The Health Insurance TPA of India is set to commence its operations from September 2015. It is set up to manage health claims of psu general insurers in-house.
A Third Party Administrator (TPA) assesses the claim and presents a report to the insurer, which accepts or rejects it.
The Health Insurance TPA of India will provide services of call centres, customer service and grievance management, pre-authorization, and claim processing. It would be involved in providing network empanelment, verification and investigation and pre-policy health check-up. It will also provide services to support all types of health insurance policies –individual, family floater, group covers, mass schemes, indemnity, and fixed benefit, among others.
The internal TPA has been set up to curtail large scale leakages while settling insurance claims in the health segment. It is expected to speed-up the claims settlement process and reduce the claims ratio of insurers. It is also expected to reduce cost for insurers, who pay commission to TPAs to settle claims.
Health insurance TPA of India is a joint venture of public sector general insurers –United India Insurance, Oriental Insurance, National Insurance, New India Assurance and General Insurance Corporation of India (GIC Re). The first four have 23.75% stake each and GIC have 5% stake. M Nagaraja Sarma is the Managing Director (MD) and Chief Executive Officer (CEO) of the firm.
The company has been formed with an authorized capital of Rs 300 crores and paid-up capital of Rs 10 crores.
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