के न्द्रीय सूचना आयोग Central Information Commission बाबा गंगनाथ मागग, मुननरका

Baba Gangnath Marg, Munirka नई निल्ली, New Delhi – 110067 File No: CIC/UIICL/C/2024/623023 Parthiban A ….निकायतकताग /Complainant VERSUS बनाम CPIO United India Insurance Company Limited, Chennai Region, 134, Shillingi Building, Greams Road, Chennai 600006 ….प्रनतवािीगण /Respondent Date of Hearing : 17.11.2025 Date of Decision : 19.11.2025 INFORMATION COMMISSIONER : Vinod Kumar Tiwari Relevant facts emerging from complaint:

RTI application filed on : 29.02.2024 CPIO replied on : 22.04.2024 First appeal filed on : Not on record First Appellate Authority’s order : Not on record

2nd Appeal/Complaint dated : 31.05.2024 Information sought:

1. The Complainant filed an RTI application dated 29.02.2024 (offline)

seeking the following information:

“Attachment: Letter No. 042251/5631/F46/F461/PPO No. 383R/Date:

01.2023 Reference: E. DEEPA, D.M., RTI Dept., UIIC, CHENNAI REGION, LETTER.

REF. Q4/F428/2023-2024 I, Mr. A. Parthiban, residing at 14, Middle Periya Street, Manachanallur, Trichy District, submit this application under Section 6.1 of the Right to Information Act, 2005.

My mother, Mrs. Padmavathi Achimuthu (Tamil Nadu Electricity Board Family Pensioner, PPO.No.383R), was treated for COVID-19 at Kaveri Hospital, Trichy, from 27.12.2021 to 08.01.2022, for which I paid Rs.

3,88,330/- to the hospital.

I submitted a request to the Tamil Nadu Electricity Board with all documents from Kaveri Hospital to reimburse this medical expense of Rs. 3,88,330/- as per Board Order 148, dated 22.09.2020. The Tamil Nadu Electricity Board Audit Office Pension communicated in their letter No. 033319/4143/F46/F461/PPO No.383R/2022 dated 11.10.2022 that my mother's treatment expense reimbursement application was recommended by the committee formed under Board Order No. 148.

The Tamil Nadu Electricity Board Audit Office Pension informed in letter No. 042251/5631/F46/F461/PPO No.383R/2022 dated 01.2023 that all original documents submitted for my mother's PPO No. 383R treatment expenses were sent to the insurance company (UIIC) for further action on

01.12.2022.

The insurance company reimbursed Rs. 2,15,500/- to my bank account on 20.01.2023. This amount is 55.5% of the Rs. 3,88,330/- I paid for the treatment. No information was provided regarding the remaining amount of Rs. 1,72,830/-. When I approached the Tamil Nadu Electricity Board Audit Office - Pension regarding the remaining amount, they directed me to contact the insurance company, stating that the authority to reimburse medical expenses lies with the insurance company, as mentioned in their letter No. 007651/891/F46/F461/PPO No.383R/2023 dated 03.2023.

I submitted a request to the Divisional Manager, United India Insurance Company Limited, Divisional Office, P.L.A. Ratna Towers, 5th Floor, 212 Anna Salai, Chennai 600006 on 12.07.2023 and a reminder on 28.08.2023. No response was received. Therefore, I submit this request under Section 6.1 of the Right to Information Act, 2005 to obtain general information.

Requested Information:

1. A certified copy of all documents sent to UIIC for further action as stated in letter No. 042251/5631/F46/F461/PPO No. 383R/ Date:

01.2023 dated 01.12.2022.

2. The regulations under which the insurance company calculated and provided Rs. 2,15,500/- out of Rs. 3,88,330/-. A certified copy of these regulations is requested.

3. Certified copies of all documents used to calculate Rs. 2,15,500/- out of Rs. 3,88,330/-.

4. A certified copy of the Summary of Settlement Detail document for providing Rs. 2,15,500/- out of Rs. 3,88,330/-.

5. The monthly insurance premium paid by Tamil Nadu Electricity Board employees, pensioners, and family pensioners from 01.01.2021 to

01.06.2022. A certified copy of the relevant orders/reports is requested.

6. The policy/order allowing current Tamil Nadu Electricity Board employees to get cashless COVID-19 treatment while pensioners and family pensioners must pay first and get reimbursed. A c