A major fire insurance claim dispute involving Oriental Insurance Company Ltd led to a series of right to information (RTI) applications, in which the applicant requested information pertaining to his factory that was gutted and subsequently filed a complaint with the central information commission, accusing the insurer of claim settlement irregularities and giving false reason of unavailability of the information which is a gross violation of the RTI Act.
Also, RTI applicant Sham Advani, owner of Vishnu Coaters, who had procured a fire insurance policy for his factory; during settlement accused the Oriental Insurance Company that it withheld the crucial copy of the survey report which is a public document under the RTI Act and that his claim was processed in violation of the insurance regulatory and development authority of India (IRDAI) norms.
Mr Advani had requested in his complaint to the commission to impose penalties, take disciplinary action against those responsible and provide compensation for financial loss and mental agony.
Central information commissioner (CIC) Vinod Kumar Tiwari, in his recent order of 9 April 2025, observed several instances where Oriental Insurance provided misleading or incorrect replies. In one of the replies, he observed that Oriental Insurance Company claimed that no relevant information was available on record. However, RTI applicant Advani had brought evidence of a communication between him and the PMO (prime minister's office) office where he had also filed two grievances in this matter.
In another case, noted CIC Tiwari, the company stated that no minutes of the meeting were recorded but Mr Advani had produced a copy of the document from another public authority, and therefore the CIC concluded that the denial by the CPIO of the Oriental Insurance Company was done with 'mala fide intent'.
In a stern directive, CIC Tiwari has ordered the CIC registry to issue a show-cause notice to RK Raman, CPIO-cum-regional manager of Oriental Insurance, Indore, for violating the provisions of the RTI Act. Mr Raman has been asked to submit a written explanation within eight weeks, giving reasons as to why penalty proceedings should not be initiated against him under Sections 20(1) and 20(2) of the Act.
Mr Advani had argued through his lawyer during the hearing of his complaint in the CIC that:
• As per IRDAI regulations on claim settlement, it is mandatory for the insurance companies to provide a copy of the survey report to the insured if he so desires. In this instant case of RTI, Advani had asked for a copy of the survey report, as per IRDAI norms, but to hide their wrongdoings, the Oriental Insurance Company rejected this RTI application, saying 'duplicate entry'.
• While rejecting this RTI application, the CPIO has not mentioned the clause of the 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 wrongdoing, the CPIO chose to reject it.
• After the RTI being rejected, the applicant filed for the first appeal which was not responded to by the FAA within the stipulated period of 45 days. This again shows that the CPIO and the FAA wanted to illegally withhold the information, so that their wrongdoings don't come out in the open.
• 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.
• On not getting any reply from the FAA within 45 days, the appellant was forced to do a second appeal with the CIC. After this second appeal, the FAA rejected the first appeal, saying the case is subjudice in court. Although the court has not stopped the respondent from sharing any information under the RTI Act. And 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.
RK Raman, CPIO-cum-regional manager, had sent a letter to the CIC, the extract of which is as follows:
• 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 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 the court, but the matter could not reach for hearing. The revised date is not uploaded on the Court Portal.
• The delay in serving replies to the applicant must be due to office exigencies for which an 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.”
Citizens, indeed, go through trying times during claim settlements of any kind of insurance and hopefully, this stick from the CIC will set a tone for fair compensation and transparency between the customer and the insurance companies.
(Vinita Deshmukh is consulting editor of Moneylife. She is also the convener of the Pune Metro Jagruti Abhiyaan. She is the recipient of prestigious awards like the Statesman Award for Rural Reporting, which she won twice in 1998 and 2005 and the Chameli Devi Jain Award for outstanding media person for her investigation series on Dow Chemicals. She co-authored the book "To The Last Bullet - The Inspiring Story of A Braveheart - Ashok Kamte" with Vinita Kamte and is the author of "The Mighty Fall".)
And Nirmala Mathaji is creating thuglak Mathaji of we the citizens
The insurance company has been taken for a ride.
Clients are saying away from oriental because the company is not transparent to even agents of the commission and incentives detail unlike private player.
Claim settlement is the whims and fancy of officials at SVC .
A cursory and random check will reveal many "issues"
Even they don't know the basics of CSR!!!