Central Information Commission
Jayesh Hematlal Gondaliya vs Life Insurance Corporation Of India on 16 August, 2018
के ीय सूचना आयोग
Central Information Commission
बाबा गंगनाथ माग
, मुिनरका
Baba Gangnath Marg, Munirka
नई द
ली, New Delhi - 110067
ि तीय अपील सं या / Second Appeal No.:- CIC/LICOI/A/2017/136089-BJ
Mr. Jayesh Hematlal Gondaliya
....अपीलकता
/Appellant
VERSUS
बनाम
CPIO & Secretary (CRM),
LIC of India, Western Zonal Office,
CRM Dept., 2nd Floor Link, Yogakshema Bldg.,
J. B. Marg, Mumbai - 400021
... ितवादीगण /Respondent
Date of Hearing : 14.08.2018
Date of Decision : 16.08.2018
Date of RTI application 23.01.2017
CPIO's response 02.03.2017
Date of the First Appeal 08.03.2017
First Appellate Authority's response 16.03.2017
Date of diarised receipt of Appeal by the Commission 29.05.2017
ORDER
FACTS:
The Appellant vide his RTI application sought information on 02 points regarding the name, designation and address of the LIC officer who initially accepted his proposal number 3357 with CL-IV Health Extra and issues related thereto.
The CPIO, vide its letter dated 02.03.2017 provided a point wise response denying information on point no. 01 regarding remarks of LIC/ Doctor/ Officer in which Class IV health extra imposed and photocopy of documents relating to criteria/ standards/ parameters for deciding exemption of Class IV health extra under Section 8 (1) (d) of the RTI Act, 2005. As regards point no. 02, names of the officers were denied u/s 8 (1) (e) of the RTI Act, 2005. Dissatisfied by the response, the Appellant approached the FAA. The FAA, vide its order dated 16.03.2017 concurred with the response of the CPIO.Page 1 of 5
HEARING:
Facts emerging during the hearing:
The following were present:
Appellant: Mr. Jayesh Hematlal Gondaliya through VC;
Respondent: Mr. R. K. Chaudhury, Secretary (CRM)/CPIO and Ms. Asha Nair, Regional Manager (Actuarial) through VC;
The Appellant reiterated the contents of his RTI application and stated that although the Medical Report and documents were provided by the Respondent, the comments of the LIC on the Medical Report had not been disclosed citing exemption under Section 8(1)(d) & (e) of the RTI Act, 2005. The Respondent explained the Policy pursued by LIC in such matters and stated that complete and correct information was provided. Contesting that the Medical Report produced by LIC was incorrect and contrary to the other medical results available with him, it was argued that the categorisation criteria pursued by LIC should be made available to him forthwith as it was not considered to be a Third Party information. The Commission was in receipt of a written submission from the Respondent dated 06.08.2018 wherein while replying to the contention of the Appellant that information on two points was denied u/s 8 (1) (d) and (e) with a malafide intention, it was stated with regard to query no. 01 that the rationale behind their underwriting rules could not be given/ disclosed as rating sheet disclosed their policies/ rules etc on the basis of which they were underwriting the proposal medically as well as financially. The rules were framed in consultation with the re-insurer and were based on the reinsurance treaty with the Reinsurer. As per the existing terms and conditions of the treaty, the methods of underwriting were privy to LIC of India and Swiss Re being intellectual property. Further, it could harm their competitive position in the market, hence the information with respect to the part i.e., standards/ parameters/ criteria for deciding class IV extra was exempted from disclosure as per Section 8 (1)(d) of the RTI Act, 2005. However, copies of the medical bill were provided vide their reply dated 02.03.2017. As regards query no. 02, it was stated that the decision was taken by the Asst. AO. However, information with respect to the name of the officer was exempted as per Section 8 (1) (e) of the RTI Act, 2005.
The Commission referred to the judgement of the Hon'ble Supreme Court of India in Consumer Education & Research Centre and Union of India, AIR 1995 SC 992, dated 27.01.1995 wherein it was held that the right to health, medical aid to protect the health and vigour to a worker while in service or post retirement is a fundamental right under Article 21, Article 39(a), 41, 43, 48A and all related Articles and fundamental human right to make the life of a workman meaningful and purposeful with dignity of person.
