| S.No. |
ENTITY |
PERSONS |
REGULATORY CHARGES |
REGULATORY ACTION(S) / DATE OF ORDER |
FURTHER DEVELOPMENTS |
| 1 |
|
ALANKIT HEALTH CARE TPA LTD.
|
|
|
PUBLISHED WRONG/MISLEADING INFORMATION TO GENERAL PUBLIC THROUGH ITS WEBSITE
|
CENSURED/WARNED & DIRECTED/ADVISED TO BE DILIGENT IN COMPLYING WITH ALL THE ACTS, REGULATIONS ETC.
01-JUL-2016
|
|
| 2 |
|
|
ANMOL MEDICARE INSURANCE TPA LTD.
|
|
|
DID NOT GET APPROVAL AND DID NOT INFORM IRDA ABOUT CHANGES IN SHAREHOLDING PATTERN BY WAY OF TRANSFER OF EXISTING SHARES TO EXISTING AS WELL AS NEW SHAREHOLDERS
SUBMITTED WRONG/MISLEADING UNDERTAKING WHILE PROVIDING INFORMATION ABOUT ENGAGEMENT IN ANY OTHER BUSINESS
DELAY IN SUBMISSION OF ANNUAL REPORT
|
IMPOSED PENALTY RS.5,00,000
11-JAN-2016
|
|
| 3 |
|
|
E-MEDITEK (TPA) SERVICES LTD.
|
|
|
DID NOT PROVIDE INFORMATION ABOUT INVOLVEMENT OF ITS PROMOTERS AND/OR DIRECTORS IN INSURANCE & INSURANCE RELATED ACTIVITIES TO IRDA
DID NOT SUBMIT TRUE AND CORRECT STATEMENT TO IRDA
PROVIDED WRONG/MISLEADING INFORMATION THROUGH WEBSITE ABOUT SELF-FUNDED SCHEMES OF STATE GOVERNMENT AND/OR CGHS CLAIMS AUDIT
|
IMPOSED PENALTY RS.5,00,000
25-AUG-2014
|
|
| 4 |
|
|
E-MEDITEK (TPA) SERVICES LTD.
|
|
|
DELAY IN SUBMISSION OF ANNUAL REPORT
|
ADVISED INSURANCE COMPANIES TO STRICTLY ADHERE TO IRDA GUIDELINES
01-SEP-2014
|
|
| 5 |
|
|
FAMILY HEALTH PLAN (TPA) LTD.
|
|
|
RENDERED SERVICES IN THE FORM OF IT SUPPORT FOR PORTING THE MEMBER DETAILS COVERED UNDER HEALTH INSURANCE POLICIES
ENTERED INTO AGREEMENT WITH ALLIED INSURANCE CO. FOR PROVIDING SERVICES TO THEIR CLIENTS VISITING INDIA FOR MEDICAL TREATMENT
PROVIDED EMERGENCY ASSISTANCE AND OTHER ALLIED SERVIES TO CLIENTS OF FOREIGN INSURERS IN INDIA
ENGAGED IN PRINTING AND DISPATCH OF HEALTH INSURANCE POLICY KITS TO ITS CUSTOMERS AND SEPARATE CHARGES RECEIVED FOR THE SAME FROM INSURER
DID NOT MAKE DISCLOSURE OF CLAIMS OUTSTANDING FOR MORE THAN 6 MONTHS AT THE YEAR-END IN RETURN TPA 4(7) OF ANNUAL REPORT
|
IMPOSED PENALTY RS.25,00,000
CENSURED/WARNED & DIRECTED/ADVISED TO BE DILIGENT IN COMPLYING WITH ALL THE ACTS, REGULATIONS ETC.
29-JAN-2015
|
|
| 6 |
|
|
GRAND INSURANCE TPA PVT.LTD.
|
|
|
DELAY IN SUBMISSION OF ANNUAL REPORT
|
IMPOSED PENALTY RS.1,00,000
19-SEP-2017
|
|
| 7 |
|
|
GRAND INSURANCE TPA PVT.LTD.
|
|
|
DID NOT FILE APPLICATION TO RENEW CERTIFICATE OF REGISTRATION VIOLATING REGULATION 19 (9) OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
DID NOT FILE ANNUAL RETURNS
|
CERTIFICATE OF REGISTRATION REVOKED
DIRECTED ALL INSURER HAVING TPA AGREEMENT WITH GRAND TPA TO IMMEDIATELY TAKE SUCH ALTERNATIVE STEPS INCLUDING APPOINTMENT OF ANOTHER TPA
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
DIRECTED TO SUBMIT DATA COLLECTION AND BOOKS, RECORDS OR DOCUMENTS ETC. RELATING TO TPA BUSINESS
ADVISED TO REMOVE WORD TPA FROM NAME OF THE COMPANY
23-JUN-2021
|
|
| 8 |
|
|
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
|
| 9 |
|
|
SAFEWAY TPA SERVICES PVT.LTD.
|
|
|
DELAY IN SUBMISSION OF ANNUAL REPORT
SUBMITTED INCOMPLETE & MISLEADING INFORMATION TO IRDA
DID NOT SUBMIT TRUE AND CORRECT STATEMENT TO IRDA
DID NOT INTIMATE IRDA ABOUT REAPPOINTMENT OF CAPT.MAHESH SHARMA
|
IMPOSED PENALTY RS.5,00,000
22-DEC-2014
|
|
| 10 |
|
|
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
|
|
| The regulatory charges/regulatory actions may be fully or partly applicable to the entities/persons mentioned in the second column. |
