TPA or Third Party Administrator (TPA) is a company/agency/organization holding license from Insurance Regulatory Development Authority (IRDA) to process claims – corporate and retail policies in addition to providing cashless facilities as an outsourcing entity of an insurance company.TPAs function as an intermediary between the insurance provider and the insured. The stakeholders involved are as follows:
- Insurance companies
- Healthcare providers
- Policyholders
According to experts, providing cashless hospitalization of the insured should be the primary service offered by TPAs. It is important to note that some insurance companies have a separate department which performs the functions of TPA instead of outsourcing it to another entity. Introduced by the IRDA in 2001, TPAs handle various pertinent aspects of insurance. With Central and State governments rolling out health insurance schemes to cover those below poverty line and unorganized sector workers, to clock 15-20 per cent growth every year over the next few years. Today less than 4 per cent of the public has private health insurance cover. If you include government schemes, then this goes up to 25-30 per cent. Given the under-penetration in the health insurance segment, the scope for growth is tremendous. Indian insurance market becomes a little more advanced, we are hoping that the insurance regulator will see the TPA as a segment that has matured. This will enable the segment to follow the practices of the West. For example, in the US, the TPA business is a multi-billion dollar industry. There the TPAs are allowed to handle insurance premiums.
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Indian Affairs India’s Most Trusted & Valuable TPA Company 2017 Final Six Nominees
1.Good Health TPA Services Limited.(61)
2. Focus Health services TPA Pvt. Ltd.(62)
3. Vipul Med Corp TPA. Pvt. Ltd.(63)
4. Rothshield Healthcare (TPA) Services Limited.(64)
5. Dedicated Healthcare Services TPA (India) Private Limited.(65)
6. Ericson Insurance TPA Pvt. Ltd .(66)