Information regarding IRDA’s approval of HDFC Life product etc. was sought - Appellant: IRDA should declare the existing system of approval on their website highlighting the risk involved & course of action - CIC: check the record & provide a reply

Information regarding IRDA’s approval of HDFC Life product, personal pension plan,  New India Assurance product Mediclaim 2007, 2012  was sought - Appellant: IRDA should declare the existing system of approval on their website highlighting risk involved for policyholders suggesting the clear course of action policyholder should take in case they found discrepancy in product with IRDA regulation - CIC: check the record and provide reply based on the available information

ORDER

1. The appellant, Shri Shanaram Walavalkar, submitted RTI application dated 10.10.2013 before the Central Public Information Officer (CPIO), Insurance Regulatory & Development Authority (IRDA), Hyderabad seeking information on the following four points relating to (1) IRDA’s approval of HDFC Life product, personal pension plan having sub paras (A to F) (2) The New India Assurance product Mediclaim 2007 having sub paras(G to J), (3) (K) The New India Assurance product Mediclaim 2012 regarding transferring existing cumulative bonus on migration as cumulative bonus buffer and (4) having sub paras (L to O) If IRDA has allowed New India Assurance Company in Mediclaim 2012 to reduce entire accumulated “No Claim Discount” to Zero on claim which is contradictory to New Health Policy. If allowed by IRDA then provide copy of approval letter.

2. The CPIO (Actuarial) vide letter dated 28.10.2013 replied on Point 1 (A), 1(B), 1(C), 1(D & E) provided copy of the relevant page of the F&U of HDFC Personal Pension Plan indicating the premium chargeable under the Single Premium Policy; and in response to Point 1(F) provided copy of the approval letter of HDFC Personal Pension Plan. The CPIO (Health) vide letter dated 5.11.2013 informed the appellant in response to Point 2(G) that the insurer has filed compliance certificate as per the requirement of Regulation 17(b)(i) of IRDA (Health Insurance) Regulations, 2013 stating that “the captioned existing product would be modified to make it compliant with the IRDA (Health Insurance) Regulation 2013 and these modifications would not be related to benefits offered, premium bases, loadings levied or discounts offered in the product”. The certificate of compliance has been noted by IRDA. As per the said Regulation, it renders the product compliant to the IRDA (Health Insurance) Regulation and there is no need to file whole set of documents for approval. For the terms and conditions of the policy, the appellant was informed to approach the New India Assurance Co. Ltd. which is a public authority in terms of the RTI Act; in response to 2(H) the CPIO provided copy of IRDA letter with respect to noting of certificate based compliance of ‘Mediclaim 2007 with the IRDA (Health Insurance) Regulations, 2013. in response to 3(K) and 4 the appellant was informed that the insurer has filed compliance certificate of Mediclaim 2012 as per the requirement of Regulation 17(b)(i) of IRDA (Health Insurance) Regulations, 2013 stating that the captioned existing product would be modified to make it compliant with the IRDA (Health Insurance) Regulations, 2013 and these modifications would not be related to benefits offered, premium bases, loadings levied or discounts offered in the product and based on their certification the IRDA has noted it; in response to Point 4 (L, M,N & O) the appellant was informed that no such information was available with IRDA. However, it may be noted that the claims under a specific policy would be subject to the terms and conditions of that specific policy. Aggrieved with the reply of the CPIO on Point 2 to 4, the appellant preferred appeal on 16.11.2013 before the FAA. The FAA vide order dated 7.2.2014 while upholding the reply of the CPIO (Health) recorded with respect to his statement in appeal that just making regulations was not enough but it is necessary to see if benefits were going to policyholders and compliance was made, the FAA stated that the CPIO/FAA under the provisions of the RTI Act are mandated to provide the information as available with the pubic authority.

3. Thereafter the appellant preferred the present appeal before the Commission.

4. The matter was heard by the Commission. The appellant stated that after the IRDA (Health Insurance) Regulations, 2013 there is a change in the premium condition. The IRDA should declare clearly the existing system of approval on their website highlighting risk involved for policyholders suggesting the clear course of action policyholder should take in case they found discrepancy in product with IRDA regulation. The respondents reiterated on their replies to the appellant.

5. The Commission finds that the replies to Points 2 to 4 of the RTI application are not quite clear. Therefore, the respondents will revert the RTI application, check their record and provide reply based on the available information within two weeks of the receipt of the order of the Commission. The appeal is disposed of.

(Manjula Prasher)

Information Commissioner

Citation: Shri Shantaram Walavalkar v. Insurance Regulatory & Development Authority in Appeal: No. CIC/MP/A/2014/900689