable to provide you at this stage". is correct. Final Survey report received on 19.3.2023. The claim has been settled on 20.03.2023. Full & Final Discharge Voucher received from Insured on 25.3.2023 for Rs.8267814/-, and the payment amount has been accepted by the insured.

B] The subject case is under arbitration at HC Jabalpur - Case No.49/2023 Vishnu Coaters V/s Oriental Insurance Co Ltd.

11.CIC/OICOL/C/2024/600443 Relevant facts emerging from complaint:

RTI application filed on               :   13.11.2022
CPIO replied on                        :   28.12.2022
First appeal filed on                  :   Nil
First Appellate Authority's order      :   25.08.2023
2nd Appeal/Complaint dated             :   03.01.2024

Information sought:

The Complainant filed an RTI application (online) dated 13.11.2022 seeking the following information:

"Under the IRDAI (Protection of Policy holders Interest) Regulations 2017, which clearly states that on receipt of the surveyor report, if the insurer finds it incomplete in any respect then the insurer shall ask the surveyor to furnish an additional report UNDER INTIMATION TO THE INSURED. Under the RTI act, Page 29 of 35 please inform me if such intimations were given by the insurer to the insured every time when such additional information/report was sought from the surveyor in claim id no 153501/11/2022/00000001? If yes, then please provide soft copies and certified hard copies for all such intimations from the insurer to the insured. And if such intimation was not provided by the insurer to the insured, then please provide reason for not adhering to the above mentioned IRDAI regulation."

The CPIO furnished a reply to the complainant on 28.12.2022 stating as under:

"Since the claim is under process and the surveyor is still to submit the reply of the queries raised, we are unable to provide the required information. Rejected reason: Section 8(1)(e)"

Being dissatisfied, the complainant filed a First Appeal dated Nil. The FAA vide its order dated 25.08.2023, held as under.

"The claim has been already paid and accepted by the applicant (discharge voucher received)."

A written submission has been received from the Complainant/Appellant vide letter dated 27.03.2025 and the same has been taken on record. The relevant extract of the same is as under:

"(1) After filing RTI on 13/November/2022, and not getting reply, the complainant sent first reminder email on 30/November/2022, to the senior officers of the respondent insurance company including the CPIO, regarding the pending RTI application. Copy of the same is being attached as Attachment 1. (2) A second reminder was delivered in hard copy to the respondent insurance company's office, on 05/December/2022, addressed to the CPIO, RTI Nodal officer, etc reminding the respondent about pending RTI application. Copy of the same is being attached here as Attachment 2.

(3) A third reminder was sent by email on 05/December/2022, addressed to the CPIO and other senior officers, reminding them about the pending RTI applications, but to no avail. Copy of this email is being attached herewith as Attachment 3. (4) Even after above 3 reminders, the CPIO did not provide information asked for in the RTI application within stipulated time of 30 days, thus proving his malafide intention.

(5) On not getting any reply from CPIO, within stipulated time of 30 days, the complainant filed First Appeal on 15/December/2022. (6) After the First Appeal, the CPIO on 28/December/2022, rejected the RTI under section 8(1)(e).

(7) The RTI was rejected under Section 8(1)(e), which, as per the RTI act, deals with information which is related to Fiduciary relationship of the respondent. It's worth Page 30 of 35 mentioning here, that the respondent is an Insurance Company and as per the law, is governed by rules and regulations laid out by IRDAI (Insurance Regulatory and Development Authority of India). The IRDAI, in its gazetted notification titled "Protection of Policyholder's Interest 2017", has clearly mandated the insurance companies to intimate the insured (in this case the complainant) while asking for additional report from the surveyor. Thus, it is mandatory for the respondent to intimate the complainant before asking for additional report. Through this RTI, the complainant asked for copy of that intimation, which in no way can be treated some information related to the Fiduciary relationship of the respondent.