Moreover, the expression "Consumer'' is defined in the Consumer Protection Act, 1986 under S 2(1) (d) which reads as under:
"Consumer' means any person who, (i) omitted (ii) hires (or avails of) any services for a consideration which had been paid or promised or partly paid and partly promised, or under any system of deferred payment and includes any beneficiary of such services other than the person who hires (or availed of) the service for consideration paid or partly promised, or under any system of deferred payment, when such services are availed of with the approval of the first mentioned person"Page 2 of 5
Similarly as per Section 2(1)(o): "service" means -
"service" of any description which is made available to the potential users and includes the provision of facilities in connection with banking, financing, insurance, transport, processing, supply of electrical or other energy, board or lodging or both, (housing and construction), entertaining, amusement or the purveying of news or other information, but does not include rendering of any service free of charge or under a contract of personal service"
Thus, as per the aforementioned definition services rendered by Insurance Companies are also covered within the purview of the Consumer Protection Act, 1986 and are liable for claims of defect, deficiency of service and unfair trade practices as per the provisions of the Act. Furthermore, in the matter of Ozair Husain Vs Union of India [ AIR 2003 Delhi 103]dated 13.11.2002, the Division Bench of the Hon'ble High Court of Delhi while observing that the it was the right of the consumers to know whether the food products, cosmetics and drugs of non- vegetarian or vegetarian origin held as under:
"21. In view of the aforesaid discussion, we are of the view that it is the fundamental right of the consumers to know whether the food products, cosmetics and drugs of non- vegetarian or vegetarian origin, as otherwise it will violate their fundamental rights under Article 19(1)(a), 21 and 25 of the Constitution. Accordingly, we answer the main question in the affirmative. Since there is a constitutionally guaranteed right of the consumers to the full disclosure of the ingredients of cosmetics, drugs and articles of food, answers to remaining questions (ii) and (iii) necessarily are required to be answered in the affirmative. We, accordingly, answer the questions (ii) and (iii) also in the affirmative.
22. It seems that the Parliament Realizing that the consumers have a fundamental right to be apprised of the fact whether or not a food article contains whole or part of any animal including birds, fresh water or marine animals or eggs or products of animal origin, brought about necessary changes in the Prevention of Food Adulteration Act, 1954.
Furthermore, the information sought related to the Appellant himself and did not pertain to any third party hence he was entitled to receive the same. In this context, a reference can be made to the decision of the Hon'ble High Court of Delhi in the matter of Treesha Irish vs. CPIO and Ors., WP (C) No. 6352 of 2006 dated 30.08.2010 while deciding that a candidate was entitled to his own answer sheet had held as under:
21...................... The valued answer paper, if at all, can be a personal information relating to the candidate who has written the same. When the candidate applies for copy of the same, it cannot be denied to the candidate on the ground that it is personal information, insofar as, if that information would compromise anybody, it is the candidate himself/herself...........Page 3 of 5
23. There is no provision anywhere in the Act to the effect that information can be refused to be disclosed if no public interest is involved. Of course in a case of personal information, if it has no relationship with any public activity or interest, the information officer has discretion to refuse to disclose the same, if the larger public interest does not justify disclosure of such information. But on the ground of lack of public interest involved alone, the public information officer cannot refuse to disclose the information, without a finding first that the information is personal information having no relationship to any public activity or interest."
The Commission in this context also referred to several decisions pertaining to disclosure of a candidate's own answer script. Drawing the same anology, an individual should also be considered to be entitled to his own medical records. The Hon'ble Supreme Court of India in the decision of CBSE v. Aditya Bandopadhyay and Ors. SLP(C) NO. 7526/2009 had observed the following in para 11:
"11. The definition of 'information' in section 2(f) of the RTI Act refers to any material in any form which includes records, documents, opinions, papers among several other enumerated items. The term 'record' is defined in section 2(i) of the said Act as including any document, manuscript or file among others. When a candidate participates in an examination and writes his answers in an answer-book and submits it to the examining body for evaluation and declaration of the result, the answer-book is a document or record. When the answer-book is evaluated by an examiner appointed by the examining body, the evaluated answer-book becomes a record containing the 'opinion' of the examiner. Therefore the evaluated answer-book is also an 'information' under the RTI Act."
It was furthermore stated in para 14 of the above mentioned judgement "The examining bodies contend that the evaluated answer-books are exempted from disclosure under section 8(1)(e) of the RTI Act, as they are 'information' held in its fiduciary relationship. They fairly conceded that evaluated answer-books will not fall under any other exemptions in sub section (1) of section 8. Every examinee will have the right to access his evaluated answer-books, by either inspecting them or take certified copies thereof, unless the evaluated answer-books are found to be exempted under section 8(1)(e) of the RTI Act."
Similarly, the Hon'ble High Court of Delhi in the matter of Mukesh Kumar vs. Chief Information Commission, CIC, W.P. (C) 10691/ 2016 dated 19.09.2017 held as under:
"12. In the present case, the issue is not regarding any confidential gradings, but results of a public examination for selecting candidates for appointment to the Delhi Higher Judicial Service Examination. The results of the Examination have been placed in public domain and, there is no question of claiming any exemption under Section 8(1)(e) of the Act."Page 4 of 5
DECISION:
Keeping in view the facts of the case and the submissions made by both the parties and in the light of aforesaid judgments, the Commission directs the Respondent to furnish all the details pertaining to the Health Records of the Appellant including the observations of the LIC within a period of 15 days from the date of receipt of this order.
The Appeal stands disposed with the above direction.
Bimal Julka (िबमल जु का)
Information Commissioner (सूचना आयु )
Authenticated true copy
(अ भ मा णत स या पत त)
K.L. Das (के .एल.दास)
Dy. Registrar (उप-पंजीयक)
011-26182598/ [email protected]
दनांक / Date: 16.08.2018
Copy to;
1- The Chairman, L.I.C. of India, Central Office, 'Yogakshema', Nariman Point, Mumbai- 400021 Page 5 of 5