Section 8 in Insurance Regulatory and Development Authority of India (Third Party Administrators - Health Services) Regulations, 2016
8. Conditions for grant of Certificate of Registration.
(1)The Authority, while examining an application for grant of certificate of registration shall take into account all matters relevant to carrying out the business of TPA.(2)Without prejudice to the generality of provisions of Regulation 8(1), the Authority in particular, shall examine the following :a. the applicant has the words "Insurance TPA" in its name;b. the applicant has complied with the minimum capital requirements;c. the promoters of the applicant have the financial strength to carry out the business of TPA;d. at least one of the directors of a TPA holds a minimum qualification of MBBS, with a valid registration from the Medical Council of India or Medical Council of any state of India and is thereby entitled to practice medicine within its jurisdiction; and is acting within the scope and jurisdiction of his/her registration.e. the applicant or its promoters or its directors are not suffering from any of the disqualifications mentioned under section 42 D of the Act.f. the applicant has the necessary infrastructure such as adequate office space, equipment and trained manpower to effectively discharge its functions;g. the applicant has employed at least one person who has the necessary qualifications as mentioned in Regulation 11 of these regulations and has adequate experience to conduct the business of TPA;h. the Chief Executive Officer or Chief Administrative Officer and Chief Medical Officer of the applicant fulfils the fit and proper criteria as per Regulation 11 of these Regulations;i. the applicant has sufficient reach with Network Hospitals and Information Technology capabilityj. the applicant has necessary in-house medical expertise in addition to the regulatory stipulation of at least one Director having the stipulated medical qualification.(ja)[ The applicant shall demonstrate the preparedness in respect of adequate technological capabilities, data security and human resources. [Inserted by Notification F. No. IRDAI/Reg/15/166/2019, dated 3.12.2019 (w.e.f. 14.3.2016).](jb)The promoters of the applicant shall have professional competence and general reputation of fairness and integrity to the satisfaction of the Authority.]k. any other requirements that the Authority may consider necessary for grant of Certificate of Registration to the TPA.(3)[ Each of the promoters shall satisfy the following criteria.a. Must be carrying on business not related to insurance or engaged in offering professional services not related to insurance for a period of not less than three years to the date of application;b. Have positive net worth in all the immediately preceding three financial years to the date of application; andc. Have net worth of not less than the respective capital contribution in the immediately preceding two financial years to the date of application;(4)Where there are one or more investors in an applicant, any investor holding the shares in the applicant exceeding ten percent of the paid up equity capital shall be considered as promoter of the applicant.(5)Indian investors, other than promoters referred at sub-regulation 4 of regulation 8 above, put together shall not hold more than twenty-five percent of paid up equity capital of the applicant.(6)The promoters shall agree to a lock-in period of three years for the funds proposed to be invested in the applicant. The lock-in period of three years shall reckon from the date of granting certificate of registration by the Authority.] [Inserted by Notification F. No. IRDAI/Reg/15/166/2019, dated 3.12.2019 (w.e.f. 14.3.2016).]
