RTI Judgement Series
RTI Judgement Series: How government agencies take away livelihoods

This case reveals how government agencies take away livelihoods of people without bothering about compensating the affected. This is the 19th in a series of important judgements given by Shailesh Gandhi, former CIC, that can be used or quoted in an RTI application

The divisional commissioner of the National Capital Territory (NCT) of New Delhi was directed by the Central Information Commission (CIC) to ensure that details of compensation and rehabilitation to the affected persons who have been displaced must be made available at least on the website. While giving this important judgement, Shailesh Gandhi, former Central Information Commissioner, asked the divisional commissioner to also ensure that information about how the appellant could get the compensation for his loss is communicated to him.


“The Divisional Commissioner, Govt. of NCT of Delhi is directed to ensure that the details mentioned above are communicated to the appellant before 15 June 2009. The Public Authority will also ensure that in compliance with Section 4 requirements details of the project affected persons and the rehabilitation due to them is made available suo moto before 15 August 2009,” the Commission said in its order dated 27 May 2009.


Delhi resident Sunil Kant, on 5 January 2009, sought information from the Public Information Officer (PIO) of the Land & Building Department, Government of NCT Delhi about his land, compensation and rehabilitation. He sought information regarding his land, requisition of which has been done by Delhi Metro Rail Corporation (DMRC) due to which he was forced to live without any source of livelihood. He has asked that when and what amount will be given to him as compensation and where will he be rehabilitated. He has said that his land was under Delhi Development Authority (DDA) after 1947 and later acquired by DMRC for construction.


The PIO did not even reply. Sunil Kant, then approached the First Appellate Authority (FAA). In its order issued on 13 March 2009, the FAA asked the PIO to inform the appellant (Kant) about the status of the action taken on the said representation along with copy of policy of rehabilitation within a period of 15 days receipt of these orders.


After the order from FAA, the PIO gave a copy of the policy for the rehabilitation of Metro Project Affected Persons. Not satisfied with this, Sunil Kant then approached the Commission.


During the hearing before the CIC, he stated that he had a 100 sq yard shop where he was running tailoring shop and a barber shop. He said he has been displaced from there on 6 June 2008 and is running from pillar to post.


Mr Gandhi noted that the appellant is not a well-educated person and has been deprived from his livelihood. “It is a sad comment that a law abiding citizen is deprived of his property and livelihood by a government without being given alternate place and compensation,” he observed.


The Commission in its order issued on 27 May 2009, said, “A modus operandi of this nature, apart from depriving a citizen of his fundamental rights does not do credit to any state which claims to be following the rule of law. The PIO states he is helpless since the government has not fixed any method to provide rehabilitation to such citizens.”


Mr Gandhi then directed the divisional commissioner of the Govt of NCT of Delhi to ensure that details of compensation and rehabilitation to the affected persons who have been displaced in this manner must be made available at least on the website and also to make sure that the appellant receives information about how he could get compensation for his loss.





Decision No. CIC/SG/A/2009/000734/3446


Appeal No. CIC/SG/A/2009/000734


Appellant                                            : Sunil Kant


Respondent                                        : The Deputy Secretary (LA/PIO)

                                                            Land & Building Department,

                                                            GNCTD, IP Estate,

                                                            New Delhi


Insurer and not TPA to settle health insurance claims

At a high court hearing of a public interest litigation filed by Gaurang Damani, IRDA member (non-life) stated that health insurance draft guidelines accept that the insurer and not TPA will settle or reject health insurance claims

An Insurance Regulatory and Development Authority (IRDA) member (non-life) confirmed that health insurance draft guidelines limit the TPA’s (third party administrator) role to claims processing and not settlement. The insurance company will make direct payments to the hospital and policyholder (not through the TPA). Cheques will have to be written by the insurance company and sent to the hospital (for cashless) and to the policyholder (for reimbursement). It means that cheques cannot be held by TPAs as a float.

According to Gaurang Damani, a social activist, who has filed the public interest litigation (PIL), “TPAs are supposed to process claims, instead they’re settling claims. There are no standard guidelines to settle claims and it is left to the whims and fancies of the TPAs who are in fact not entitled to settle claims but are found to be doing so in several cases.”

Interestingly, at the hearing IRDA member (non-life) M Ramaprasad admitted that even veterinarians are appointed by the TPAs in addition to ayurvedics and homeopaths to assess cases. There have been cases where specialist doctors were not able to convince the need of specific procedure to TPA doctors, who may be well qualified in their respective field but not in the specialised allopathic stream.

Another point which was agreed by IRDA at the hearing was to make the TPA send scanned claims electronically to the insurance company to speed up the process. This is followed by LIC and hence it may well be implemented by TPAs working for general insurance companies.

Moneylife had reported that United India and New India Assurance have an incentive clause in the TPA agreement to keep claims ratio within a certain range. This is completely detrimental to the interest of the policyholder whose genuine claims can also be partially paid or rejected just so that the TPA is able to get incentives from the insurance company.

Read - United India Insurance doles out incentives to TPAs to reduce claims ratio!

At the hearing, Mr Ramaprasad said it was logically not correct for TPAs to be paid incentives. “If we find such instances, we shall take such companies to task.'” He will be taking the issue to the General Insurance Council to decide further steps.

Gaurang Damani's petition says that in addition to the incentive clause, there is discrimination in settling insurance claims of individuals and that of corporate clients. Group claims have better negotiation power with insurance companies due to the volume of business.

