Third Party Administrators for Health Insurance

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About Third Party Administrators

The Third Party Administrators are intermediaries who connect insurance companies, policyholders and health care providers.
The Insurance Regulatory Development Authority (IRDA) selects the TPAs on the basis of strict professional norms.

The Insurance industry in India has experienced a sea of change since the opening up of the sector for private participation. With a plethora of companies entering the foray in the near future, the health insurance sector is surging forward and is poised for a phenomenal growth.

Health insurance is an important mechanism to finance the health care needs of the people. To manage problems arising out of increasing health care costs, the health insurance industry had assumed a new dimension of professionalism with TPAs.

Further, the uncertainty related to a medical condition increases the need for a health insurance for all the citizens.

Health insurance is any health plan that pools resources up front by converting unpredictable medical expenses into a fixed health insurance premium. It also centralizes funding decisions on health needs of a policyholder. This covers private health plans as well as mediclaim policies.

While call center facilities and personalized financial planning tools are some of the innovative trends, experienced in the products front, the best thing to happen on the service front is the introduction of third party administrators as they serve as a vital link between insurance companies, policyholders and health care providers.

TPAs were introduced by the IRDA in the year 2001. The core service of a TPA is to ensure better services to policyholders. Their basic role is to function as an intermediary between the insurer and the insured and facilitate cash less service at the time of hospitalization.

A minimum capital requirement of Rs.10 million and a capping of 26% foreign equity are mandatory requirements for a TPA as spelt by the IRDA. License is usually granted for a minimum period of three years. Ideally, The TPA functions by collaborating with the hospitals in order for the patient to enjoy hospitalization services on a cashless basis.


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pls. let me know the list of diseases under reimbursement from national insurance co limited.
mediclaim_disease Wednesday, April 17, 2013
For any insurance query please dial 1800113538. need any information about any policy please contact health insurance india. our expert feeling happy to help you.
seo2012 Thursday, April 04, 2013
Hi I am Sunita looking for consultant/recruitment firm which will help me to get the job in UAE
sunitajoshi077 Sunday, February 17, 2013
Sir the insurance co with which my company has a tie up has dhs as tpa. Some of the hospitals in bangalore are not providing cashless facility for dhs and asking me to pay and then claim. Now the issue is that for same treatment costing Rs 45000 under cashless I am being ask to pay Rs. 60000.This is 33% more than cashless. I m surprised at this and seek help/ suggestions from all. The hospital in question is Cloud Nine hospital in. Bangalore. Thanks in advance for all guidance. Roshan
Rosh81 Monday, September 17, 2012
for a pure latest policy table etc. visit www.healthinsuranceindia.org or call toll free on 1800113538
seo2012 Saturday, October 19, 2013
kindly update latest data and information
kakatiyamohan Wednesday, May 23, 2012
Im working as PRO in a reputed hospital in salem, Tamilnadu. Looking for new tie up's with listed TPA's in this site. Request to please suggest me which are the companies that provides services in Tamilnadu region and also the process of tie up with those companies.

saravks Tuesday, April 10, 2012
Please provide me with name of TPA's recruting docs or some placement consultancy in Chandigarh or punjab, please.

vandna1977 Monday, February 20, 2012
Hai you looking for consultancy firm well we are from bangalore and we recruit for entire regions and all domains contact me 91 7829877154 bangalore.
swetha.R Wednesday, November 28, 2012
Please send me the list of DHS hospitals in navi mumbai Vashi.
santosh92 Friday, February 10, 2012
visit www.healthinsuranceindia.org for up to date info of insurance divisions in india
seo2012 Saturday, October 19, 2013
sir, i am running a hospital at raipur chhatisgarh and associatted with rsby and central govt kindly send detail for empanellment.
a.dube Tuesday, January 03, 2012
Sir, We are running a hospital in Orissa and have MOU with a number of TPAs for cashless treatment of their clients. Some of them are either not paying the claims in time or making arbitrary short payment and do not care to give justification for this. Our concern is as to what is the forum for lodging the complains in this regard.
SANJIVANI-FAMILY-HOSPITAL Thursday, December 29, 2011
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