CCI dismisses allegations of market dominance by United India Insurance, E-Meditak
05 July 2013
Competition Commission of India (CCI) has dismissed allegations that United India Insurance Co and its third party administrator E-Meditak have used a dominant position to abuse the market for medical insurance services.
In its order of 1 July, CCI dismissed the case filed by an individual holding a mediclaim insurance policy for CanCard Holders against United India Insurance and E-Meditak (TPA) Services.
According to the complaint, United India Insurance had obtained the business of "Mediclaim insurance for the CanCard Holders under group insurance from the year 2005-06".
The petition alleged that since United India Insurance was the only and dominant service provider to "CanCard Group Medi insurance policy holders", all holders who opted for these mediclaim policies were necessarily required to carry out all the transactions through the insurance company and its TPA.
It was "appropriate to close this case... as no contravention of the provisions of the (Competition) Act is prima facie found to exist," CCI said in its order.
"Opposite party 1 (United India Insurance) does not seem to hold a position of strength in the relevant market (mediclaim insurance), which can enable it to operate independently of the competitive forces prevailing in the relevant market or affect its competitors or consumers or the relevant market in its favour," CCI said.
It also noted that none of the TPAs was dominant in the market for medical insurance services provided by them to various health insurance policy holders and non-life insurance companies.
The complainant had also alleged that E-Meditak failed to fulfil its obligations pertaining to renewal / termination of the policy, claim intimation and repudiation of claim, among others, under its agreement with United India Insurance.
CCI, however, said that if E-Meditak was not fulfilling its obligations under the agreement, then the insurance firm could have terminated the contract or taken legal remedies and that the policy holders would have complained to the IRDA.
Third party administrators (TPA) act as intermediaries between the insurer and the insured and facilitate cashless service at the time of hospitalisation as well as processing of claims.
TPAs are appointed by insurance companies and are licensed by insurance sector regulator IRDA.