ICICI Lombard faces CBI probe

Date- 13 Mar 2014 Source- The Times of India,

Comment on “During this week we have come across 2 news item”

MUMBAI: The Central Bureau of Investigation (CBI) has registered a preliminary enquiry (PE) against ICICI Lombard for providing cover to ineligible individuals under a government-sponsored scheme. The two Rajasthan government schemes being looked into are the Rajiv Gandhi Shilpi Swasthya Bima Yojana, a health insurance scheme covering artisans, and a weather insurance scheme.

CBI is understood to have registered a PE against unknown officials of ICICI Lombard, officials of the Rajasthan government and the agriculture ministry for entering into a conspiracy. ICICI Lombard, meanwhile, said that it was a victim of fraud because of which it has suffered a loss.

“In the referred cases pertaining to 2009-10, the company has settled claims far exceeding the premiums received under the said schemes resulting in financial losses…the company during or after enrolment of beneficiaries, had initiated investigation on its own, through its in-house investigation function. Wherever any discrepancy was observed, the company on its own approached the concerned government body, sought necessary advice and promptly acted upon the advice so received. The company has also adhered to the policy guidelines and abided by the directives/ suggestions of relevant authorities,” ICICI Lombard said in a statement.
The CBI’s preliminary enquiry follows an investigation by the Insurance Regulatory and Development Authority in respect of the private insurer’s role in four government schemes. Besides the above two schemes, the ones that are being looked into by IRDA are the Shetkari Apghati Durghatna Bima Yojana and Panjikrit Kisan Durghatna Bima Yojana – personal accident policy covering farmers.

IRDA had recently written to the government regarding its investigation into fraud under these schemes. The regulator had said that under the Rajiv Gandhi Shilpi Swasthya Bima Yojana, 11,445 members alleged to be ineligible were khadi weavers. Since there was a doubt on interpretation whether khadi weavers come under a scheme meant for artisans, the company had refunded the premium to the textile ministry on July 2012.

In the weather insurance case, the company had carried out an independent investigation and found that 2,093 insured members did not exist at the given address. However, the state government called a meeting with all stakeholders and directed the company to pay the claims under the weather insurance policy in Ganganagar. ICICI Lombard had informed IRDA that it had made payments of Rs 14.37 crore as against the premium of Rs 6.42 crore received. It also confirmed that all cheques were distributed to individuals and not a single cheque was undelivered.