Saturday, December 20, 2025 | 11:12 PM ISTहिंदी में पढें
Business Standard
Notification Icon
userprofile IconSearch

Irdai warns Heritage TPA against unilaterally closing health claims

The order is in response to the remote inspection conducted by the authority from November 8, 2021 to November 11, 2021

irdai
premium

The insurance regulator noted that Heritage TPA did not forward the query letter sent by the insurance company to the policyholder before closing the claim, and no reminder letters were forwarded to the policyholder

Aathira Varier Mumbai

Listen to This Article

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