Lok Sabha Question No. 5 (STARRED), answered on 2017-12-15
Subject: Rajiv Gandhi Shilpi Swasthya Bima Yojana
Ministry: FINANCE
Asked by: UDIT RAJ

## 5* DR. UDIT RAJ:

Will the Minister of FINANCE be pleased to state:

- (a) whether the Government paid an   amount of Rs. 190 crores for insuring around 9 lacs  artisans  per  year  under  the  Rajiv  Gandhi  Shilpi  Swasthya  Bima  Yojana (RGSSBY)  for  three  years  from  the  year  2007  to  2010  and  if  so,  the  details thereof,
- (b)  whether the Insurance Regulatory and Development Authority of India (IRDAI) has  found  that  ghost  and  ineligible  beneficiaries  have  been  enrolled  by  an insurance company and hence fined and recovered about Rs. 1 crore from them and if so, the details thereof;
- (c)  the details of steps taken by IRDAI to ascertain the total number of such fake or ineligible beneficiaries including the number of such beneficiaries identified; and
- (d) whether  any  investigation  has  been  carried  out  under  Section  33  of  Insurance Act, 1938 in this regard and if so, the details thereof including the action taken thereon?

## ANSWER

## THE FINANCE MINISTER (SHRI ARUN JAITLEY)

- (a) to (d): A Statement is laid on the Table of the House.

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## GOVERNMENT OF INDIA MINISTRY OF FINANCE DEPARTMENT OF FINANCIAL SERVICES

## LOK SABHA

## STARRED QUESTION NO. 5*

TO BE ANSWERED ON 15 th  December, 2017 / Agrahayana 24, 1939 (Saka)

## Rajiv Gandhi Shilpi Swasthya Bima Yojana

## QUESTION

STATEMENT  REFERRED  TO  IN  REPLY  TO  PART  (a)  to  (d)  OF  LOK  SABHA STARRED  QUESTION  NO.  *5  FOR  15 th   DECEMBER,  2017  REGARDING  'RAJIV GANDHI SHILPI SWASTHYA BIMA YOJANA' TABLED BY DR. UDIT RAJ.

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- (a) The  year  wise  funds  released  under  Rajiv  Gandhi  Shilpi  Swasthya  Bima  Yojana (RGSSBY) of the Ministry of Textiles, is as follows:-

(In Rs. Crore)         ( In lakhs)

| Sl. NO.   | Year    |   Funds sanctioned |   Number of Artisans enrolled |
|-----------|---------|--------------------|-------------------------------|
| 1.        | 2007-08 |              67.84 |                          8.82 |
| 2.        | 2008-09 |              79.46 |                         10.11 |
| 3.        | 2009-10 |              67.55 |                          8.03 |
| Total     | Total   |             214.85 |                         26.95 |

(b) & (c): As per the Insurance Regulatory and Development Authority of India (IRDAI), there was a complaint related to ineligible beneficiaries under the Rajiv Gandhi Shilpi Swasthya Bima Yojana of the Ministry of Textiles.

IRDAI had conducted inspection at the ICICI Lombard (insurer's) office from 6 th  - 7 th May, 2013 and examined the matter in detail. It was found by the Authority that the net premium amount of 11,445 Khadi Weavers was refunded to the Ministry of Textiles by the insurer with penal interest of 10.3% totaling Rs. 1.18 crores. It was observed that the  alleged  11,445  members  in  the  scheme  were  khadi  weavers  who  were  included due to classification error as per the Insurer. Since khadi weavers could not be treated as  Artisans  under  this  health  insurance  scheme  meant  for  artisans,  the  insurer refunded the amount to the Ministry of Textiles.

(d): Further IRDAI had carried out a focused inspection in February 2014 under Sec 14(2)(h)  of  the  IRDA  Act  1999,  which  inter-alia  covered  allegations  in  the  matter  of RGSSBY. Based on the observations made during the inspection and after examining the submissions made by the insurer, IRDAI issued a show cause notice on 31 st  March 2015.  The  Final  order  was  passed  on  3 rd   September  2015,  against  ICICI  Lombard levying a penalty of Rs. 10 Lakhs for violation of certain regulatory provisions.

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