According to Mr Damani, “If mediclaim policies indicated the amount an insured was eligible for specific ailments, it will ensure that they have clarity on which hospitals to go; the hospitals too would know how much they would get.” The advocate for Association of Medical Consultants (AMC) agreed to indicate the amounts for 42 standard ailments. HC has directed the petitioner to send a notice to Association of Hospitals (AOH) and Bombay Nursing Homes Association to get the range of package rates for the 42 standard ailments.

The next hearing would be on 12th February. It is understood that the IRDA chairman wants to finalize the health insurance guidelines before he demits the office in mid-February.

Read - IRDA comes up with landmark draft health insurance regulations



Arun Kumar

3 years ago

This type of articles and the information give better view to resolve the isuue


4 years ago

To Mr. Gaurang Damani:

An aspect to be taken up by Moneylife with IRDA, is to challenge the wide spread practice of hospitals to charge for surgery, doctors fee etc, basis the type of room one takes. If one takes a single room, the cost of surgery and cost of surgeon, anaesthesia etc, is charged much higher than if the patient takes a double room. The difference becomes even more, if one takes a ward, instead of a single room. This has no logic, as the same operation theatre, doctor and team is used and same pre operation preparation area and same post operation recovery area. This is just looting of people wanting some privacy in times of stress.

pk bhor

4 years ago

insurance companies & TPAs are hand in gloves. hence how much the insurer is really going to be benefitted still remains a million dollar question.
PK Bhor

nagesh kini

4 years ago

The Insurance companies appear to have forfeited their legitimate function of settling, instead of processing, the claims to TPAs in all cases and not 'several cases' as reported.
ML should seek clarifications from New India and United India on the Incentive Clause.
At the High Court hearing, the IRDA member was categoric that they do not permit incentives. IRDA's attention needs to be directed to this infraction of conditions.
The TPAs are a law unto themselves!

nagesh kini

4 years ago

The Insurance companies appear to have forfeited their legitimate function of settling, instead of processing, the claims to TPAs in all cases and not 'several cases' as reported.
ML should seek clarifications from New India and United India on the Incentive Clause.
At the High Court hearing, the IRDA member was categoric that they do not permit incentives. IRDA's attention needs to be directed to this infraction of conditions.
The TPAs are a law unto themselves!

Thomas Kuruvilla

4 years ago

Mr. Ramaprasad is correct when he says that most doctors in the TPA's are non allopathic doctors. How can they decide whether a claim is correct or not? It should be made mandatory that when claims are being viewed with suspicion by the TPA's, the case should be referred to the Insurance company which in turn should have well qualified doctors to go through the issue.

IIFL Sensex Fund: Expect passive returns

Actively managed schemes have delivered better returns than the index in the past. However, when in doubt, index schemes would be a preferred option

India Infoline (IIFL) Mutual Fund plans to launch an open-ended index scheme— IIFL Sensex Fund. As the name suggest the scheme would invest in the securities which are constituents of BSE SENSEX Index in the same proportion as in the index. Over 95% of the assets would be invested in equity and the rest would be invested in debt and money market securities. Passive investing is ideal for those investors who feel it is difficult to outperform the market, hence they would prefer to invest in equity mutual fund schemes that follow a passive investment strategy. However, in a recent analysis of three-year and five-year rolling periods we found that actively managed schemes beat the index by an average of two percentage points. (Read: Best Equity Funds )

Index schemes are expected to deliver returns that are close to those of the index. As the fund manager does not have to put in much effort, the cost structure of these schemes is lower than that of actively managed schemes. The cost for index schemes goes up to 1.70%; for other equity schemes, the costs are capped at 2.70% (excluding the additional expense ratio depending on the inflow from the beyond 15 cities). But despite the costs, passive investing does not seem a feasible option if you are looking for high returns. There are many actively managed schemes that have consistently performed, but one has to know how to choose the right scheme.

IIFL Mutual Fund has been in existence for just about two years. At present it has just two schemes, both of which follow a passive investment strategy. IIFL Nifty ETF, an exchange traded fund based on the Nifty index, was launched in October 2011. The other scheme— IIFL Dividend Opportunities Index Fund—is the only scheme that passively invests in the stocks of the CNX Dividend Opportunities index. These schemes have tracked the returns of their respective index with a fairly low tracking error. However, both the schemes together have amassed a corpus of just around Rs45 crore.

As far as expenses are related, the IIFL Nifty ETF has an expense ratio of just 0.25%, which is much less than other ETFs. The new scheme would have as expense ratio of 1.70%, which could go up by 30 basis points depending on the inflows from the beyond 15 cities. Both the schemes are managed by Manish Bandi, who will also be managing the new index scheme.

The scheme would charge an exit load of 0.50% if the investment is withdrawn before 30 days and 0.25% if withdrawn after 30 days but before 90 days from the date of allotment of units.


Other scheme details

Minimum Application Amount

New Purchase – Rs10,000 and in multiples of Rs100 thereafter.

Additional purchase - Rs1,000 and in multiples of Rs100 thereafter

Systematic investment plan (SIP):

Monthly option - Rs1,000 per month for a minimum period of six months.

Quarterly Option – Rs1,500 per quarter for a minimum period of four quarters.


Transaction Charges

For existing/new investors: Rs100/Rs150 as applicable per subscription of Rs10,000 and above. There shall be no transaction charges on direct investments.


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