IRDAI vide its order bearing no. IRDAI/E&C/ORD/ONS/5/1/2024 dated January 09, 2024, has issued an order against M/s Anmol Medicare TPA Limited (“TPA”).
Issue:
An inspection of M/s Anmol Medicare TPA Ltd (Company) has been carried out by the IRDAI and a report was submitted to the Company, following which the Company submitted its response to IRDAI on February 04, 2022. Upon examining the submission provided by the Company, the Show-Cause Notice “SCN” was issued to the Company by the IRDAI. Following response to the SCN by the Company, a personal hearing was given to the officers of the Company on the matters contained in the SCN and response of the Company thereto.
In consideration of the responses and submissions of the Company, the IRDAI has penalised the Company to the tune of 1 Lakh arising out of one charge, the details of which are as under:
Charge:
Under the Code of Conduct, clause 2(s), Schedule II Regulation 23 of IRDAI (TPA-Health Services) Regulations, 2016 mandates the Third Party Agents (TPA) to not lend or grant any loan to any other company, entity or individual not connected with its TPA business, which the TPA has violated by providing loan to three individuals which are not connected with its TPA Business.
The IRDAI, while analysing the facts, and submission of the Company, has imposed a penalty of INR 1 Lakh to the Company for violating the Code of Conduct under Section 102 of the Insurance Act, 1938. All the regulated entity have been advised to adheres to Regulations, and especially regulation which have a bearing on the finances of the entity
Relevant Governing law:
1. Code of Conduct, clause 2(s), Schedule II Regulation 23 of IRDAI (TPA-Health Services) Regulations, 2016:
All Third-Party Agents (TPA) shall not lend or grant any loan to any other company, entity or individual not connected with its TPA business.
2. Section 102 of the Insurance Act, 1938, that deals with the power to impose penalty for default in complying with rules and regulations issued by the IRDAI, or act in contravention of this Act.
Source category: IRDAI
Attachments
- /2024/336_Final_Order_In_the_matter_of_M_s_Anmol_Medicare_TPA_Ltd.pdf
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