July 22, 2019
Health insurance policyholders in India could soon be able to select a third party administrator (TPA) of their own choice to service claims on their health insurance policies, depending on their insurer’s ties with TPAs. Insurers would need to explicitly provide the names of the TPAs associated with them, from whom the policyholder may choose one, at the time of purchase or renewal of the health insurance policy.
This move will enhance competition among TPAs and also improve services for health insurance policyholders. The proposed revisions to the rules are set out in an exposure draft published on the IRDAI website.
The concept of TPAs in the Indian health insurance space was first introduced in 2001. TPAs are primarily engaged in the business of servicing claims under health insurance policies by authorising cashless treatment and settling claims. They also carry out pre-insurance medical examinations in connection with underwriting of health insurance policies. According to the data available on the IRDAI website, 26 TPAs are registered with the regulator as at 31 March 2019.