The insurance regulator on Friday warned Heritage TPA against unilaterally closing health claims, saying that such actions violate regulatory norms, which mandate that only insurers are authorised to communicate claim decisions to policyholders.
“The TPA is hereby warned for closing the health claims on its own and issuing the communication regarding denial/repudiation of the claim directly to the policyholders in contravention of regulations…” Insurance Regulatory and Development Authority of India (Irdai) said in a statement.
The regulator also added that the TPA must ensure that the decisions on claims are not influenced by them and that the communication on claims

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