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SOURCE OF INFORMATION : INSURANCE REGULATORY & DEVELOPMENT AUTHORITY OF INDIA WEBSITE
PERIOD COVERED : 16-AUG-2002 TO 13-JUL-2024

NAMES IN BROWN COLOUR
Names of entities/persons in brown colour denote that the regulatory order is not against them but their names have been mentioned only for association purposes.

INSURANCE THIRD PARTY ADMINISTRATOR (TPA): DEFAULTED IN MAINTAINING PRESCRIBED WORKING CAPITAL

S.No. ENTITY  PERSONS  REGULATORY CHARGES REGULATORY ACTION(S) / DATE OF ORDER FURTHER DEVELOPMENTS
1
History of entity/person HAPPY INSURANCE TPA SERVICES PVT.LTD.  
  DID NOT MAINTAIN VALID REGISTRATION PERTAINING TO ITS DIRECTOR HAVING MEDICAL QUALIFICATION

SUBMITTED TPA-6 FORMS AFTER EXPIRY OF THREE YEARS FROM THE DATE OF APPOINTMENT OF NEW DIRECTORS ON THE BOARD OF COMPANY

DID NOT TAKE PRIOR APPROVAL FROM IRDA FOR CHANGE IN SHAREHOLDING PATTERN

DID NOT ADHERE TO WORKING CAPITAL REQUIREMENTS   		REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)

ADVISED TO REMOVE WORD TPA FROM NAME OF THE COMPANY

DIRECTED ALL INSURER HAVING TPA AGREEMENT WITH HAPPY TPA TO IMMEDIATELY TAKE SUCH ALTERNATIVE STEPS INCLUDING APPOINTMENT OF ANOTHER TPA

DIRECTED TO SUBMIT DATA COLLECTION AND BOOKS, RECORDS OR DOCUMENTS ETC. RELATING TO TPA BUSINESS

DIRECTED TO CO-OPERATE WITH INSURANCE COMPANIES IN MAKING SUITABLE ALTERNATE ARRANGEMENTS TO SERVICE POLICY HOLDERS IN RESPECT OF WHOM POLICIES ARE IN FORCE

DIRECTED TO RECONCILE AND CLOSE THE ACCOUNTS WITH CONCERNED INSURANCE COMPANIES AND NETWORK PROVIDERS

19-JUL-2016 		IRDA VIDE ITS ORDER DATED 22/01/2018 A) ADVISED TO REMOVE THE WORD TPA FROM THE NAME OT ITS COMPANY AND SHALL NOT DO TPA BUSINESS B) ALL INSURERS HAVING TPA AGREEMENT WITH HAPPY TPA, SHALL IMMEDIATELY TAKE SUCH ALTERNATIVE STEPS INCLUDING APPOINTMENT OF ANOTHER TPA, IF ANY, AS MAY BE NECESSARY TO CONTINUE TO CATER TO THE POLICY HOLDERS SERVED BY HAPPY TPA C) HAPPY TPA SHALL IMMEDIATELY SUBMIT DATA COLLECTION AND THE BOOKS, RECORDS OR DOCUMENTS ETC., RELATING TO TPA BUSINESS CARRIED ON IT TO RESPECTIVE INSURERS D) SHALL COOPERATE WITH INSURANCE COMPANIES IN MAKING SUITABLE ALTERNATE ARRAGEMENTS TO SERVICE THE POLICY HOLDERS IN RESPECT OF WHOM THE POLICIES ARE IN FORCE E) SHALL RECONCILE AND CLOSE THE ACCOUNTS WITH CONCERNED INSURANCE COMPANIES AND NETWORK PROVIDERS, IF ANY  
2
History of entity/person ICAN HEALTH SERVICES PVT.LTD.  
  COMMITTED BREACH OF CODE OF CONDUCT UNDER IRDA REGULATIONS

DEFAULTED IN MAINTAINING PRESCRIBED WORKING CAPITAL UNDER REGULATION 3(4)

CHANGED THE CHARACTER AND OWNERSHIP OF COMPANY SINCE GRANT OF LICENCE

UNSATISFACTORY AND WEAK FINANCIAL POSITION

CONDUCTED OPERATIONS AGAINST THE INTERESTS OF INSURANCE COMPANY AND POLICYHOLDERS   		REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)

22-MAR-2006 		 
3
History of entity/person SPURTHI MEDITECH (TPA) SOLUTIONS PVT.LTD.  
  DID NOT ADHERE TO WORKING CAPITAL REQUIREMENTS   REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)

31-DEC-2015 		 
4
History of entity/person SRI GOKULAM HEALTH SERVICES TPA PVT.LTD.  
  DID NOT FURNISH REQUIRED INFORMATION/DOCUMENTS TO IRDA WITHIN STIPULATED TIME

DID NOT DEAL WITH REGULATORY COMPLIANCE IN PROFESSIONAL MANNER

DID NOT ADHERE TO WORKING CAPITAL REQUIREMENTS

PROVIDED WRONG/MISREPRESENTING STATEMENT IN FORM TPA-5 (QUARTERLY) ABOUT WORKING CAPITAL

DID NOT ADHERE TO OWN UNDERTAKING OF BRINGING IN SUFFICIENT WORKING CAPITAL   		IMPOSED PENALTY RS.2,00,000

13-APR-2015 		 
5
History of entity/person SRI GOKULAM HEALTH SERVICES TPA PVT.LTD.  
  DID NOT ADHERE TO WORKING CAPITAL REQUIREMENTS   REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)

15-JAN-2016 		 
The regulatory charges/regulatory actions may be fully or partly applicable to the entities/persons mentioned in the second column.

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