Central Information Commission
S Balakrishnan vs United India Insurance Co. Ltd. on 3 July, 2025
के ीय सूचना आयोग
Central Information Commission
बाबा गंगनाथ माग, मुिनरका
Baba Gangnath Marg, Munirka
नई िद ी, New Delhi - 110067
File No: CIC/UIICL/A/2024/104960
S Balakrishnan .....अपीलकता/Appellant
VERSUS
बनाम
PIO,
O/O THE CPIO United India
Insurance Co. Ltd, PLA Rathna
Towers, 5th Floor, 212, Anna Salai,
Chennai - 600006 .... ितवादीगण /Respondent
Date of Hearing : 02.07.2025
Date of Decision : 03.07.2025
INFORMATION COMMISSIONER : Vinod Kumar Tiwari
Relevant facts emerging from appeal:
RTI application filed on : 03.05.2023
CPIO replied on : Not on record
First appeal filed on : 11.07.2023
First Appellate Authority's order : 30.11.2023
2nd Appeal/Complaint dated : 15.02.2024
Information sought:
1. The Appellant filed an (offline) RTI application dated 03.05.2023 seeking the following information:Page 1 of 4
"Ref: Petition of S. Balakrishnan addressed to Divisional Manager UIIC dated 13.03.2023 A copy of petition dated 13.03.2023 by mentioning the details of medical expenses incurred by me is sent herewith for immediate perusal. I came to know that a sum of Rs. 65,000/- has been credited in my bank account vide copy of message received from State Bank of India on 27.04.2023. No information was received from the UIIC Chennai in this regard. At this stage, I request following information about the medical reimbursement of Rs. 65000/- which are wanted to me.
Information needed:-
1. According to the medical doctor's receipt bill total amount is Rs. 184559 which was padi by me to the hospital. Full details about the medical bill paid by me has been shown in my petition dated 13.03.2023. All supporting documents sent to the Joint Dr. of Health Services and in turn he has sent the same to District Collector, with his recommendation. A copy of the letter is enclosed. But, in my case, our of Rs. 184559 paid for my medical reimbursement only 1/3 of the amount Rs. 65000/- " has been received to my bank account. In this regard, I request information about the lesser amount calculated on my claim as stated below.
2 As per the prevailing rules how much total reimbursement amount was sanctioned to me."
2. Having not received any response from CPIO, the appellant filed a First Appeal dated 11.07.2023. The FAA vide its order dated 30.11.2023, held as under.
"We acknowledge the receipt of your appeal letter under RTI. We hereby furnish the information received by us from DO 6 & MD INDIA TPA, the holder of the information For the treatment taken by Mr. Balakrishnan in NTC Hospital from 28.4.2022 to 30.4.2022 with the diagnosis of Epigastric Hernia. TPA has received DLEC documents for processing against CON NO.MD14277985 and paid for an amount of Rs.65000/- (package rate for the mentioned procedure) vide UTR No.23355807081 Dt.27.4.2023 as per G.O.222 Dt.30.6.18 issued by Finance (Pension)dept. Govt. of Tamil Nadu. You can approach the State Level Empowered Committee for the Appeal against the claims of the District Level Empowered Committee for further direction."Page 2 of 4
3. Feeling aggrieved and dissatisfied, appellant approached the Commission with the instant Second Appeal.
Relevant Facts emerged during Hearing:
The following were present:-
Appellant: Absent.
Respondent: Shri P.M. Soundira Rajan, APIO-cum-Manager, attended the hearing through VC.
4. The Appellant did not participate in the hearing.
5. The Respondent submitted that the relevant information based on available records has been given to the Appellant vide letter dated 30.11.2023.
6. A written submission has been received from Shri Chandra Srinivasan, CPIO, vide letter dated 30.06.2025, stating as under:
"REPLY FOR THIS APPEAL:
No specific grievances were mentioned in the second appeal, But still we provide the information once again against his reimbursement claim. Mr. Balakrishnan was admitted in NTC Hospital from 28.4.22 to 30.4.22 with the diagnosis of Epigastric Hernia. We received DLEC documents for processing against CCN NO.MDI4277985 and paid for an amount of Rs. 65000/- maximum eligible amount for this procedure vide UTR No.23355807081 Dt.27.4.23 as per G.O.222 Dt.30.6.18 issued by Finance (Pension) dept. Govt. of Tamil Nadu. Hence we pray that we have already replied for the appeal related to the RTI query requested by the applicant and the claim also settled for an amount of Rs.65000/-vide UTR NO. 23355807081 Dt.27.4.23."
Decision:
7. The Commission after adverting to the facts and circumstances of the case and perusal of the records, observes that the relevant information based on available records has been given by the Respondent vide letter dated 30.11.2023. Moreover, the Appellant has not participated in the hearing to contest the submissions made by the Respondent. Intervention of the Commission is not required in the instant case.
Page 3 of 48. However, before parting with the case, the Respondent is cautioned to act strictly within the precincts of the RTI Act by observing the timelines scrupulously and punctually, in future.
The appeal is disposed of accordingly.
Vinod Kumar Tiwari (िवनोद कुमार ितवारी) Information Commissioner (सूचना आयु ) Authenticated true copy (अिभ मािणत स!ािपत ित) (S. Anantharaman) Dy. Registrar 011- 26181927 Date Page 4 of 4 Recomendation(s) to PA under section 25(5) of the RTI Act, 2005:-
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