The Competition Commission has rejected allegations of abuse of dominance against United India Insurance Co and its third party administrator E-Meditak in the market for medical insurance services.
In its order on July 1, Competition Commission of India said it was “appropriate to close this case...as no contravention of the provisions of the (Competition) Act is prima facie found to exist“.
The case was filed against United India Insurance and E-Meditak (TPA) Services.
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. They are appointed by insurance companies and licensed by insurance sector regulator IRDA.
As per the complaint filed by an individual, United India Insurance had obtained the business of “Mediclaim Insurance for the CanCard Holders under group insurance from the year 2005-06”.
It was 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.
“... Opposite Party 1 (United India Insurance) does not seem to hold a position of strength in the relevant market (services of medical 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 none of the TPAs was dominant in the market of the services provided by them to various health insurance policy holders and non-life insurance companies within India.
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.
However, CCI noted that if E-Meditak was not fulfilling its obligations under the agreement, then the insurance firm could have terminated the contract or take legal remedies and that the policyholders could have complained to the IRDA.