Health insurance TPA of India is expected to begin operations only by December 2014 instead of the scheduled April 2014. This is because the company is yet to get a license from the Insurance Regulatory and Development Authority (IRDA).
Health insurance TPA of India is an in-house Third Party Administrator (TPA) of psu general insurers -National Insurance, New India Assurance, Oriental Insurance, United India Insurance and General Insurance Corporation of India (GIC Re).
It was formed in August 2013 to handle health insurance claims of psu general insurers. Currently, these claims are handled by external TPAs. Meanwhile the team is already in place and the company is setting up all the software-systems in place.
Health insurance TPA of India will provide end-to-end health services. This will include member enrollment, call centre, customer service and grievance management, pre-authorization and claims processing. It will also be involved in provider network empanelment, verification and investigation, pre-policy health check-up and facilitate customer awareness and wellness programmes.
The company will provide services to support all types of health insurance policies sold by insurance companies. This includes individual, family floater, group covers, mass schemes, indemnity, fixed benefit among others.
The common TPA has been proposed to curtail large scale leakages while settling health insurance claims. This common TPA is expected to speed up the claim settlement process, as well as reduce the claims ratio of insurance companies. This move is expected to reduce cost for insurers since insurers pay a commission of around 6% of premiums to TPAs to settle claims.
When the TPA comes into operation, the claims handling and processing from external agencies will gradually be transferred to the new entity. Health insurance TPA of India has been formed with an authorized capital of Rs 300 crores and paid up capital of Rs 10 crores.