2014 end- The Beginning of Health Insurance TPA of India

Incorporated in August 14, 2013 for handling claims of health insurance of the state-owned insurers, the common in-house Third Party Administrator (TPA) of the public sector general insurers-Health Insurance TPA of India will be operationalized completely by November only. It will lead to the continuation of loss ratios in the health portfolio. However, IRDA (Insurance Regulatory and Development Authority) has not yet given the license to it. Now, external TPAs will handle these claims.

Read More

Policybazaar exclusive benefits
  • 30 minutes claim support*
  • 50,000 claims approved in last 15 months*
  • Schedule home visit with our advisors
  • Get a plan based on your medical needs

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Back
All health plans cover Covid-19 treatment
  • 1
  • 2
  • 3
  • 4

Who would you like to insure?

  • Previous step
    Continue
    By clicking on “CONTINUE”, you agree to our Privacy Policy and Terms of use
    Previous step
    Continue

      Popular Cities

      Previous step
      Continue
      Previous step
      Continue

      Do you have an existing illness or medical history?

      This helps us find plans that cover your condition and avoid claim rejection

      Get updates on WhatsApp

      What is your existing illness?

      Select all that apply

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step

      National Insurance Company, New India Assurance Company, United Insurance Company, Oriental Insurance Company and General Insurance Corporation of India- these are the stakeholders that the common TPA has to process health claims. General Insurance Company has five percent stake whereas the first four have 23.75 % each.

      Headquartered in New Delhi, the key objective of Health insurance TPA is the enhancement of customer experience and to make health insurance claims management more efficient. It shall develop its branches in various cities in due course.

      Health Insurance TPA has applied for a TPA license to IRDA and is expecting to get the approval in the next few weeks.

      A senior official from Health Insurance TPA of India said that putting all the software and IT systems in place is in the process. In the next six to nine months, the TPA would begin doing business with public insurers. 

      Providing end-to-end 'Health Services' by Health Insurance subject to regulatory approvals would include call centre, member enrolment, grievance management and customer service, pre-authorisation and claims processing. Further, it's involvement in provider network empanelment, investigation & verification, pre-policy health check-up, customer awareness and wellness programmes can also be seen. Health insurance loss ratios which refer to the ratio between premiums collected and claims paid, range from 95 to 100 per cent, depending on the company's size. The losses however have been on the rise with stiff competition in group portfolio with aggressive discounts given to retain customers. 

      Till the common TPA is operationalised, losses are expected to continue. The reason for introducing a common TPA is that external TPA handing claims will add to the costs. 

      All types of Health Insurance policies should be supported by the company by providing services. It covers family floater, individual, mass schemes, group covers, indemnity and fixed benefit among others.

      The common TPA will lead to the prohibition of large scale leakages while setting claims of insurance in the health segment. To speed up the claim-settlement process and to reduce the claim ratio of insurance companies, this common TPA was expected according the sector. Insurance companies pay a commission of approximately 6% of premiums to TPAs to settle claims. To reduce the costs also for these companies, this move is expected. 

      For a period of two years or till the time of superannuation, P K Bhagat has been appointed the first Managing Director and Chief Executive Officer of Health Insurance TPA of India. 

      The claims handling and processing from external sources will gradually be transferred to the new TPA after it comes into operation. This new TPA of India has been formed with Rs 300 crore authorised capital and Rs 10 crore paid-up capital.

       

      Search
      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance articles

      Recent Articles
      Popular Articles
      Monkeypox: Dos and Don’ts of the Disease That You Should Know

      15 Sep 2022

      Monkeypox has slowly and steadily spread to more than 85 countries...
      Read more
      Why is It Important to Disclose Pre-existing Diseases to Your Insurer?

      06 Sep 2022

      As we grow old, the chances of developing a disease or a medical...
      Read more
      Benefits of Multi-Year Health Insurance Plans

      25 Aug 2022

      Ever since COVID-19 entered our lives, health insurance has come...
      Read more
      Does Health Insurance Cover Monkeypox?

      25 Jul 2022

      Monkeypox is the latest disease to make its way to India while we...
      Read more
      List of Diseases Covered by Bajaj Allianz Health Insurance Plans

      05 Jul 2022

      Barely any person has remained unaffected due to rising health...
      Read more
      PMJAY Scheme: Ayushman Bharat Yojana Eligibility & Registration Online
      Prime Minister Shri Narendra Modi announced the launch of (PMJAY) Ayushman Bharat Yojana in his Independence...
      Read more
      Best Health Insurance Plans in India 2022
      Finding the best health insurance plan from so many different health insurance companies can get confusing for many...
      Read more
      How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal...
      Read more
      Best Maternity Insurance Plans
      Maternity insurance offers comprehensive coverage for medical expenses incurred during pregnancy, including the cost...
      Read more
      Best Health Insurance Plans for Senior Citizens in 2022
      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance...
      Read more

      top
      Close
      Download the Policybazaar app
      to manage all your insurance needs.
      INSTALL