The Insurance Regulatory and Development Authority of India ( IRDA) by its order of 10th January 2019 suspended the licence of E – Meditek Health Insurance TPA. Earlier the TPA licence of the company was suspended pending investigation of Insurance frauds.
The investigation by the IRDA revealed that the company had made numerous fictitious insurance claims and had em-paneled fake hospitals or hospitals which had already closed down .
A Police FIR accused some employees of this TPA of creating false insurance claims and then making payments. After the payments were made, the internal records of the patients were destroyed .
The National Insurance Company had earlier taken E Meditek TPA to court and had suspended operating with this TPA.
The IRDA order documented United India Insurance Company of India (UIIC) of having found 60 cases of its insurance claim handled by this TPA to be irregular besides recording other irregularities in its investigation and inspection . The UIIC had asked E – Meditek to pay Rs 1,41,69,193.
The IRDA has ordered all Insurance companies to have alternative arrangements within three months. E – Meditek has been banned from using the term “ TPA”.
The full order of IRDA banning E – Meditek Insurance TPA is available for download in the IRDA website under “ orders”
Visit the IRDA website for the E- Meditek Order under “orders”