IRDAI suspends E-Meditek TPA’s registration certificate

Regulator acted on a whistle blower’s complaint against TPA

The lnsurance Regulatory and Development Authority of lndia (IRDAI) has suspended the certificate of registration of E-Meditek lnsurance TPA Ltd, a Gurgoan-based third party administrator-health services.

A whistle blower complaint that the regulator received in September 2017 proved to be a trigger for the action against the company.

With the complaint against E-Meditek TPA alleging misconduct, corruption, malpractice, money laundering and financial irregularities, IRDAI undertook an on-site inspection in November.

Irregularities in respect of policy/claim servicing; in respect of accounting practices; besides other irregularities were found during the inspection, the regulator said.

The irregularities are of “such serious nature that it is detrimental to the interests of policy holders and the insurers and allowing E-Meditek to continue their activities as TPA shall have adverse impact on the policyholders and insurers,” the suspension order issued on Tuesday by Member (Non Life) P.J. Joseph.

The Authority after “careful consideration of the seriousness of violations observed and in exercise of the powers vested with Authority in Regulation 16 (3) of IRDAI (TPA-Health Services) Regulations, 2016, hereby suspends the certificate of registration of E-Meditek lnsurance TPA Ltd without notice,” the order said.

IRDAI had issued the certificate of registration (No. 007) to E-Meditek in March 2002 and renewed it, with the validity till March 20, 2020. As per the regulator’s website, there are 27 TPAs, including the firm.

“The certificate of registration of E-Meditek lnsurance TPA Ltd stands suspended with immediate effect till further orders. EMeditek TPA shall cease to do the business of TPA. However, it may continue servicing the existing health insurance policies based on the discretion and direction of the respective insurers. No lnsurer shall entrust servicing of new policies or servicing of new lives under the existing group schemes / policies to E-Meditek TPA,” the order suspending the certificate said.