Insurance claim rejected by PSU insurer - RTI for surveyor report
Starter question based on recurring Ask RTI reader problems: Health insurance claim with PSU insurer rejected as pre-existing disease. Need proposal form, underwriting note, and surveyor/TPA report.
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Share the record to ask for, the authority to approach, or the next appeal step.
Answers
7 answersShort answer: file the RTI to Public sector insurer PIO and ask for records, not explanations. The strongest first application asks for file movement, current stage, deficiency memo, officer responsible, and certified copies of any order or note that caused the delay.
Use this structure: - application or complaint number, date, and applicant name - current status with date of last action - copies of file notings, inspection report, or deficiency memo - name and designation of the officer holding the file now - appeal or grievance route if no action is taken
Related RTI Wiki guide: Insurance claim rejected by PSU insurer - RTI for surveyor report.
Do not make the RTI sound like a complaint. Write the grievance separately, then use RTI for documents. That way the authority cannot reject it as a request for action.
Kashvi here. I would keep the draft simple and evidence-led.
If the reply is vague, your first appeal should say: the PIO did not provide the specific records held by Public sector insurer PIO, did not identify the custodian, and did not cite any exemption.
Also add a short line that you are not asking the PIO to create a new explanation, only to provide records already held by the public authority.
Ask for certified copies where you may later use the record before an appellate authority, ombudsman, court, or department. Plain screenshots are useful, but certified copies carry more weight.
My preferred wording is: 'Please provide certified copies of records showing the present status, file movement, reasons recorded on file, and the officer currently responsible for the matter.'
-- Shrawaaan RTI Book: The RTI Playbook
For the psu-insurer angle, include dates. A date-wise file movement chart is often more useful than one final status line.
If the authority transfers the RTI, track the transfer date. A late or wrong transfer becomes a separate appeal ground.
Also see the RTI Book for drafting patterns: The RTI Playbook.
Keep the fee proof and delivery proof. Many strong appeals fail because the applicant cannot show the exact filing date.
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