Section 15 in Insurance Regulatory and Development Authority of India (Third Party Administrators - Health Services) Regulations, 2016
15. Renewal of Certificate of Registration.
- A. Application and fees(1)Every TPA seeking renewal of Certificate of Registration shall make an application for renewal to the Authority in such form and accompanied by such documents as may be specified by the Authority.(2)The application may be made to the Authority not earlier than one hundred and eighty days and not later than thirty days before the date on which the Certificate of Registration ceases to be valid.(3)The application shall be accompanied by a non-refundable renewal processing fee of [Rs. 1,50,000/- (Rupees one lakh fifty thousand only) and other taxes as may be applicable] [Substituted 'Rs. 15,000/- (Rupees Fifteen Thousand only) and applicable service tax' by Notification F. No. IRDAI/Reg/15/166/2019, dated 3.12.2019 (w.e.f. 14.3.2016).] to be paid to the Authority in the manner mentioned in Regulation 7(2) of these regulations.B. Delay in submission of application:(4)Where the application for Renewal has been filed after the period mentioned in regulation 15 (A) (2) of these regulations, but before the expiry of the validity of Certificate of Registration, the application shall be accompanied by an additional fee of Rs. 100/- (Rupees one hundred only) and applicable service tax.(5)Where the application for renewal has been filed after the expiry of the validity of Certificate of Registration, the Authority may, if satisfied that undue hardship would be caused otherwise, accept the application on payment of a penalty of Rs. 750 (Rupees seven hundred and fifty only) and applicable service tax :C. Non-compliance with minimum business requirements:(6)Where a TPA does not fulfill the Minimum Business Requirement stipulated under Regulation 14 of these regulations, the Authority shall deal with the application for renewal of registration of the TPA in the following manner:a. Where the TPA has failed to fulfill the minimum business requirements in any of the parameters (Parameter-1 Number of policies serviced and Parameter-2 Number of lives serviced) by a margin of 20 percent, but exceeded by a similar margin in respect of the other parameter in respect of the relevant financial year, the Authority may consider the renewal based on the reasons furnished by the TPA. For the purpose of these Regulations, any fraction shall be rounded off to the next higher integer :Provided that the Authority may specify separate norms for those TPAs who are exclusively servicing the Group Health Insurance policies and the stipulation of Regulation 15(C)(6)(a) is not applicable for such TPAs.b. Where a TPA has failed to fulfill the minimum business requirements in any of the parameters specified in one financial year, but has met with the norms on an average basis for the years under consideration the Authority may consider the renewal based on the reasons furnished by the TPA.c. Where a TPA has failed to comply with Reg. 15 (C) (6) (a) or 15 (C) (6) (b) of these regulations, the registration shall not be renewed.D. Additional Information(7)While processing of the application for renewal of Certificate of Registration of a TPA, the Authority may call for additional information, clarifications or data as deemed necessary and it shall be the duty of the TPA to comply within the timelines given by the Authority. On failing to comply, the Authority may take appropriate regulatory action as deemed fit under the regulations.E. Consideration of renewal application(8)The conditions for grant of Certificate of Registration under Regulation 8 of these regulations, to the extent relevant, shall be the basis for consideration of an application for grant of renewal of Certificate of Registration.F. Renewal of Certificate of Registration(9)The Authority, on being satisfied that the TPA fulfils all the conditions mentioned herein for renewal of the Certificate of Registration and that there are no reasons for denial of renewal under Regulation 16 of these regulations, shall renew the certificate of registration in such a form as specified by the Authority.(10)A Certificate of Registration granted to a TPA may be renewed for a further period of three years.
