The Central Information Commission has rejected a complaint filed by a Tamil Nadu resident who alleged that United India Insurance Company Limited failed to properly explain how it handled the medical reimbursement claim for his late mother’s COVID-19 treatment. Information Commissioner Vinod Kumar Tiwari issued the order on 19 November 2025 after hearing both sides earlier in the month.
The dispute began when the complainant, Parthiban A, sought clarity on why he received only a part of the amount spent on his mother’s hospitalization at Kauvery Hospital in Tiruchirappalli. She had been treated for COVID-19, and the total bill came to a little over ₹3.88 lakh. According to submissions on record, the Tamil Nadu Electricity Board Audit Office had forwarded all original documents to United India Insurance in December 2022, following which the insurer reimbursed ₹2,15,500 in January 2023. Parthiban maintained that he received no clear explanation for the remaining unpaid amount of ₹1,72,830.
His RTI application, filed in February 2024, asked for certified copies of the documents sent by TNEB, the rules and Government Orders used to assess the claim, the full settlement sheet, premium details under the New Health Insurance Scheme and the reasons behind the different procedures for employees and pensioners. The insurance company responded in April 2024, noting that the claim had been processed by its third-party administrator under the ceiling rates prescribed by Government Order 281 of June 2020. It said the maximum eligible amount had been paid and advised him to contact the power utility for information related to premium collections or scheme administration.
When the matter came up before the CIC, the insurer submitted a detailed explanation. It stated that the claim had been assessed under Government Orders 280 and 281 of 2020 and G.O. 222 of 2018, which introduced treatment packages and ceiling rates for COVID-19 care. The company explained that the reimbursement amount covered room and COVID management charges for 13 days as well as an ARDS package for cases involving multi-organ failure. It also told the Commission that copies of the settlement sheet and relevant Government Orders had already been shared with the complainant.
At the hearing, Parthiban insisted that he still had not received a full account of how his mother’s claim was assessed. The insurer maintained that it had provided all information available under the RTI Act and added that grievances about the amount reimbursed should be taken up with the competent authority under the state government, not through an RTI complaint.
In its decision, the Commission underlined that a complaint under Section 18 of the RTI Act is different from a second appeal. It said its role in such proceedings is limited to examining whether the Public Information Officer unreasonably or deliberately withheld information. The Commission found that the insurance company had offered a timely and adequate response, later supplemented with detailed calculations and official documents. It said there was no indication of mala fide intent on the part of the CPIO.
The CIC concluded that the complainant’s dissatisfaction was essentially about the settlement amount rather than the disclosure of information. Since the RTI complaint mechanism cannot be used to reopen or re-evaluate claim decisions, the Commission dismissed the complaint without issuing any recommendations to the public authority.
Case Details : Parthiban A vs CPIO, United India Insurance Company Limited, Chennai Region, 134, Shillingi Building, Greams Road, Chennai 600006
