| S.No. |
ENTITY |
PERSONS |
REGULATORY CHARGES |
REGULATORY ACTION(S) / DATE OF ORDER |
FURTHER DEVELOPMENTS |
| 1 |
|
ALANKIT INSURANCE TPA LTD.
|
|
|
DID NOT ADHERE TO MINIMUM BUSINESS REQUIREMENTS VIOLATING REGULATION 14 OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
DID NOT FULFIL CRITERIA ON AVERAGE BASIS FOR NUMBER OF POLICIES SERVICED VIOLATING REGULATION 15 (C) (6)(C) OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
|
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 ALANKIT 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
30-JUN-2021
|
|
| 2 |
|
|
ANMOL MEDICARE INSURANCE TPA LTD.
|
|
|
DID NOT ADHERE TO MINIMUM BUSINESS REQUIREMENTS VIOLATING REGULATION 14 OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
|
ADVISED TO REMOVE WORD TPA FROM NAME OF THE COMPANY
DIRECTED ALL INSURER HAVING TPA AGREEMENT WITH ANMOL 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
REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)
04-JUL-2024
|
|
| 3 |
|
|
ANYUTA INSURANCE TPA IN HEALTH CARE PVT.LTD.
|
|
|
DID NOT ADHERE TO MINIMUM BUSINESS REQUIREMENTS VIOLATING REGULATION 14 OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
|
REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)
25-JUN-2020
|
|
| 4 |
|
|
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
|
| 5 |
|
|
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
|
|
| 6 |
|
|
ROTHSHIELD INSURANCE TPA LTD.
|
|
|
DID NOT ADHERE TO MINIMUM BUSINESS REQUIREMENTS VIOLATING REGULATIONS 14 AND 15 OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
|
REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)
ADVISED TO REMOVE WORD TPA FROM NAME OF THE COMPANY
DIRECTED TO SUBMIT DATA COLLECTION AND BOOKS, RECORDS OR DOCUMENTS ETC. RELATING TO TPA BUSINESS
DIRECTED ALL THE INSURERS HAVING TPA AGREEMENT WITH ROTHSHIELD 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
27-SEP-2022
|
|
| 7 |
|
|
SPURTHI MEDITECH (TPA) SOLUTIONS PVT.LTD.
|
|
|
DID NOT ADHERE TO WORKING CAPITAL REQUIREMENTS
|
REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)
31-DEC-2015
|
|
| 8 |
|
|
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
|
|
| 9 |
|
|
UNIVERSAL MEDI-AID SERVICES PVT.LTD.
|
|
|
CHANGED SHAREHOLDING PATTERN WITHOUT PRIOR PERMISSION OF IRDA
MADE LOANS AND ADVANCES TO COMPANIES NOT RELATED TO TPA BUSINESS
PROCESSED CLAIMS OF SOME CORPORATES DIRECTLY AND NOT THROUGH ANY INSURER
|
REJECTED APPLICATION FILED FOR RENEWAL OF LICENCE (TPA)
DIRECTED TO SUBMIT DATA COLLECTED AND BOOKS, RECORDS OR DOCUMENTS ETC.RELATING TO BUSINESS CARRIED ON IN RELATION TO DIFFERENT INSURERS, TO RESPECTIVE INSURERS
DIRECTED TO SUPPORT INSURANCE COMPANY (IES) IN MAKING SUITABLE ALTERNATIVE ARRANGEMENTS TO SERVICE POLICYHOLDERS IN RESPECT OF WHOM POLICIES ARE STILL IN FORCE
DIRECTED TO RECONCILE AND CLOSE ACCOUNTS WITH INSURANCE COMPANIES AND SERVICE PROVIDERS
06-MAR-2009
|
DELHI HIGH COURT-DIRECTED IRDA TO RENEW TPA LICENCE AND IRDA RENEWED THE SAME FOR A PERIED OF THREE YEARS I.E.UPTO 21/03/2013,VIDE ORDER DATED 15/02/2010. FURTHER AS PER COURT ORDER DATED 07/04/2010,OPERATION OF TPA LICENCE 22/03/2010 TO 21/03/2013,STAYED WITH IMMEDIATE EFFECT UNTIL FURTHER ORDER
|
| 10 |
|
|
VISION DIGITAL INSURANCE TPA PVT.LTD.
|
|
|
DID NOT ADHERE TO MINIMUM BUSINESS REQUIREMENTS VIOLATING REGULATIONS 14 AND 15 OF IRDAI (TPA-HEALTH SERVICES) REGULATIONS, 2016
|
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 VISION 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
04-OCT-2021
|
|
| The regulatory charges/regulatory actions may be fully or partly applicable to the entities/persons mentioned in the second column. |
