Health Insurance

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INSURANCE LAW PROJECT | HEALTH INSURANCE AND REGULATORY ISSUES UNDER IRDA ACT 1999 | Rudresh Pratap Singh Roll No. 49 Semester V RMLNLU | Contents INTRODUCTION 4 The Insurance Regulatory and Development Authority 5 Regulatory issues in the health insurance business 5 It should be the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector: 5 II. Regulations Pertaining To Consumer Protection 8 Relationship Between Insurers And Providers 9 Is A Health Insurance Policyholder A Consumer? 10 III. Regulations Pertaining To The Functioning Of Third Party Administrators 10 Operational Requirements 11 Other Requirements…show more content…
I. Regulations pertaining to financial requirements In an era of “cut-throat” competition where strict financial requirements may lead to financial instability and bankruptcies, the key should be an achievement of a harmonized approach between the extremes. The regulator’s obligations as regards maintenance of financial requirements can be analysed from three perspectives: 1. Entry Requirements 2. Operation requirements and 3. Exit Requirements 1. Entry Requirements It should be the duty of the regulator (IRDA) to ensure that the new entrant in the health insurance sector: Fulfils the Capital Requirement, i.e., has a minimum capital of Rs. 100 crores; According to the Statement of Objects and Reasons of the Insurance Development and Regulatory Authority Act, 1999, the duties, powers and functions of Authority, inter alia, include regulation and maintenance of margin of solvency. Section 6 of the IRDA Act, 1999 deals with the requirements as to capital. This section sways that no insurer carrying on the business of life insurance, general insurance or re-insurance in India on or after the commencement of the 1999 Act shall be registered unless he has: (1) A paid-up equity capital of Rs. 100 crores,
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