Third Party Administrator
What is TPA (Third Party Administrators)?
TPA stands for Third Party Administrator. TPA is a middleman between Insurer and the Customer. At the time of claim, the customer can directly deal with the TPA and the TPA will help them with all the process of claim settlement. A TPA is a specialized health service provider providing a variety of services like networking with hospitals, arranging for hospitalization and claim processing and settlement. The concept was introduced by the Insurance Regulatory and Development Authority of India (IRDA) for the benefit of both the insured and the insurer. While the insured is benefited by quicker & better health service, insurers are benefited by reduction in their administrative costs, fraudulent claims and ultimately bringing down the claim ratios. An insurance company can have more than one TPA and a TPA can serve more than one insurance company.
Some of the services provided by the TPA are:
- Maintaining database of policyholders
- Issuing of ID cards to all policyholders
- Providing ambulance service
- Providing information to policyholders about hospitals
- Checking various investigations
- Providing cashless service
- Processing claims
