Information relating to claim settlement details of Group Policy issued by NICL for “Jain” person & proposed by JIO (popularly known as JIO-Shravak Arogyam Policy) - CIC: Provide copy of TPA agreement; The group policy details are exempt from disclosure
10 Jun, 2016Date of Hearing : 05th February, 2016.
Date of Decision : 16th February, 2016
ORDER
1. The appellant, Shri Ashok Nemji Gala, submitted RTI application dated 16.03.2015 before the Central Public Information Officer (CPIO), National Insurance Co. Ltd. (NICL), Mumbai seeking information relating to claim settlement details of Group Policy issued by NICL for “Jain” person & proposed by JIO & popularly known as JIO-Shravak Arogyam Policy in respect of number of claims received, the number of claims settled where settlement amount was less than 90% of claim amount , number of claims fully settled and the number of claims rejected from 1.11.2014 to 31.12.2014; and copy of agreement between NICL and T.P.A. (Paramount Health Services Pvt. Ltd) for the region Greater Mumbai and Thane etc. through two points.
2. The CPIO vide letter dated 15.04.2015 denied the information under the provisions of Section 8(1)(d) Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; of the RTI Act the disclosure of which would harm the competitive position of a third party Dissatisfied with the decision of the CPIO, the appellant filed first appeal on 28.04.2015 before the first appellate authority (FAA). The FAA vide order dated 20.05.2015 while upholding the decision of the CPIO, held that the information could not be given being their intellectual property, particularly when NICL were in competitive market with other companies.
3. Thereafter, dissatisfied with the decision of the respondents the appellant filed the instant appeal before the Commission on 15.06.2015 questioning the non transfer of RTI application to the CPIO concerned and that in spite of his reminder, he had not been provided with any information. The policy number mentioned was also not correct.
4. The matter was heard by the Commission. The appellant’s representative stated that the information was denied u/s 8(1)(d) Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; of the RTI Act. Since the information was only asked for two months period and did not reveal anything which could harm the competitive position, it should have been provided. The agreement with TPA was also denied. The purpose of asking the information was to ensure that the third party administrator was providing the requisite services which he had undertaken to provide. He quoted the decision of the Commission in the matter of Shri Dhruv Kumar vs UICL in case no. CIC/AT/A/2009/000165 dated 29.5.2009 in which the Commission held “it is also important to remind the respondents that their primary responsibility was towards servicing the clientele which comprise their customers. When they choose to serve such customers through a third party entity (read TPA), it is important that the terms and conditions of engaging the third party and all the entitlements for service of the customers should be brought out into open. …Such voluntary disclosure by the insurance companies to access a set of information which must even otherwise be made available to them to enable them to make informed choices to protect their interests.” The respondents stated that the information asked did not belong to the appellant and was extremely vast and comprehensive and therefore, it was to work out the said information. The information sought was not maintained in material form. The copy of agreement between NICL and TPA could not be provided as no such location specific agreement had been entered. Moreover, disclosure of this information is exempt u/s 8(1)(d) Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; Notwithstanding anything contained in this Act, there shall be no obligation to give any citizen, information including commercial confidence, trade secrets or intellectual property, the disclosure of which would harm the competitive position of a third party, unless the competent authority is satisfied that larger public interest warrants the disclosure of such information; of the RTI Act.
5. Having considered the submissions of the parties, the Commission directs the CPIO to provide copy of TPA agreement to the appellant within ten days of receipt of this order. The policy details of the group cannot be provided under the provisions of Section 8(1) (d) and (j) of the RTI Act, 2005 being third party information. The appeal is disposed of.
(Manjula Prasher)
Information Commissioner
Citation: Shri Ashok Nemji Gala v. National Insurance Co. Ltd., in Case No. CIC/MP/A/2015/001588