The CPIO by not providing the asked information was trying to hide the fact that against the IRDAI regulations, the insurance company did not provide any intimations to the insured while asking for additional reports from the surveyor. Thus, it is clear here that the respondent has done illegal act on 2 counts, firstly, he did not answer the RTI within stipulated time period of 30 days, and secondly, he illegally rejected the same after about 40-45 days, with malafide intention to hide wrong doing. (8) That after filing the first appeal, and not getting any reply, the complainant sent multiple reminder mails to senior officers of the respondent company, reminding them of pending First Appeals and CPIOs not responding to RTI applications, but to no avail. Copy of those emails are being attached here as Attachment 4,5 and 6. (9) As per the RTI act, the FAA too has committed 2 illegal acts here, which are, firstly he has to dispose off the first appeal within 30-45 days, whereas in this case, the FAA took more then 8 months, to dispose it off and secondly, even after such a long period, did not provide the asked information. The FAA while disposing off the claim did not provide the asked information and said "The claim has already been paid.....", thus implying that if a claim is paid, then there is no obligation on the insurance company to provide information under the RTI act, which is untrue. Under the RTI act, the complainant should have received the asked information irrespective of whether the claim was paid or not. Thus, firstly, the FAA took more then the stipulated time to dispose off the First Appeal and secondly, did not provide the asked information even after 8 months, thus proving malafide intention.

(10)

It is worth mentioning here that there have been many cases in the past where insurance company officials have been caught taking bribes to settle the claim and in cases where they don't get what they want, they drag on the claim settlement. In this case too, the way in which the CPIO and the FAA have broken all regulations of IRDAI and RTI act, it looks like they are hiding some wrongdoing, which must come out in greater public good. Also, worth mentioning here is that as per complainant's knowledge, the CPIO and the FAA were both directly involved in illegal handling of the said claim, and thus they have used all illegal tactics to not provide asked information in this RTI application, so that they can hide their wrongdoing. (11) With above points, it is clear that not only did the CPIO and FAA acted unlawfully, but they did it with malafide intention. Thus, the complainant hereby requests the respected CIC to impose penalty on the responsible, to take disciplinary action them, to provide the information sought to the complainant and to provide Page 31 of 35 compensation to the complainant for his financial losses and mental agony faced by him.

(12) That copy of this written submission is also being forwarded by the complainant to the respondent through email."

"A) These are our internal correspondence/process of claim, so many times we have to contact to Surveyor for clarification, additional documents, clarifications. It's not necessary to inform each and every time to insured. In case surveyor wanted additional information/documents from insured they will directly contact to insured/claimant on case to case basis.

B] The claim has been settled on 20.03.2023. Full & Final Discharge Voucher received from insured on 25.3.2023 for Rs.8267814/-, and the payment amount has been accepted by the insured.

C) The subject case is under arbitration at HC Jabalpur therefore being sub judice the details could not be provided.

The delay in serving replies to the applicant must be due to office exigencies for which apology is requested.

Therefore, the submission on behalf of the Insurance Company is that no mistake or fault was intentionally committed by us. Therefore, the appeal may be dropped on the aforementioned grounds."

Feeling aggrieved and dissatisfied, complainant approached the Commission with the instant Complaint.

Relevant Facts emerged during Hearing:

The following were present:-

Complainant/Appellant: Present through VC.

Respondent: Shri R.K. Raman, CPIO-cum-Regional Manager, attended the hearing through audio conference.

Shri Mahesh Khamba, Manager, attended the hearing through VC.

The Complainant/Appellant stated that the Respondent has not provided the relevant information as sought in the RTI Applications under question. While explaining the brief background of the case, the Complainant/Appellant stated that the Respondent has not provided information regarding surveyor report which is a violation of IRDAI guidelines. He added that when he sought the said information under RTI Application, the Respondent denied the same under the Page 32 of 35 provisions of RTI Act but has provided the same information through alternate channel when he filed his grievance under DPG (CPGRAM). This proves mala fide on the part of the CPIO.

