The Health Insurance TPA of India Ltd, structured by public sector non-life insurance companies to handle their health claims, is ready to go live. About 8%-10% of the claims that are looked after by external Third Party Administrators (TPAs) would now be taken care of by this new organization, once operational.
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TPAs are bodies that process health insurance claims and ensure that users avail such benefits as cashless settlement of claims.The entity is being started as a joint venture of the following public sector non-life insurance companies: General Insurance Corporation of India, National Insurance Company, United Insurance Company, Oriental Insurance Company and New India Assurance Company.
GIC has 4% stake in the setup, while the rest have a stake of 23.75% each.
Along with providing pre-authorization services, this entity would also function in network empanelment, verification, investigation; and pre-policy health check-up. However, the prediction about the business being taken away from external TPAs is not a veracious one, as claims as less as one tenth of the total number would be handled by the organization initially.
Set up with an intention to prohibit large-scale leakages in insurance claims belonging to health segment, the internal TPA is also expected to speed up the claims settlement process and reduce the claims ratio for insurance firms.
The company has been licensed by the Insurance Regulatory and Development Authority of India (IRDAI) and living its trial period as of now.
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