The Irdai order lists 13 charges against E-Meditek. These charges are with respect to empanelment of fake hospitals and payment of claims pertaining to these hospitals, payments and servicing of fictitious and fraudulent insurance claims, unexplained dealing in cash deposits, nondisclosure and maintenance of large number of bank accounts, transfer of large sums of funds to the managing director’s account and others

Mumbai:

The Securities Appellate Tribunal (SAT) Mumbai, on Wednesday, has upheld the decision of insurance regulator Irdai to cancel the license of Gurgaon based one of the oldest third party administrators (TPAs) E-Meditek Insurance.

The firm was set up by Gopal Verma in 2001.

On receipt of a whistle blower’s complaint , the Irdai carried out inspection of the TPA  during the period November 13, 2017 to November 17, 2017. Based on the findings of the investigation, that showed flagrant violations of various existing regulations, the Irda had suspended the license of the company on March 20,2018.

E-Meditek Insurance TPA had challenged Irda’s order of suspension in SAT  which had stayed it with the direction to the regulator to give the the company an opportunity of hearing.

However, Irdai had stuck to its order even after complying with SAT’s order.

Delivering the SAT’s verdict in an almost five-year old case  Justice Tarun Agarwala, Presiding Officer, Meera Swarup, Technical Member, SAT,  said,“ We find that the appellant(E-Meditek) has violated various regulatory provisions. The seriousness of charges proved against the appellant points out that it is not able to provide services which would be in the interest of the insured, policyholders or Insurer. We find no infirmity in the Irda’s order. The appeal is dismissed with no order as to costs.’’

The Irdai order lists 13 charges against the E-Meditek. These charges are with respect to empanelment of fake hospitals and payment of claims pertaining to these hospitals, payments and servicing of fictitious and fraudulent insurance claims, unexplained dealing in cash deposits, nondisclosure and maintenance of large number of bank accounts, transfer of large sums of funds to the managing director’s account, non-cooperation and delay in providing information to the Irdai, non-payment of TDS and break down in internal control system and procedures, said the SAT.