He further submitted that in case file No. CIC/OICOL/C/2024/600367, the Respondent has provided a misleading reply stating that no such information is available on record. He further referred to Attachment- 8 of his written submission, wherein it is clearly established that communication was made between Respondent Public Authority and PMO CPGRAMS.

He further submitted that in case file No. CIC/OICOL/C/2024/600420, the Respondent has provided a misleading reply stating that no Minutes of Meeting is available on record. He further referred to Attachment- 7 & 8 of his written submission, wherein the averred Minutes of the Meeting had been recorded.

The Respondent Shri R.K. Raman, did not attend the hearing through VC and the registry of this bench received an email dated 03.04.2025, from him stating as under:

"Dear sir Appeals hearing notices from CIC are scheduled today to start at 12.05PM. At 9.32 PM 1 was informed that burglars have burgled my house at Gopalganj in the night and they have taken away most of the household goods, asc informed. Under the circumstances, it is not possible to me to attend said hearing as I am mentally disturbed."

In the interest of justice, equity and good conscience, the bench heard the Respondent through audio conference. The Respondent submitted that the main issue of the Complainant is regarding his claim which already had been settled on 20.03.2023 and the Complainant had received full & final Discharge Voucher received from insured on 25.3.2023 for Rs. 82,67,814/-. He submitted that the then CPIO Shri B. Subramaniam, Regional Manager, has not provided the relevant information to the Complainant in the RTI Applications under question.

The Complainant/Appellant interjected and apprised the bench that the Respondent is again trying to mislead the bench and stated that Shri R.K. Raman, CPIO-cum-Regional Manager, was the CPIO at that time who has denied information under the RTI Act.

Decision Upon perusal of the facts on record as well as on the basis of the proceedings during the hearing, the Commission observes that Shri R.K. Raman, CPIO-cum- Regional Manager, has denied the information to the Complainant/Appellant Page 33 of 35 under the RTI Act but the same has been given to the Complainant/Appellant through alternate channel via CPGRAM, which demonstrates violation of RTI Act.

It is further observed that in case file No. CIC/OICOL/C/2024/600367, the Respondent has provided a misleading reply stating that no such information is available on record. The Complainant/Appellant during the hearing has provided proof which is at Attachment- 8 of his written submission, wherein it is clearly seen that communication was made between Respondent Public Authority and PMO CPGRAMS.

It is further observed that in case file No. CIC/OICOL/C/2024/600420, the Respondent has again provided a misleading reply stating that no Minutes of Meeting is available on record. The Complainant/Appellant during the hearing has provided proof which is at Attachment- 7 & 8 of his written submission, wherein it is observed that the averred Minutes of the Meeting were recorded.

Under these circumstances, the Commission has a reason to believe that the denial of information to the Appellant/Complainant is with a mala fide intent. Therefore, the Commission deems it expedient to direct the Registry of this Bench to issue Show Cause notice to Shri R.K. Raman, CPIO-cum-Regional Manager, for flouting the provisions of RTI Act. The CPIO shall explain in writing as to why action should not be initiated against him under Section 20(1) and 20 (2) of the RTI Act for the foregoing reasons, written explanation of the CPIO should reach the Commission within eight weeks from the date of receipt of this order.

The cases are 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 34 of 35 Copy To:

The FAA, The Oriental Insurance Co. Ltd., 56 L, Mahatma Gandhi Road, Near Regal Square, Nehru Park 2, Chhoti Gwaltoli, Indore - 452001 The FAA, The Oriental Insurance Co. Ltd., 20, Vikram Tower, Shradhanand Marg Main Road, Snehnagar, Indore - 452001 Page 35 of 35 Recomendation(s) to PA under section 25(5) of the RTI Act, 2005:-

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Shyam Advani vs The Oriental Insurance Co. Ltd. on 11 April, 2025