Compare & Buy Car, Bike and Health Insurance Online - InsuranceDekho
Track & Policy Download Login

Third Party Administrator TPA In Health Insurance Explained

Set up by IRDAI in 2001, Third Party Administrators (TPA) are a group of agencies or companies that are assigned with the duty to provide assistance to insurance providers in the process of claim assistance in the place of the insurer. They are often referred to as the pillar of leading health insurance companies due to their help in seamless settlement of the claims. 

How Does The TPA Function?

TPAs are a third-party individual body, licensed by the IRDAI to provide multiple flexibility solutions and assist insurance companies. They are the bridge between an insurance company and its policyholder who ensure seamless settlements of claims. TPA’s are majorly responsible to take the load off insurance companies and guide its policyholder’s over every step of claim settlement with the company. 

TPA’s inform the client about the closest hospital under them and also provides clients with help at every step from admission to discharge of the patient. They are also responsible for the reconciliation of statements that are sent to them and process the claims on behalf of the policyholder. 

Third-Party Administrator And Its Role In Health Insurance

The third-party administrator or the TPA plays an essential role in helping holders with the entire process of facilitating cashless claims. Let’s have a look at how TPA provides assistance:

  • Seamless settlement of claims
  • Pre-authorization with the hospitals
  • Providing a list of hospitals under the insurance companies
  • Processing cashless claims
  • Ambulance services
  • Tracking of claims
  • 24*7*365  helplines
  • Other healthcare facilities

Listed below is an updated list of some of the TPA’s, suggested by IRDAI:

Name Of The TPA Name of CAO/ CEO/ Address Contact Details
United Health Care Parekh Insurance TPA Private Limited Mr. Shiva Belavadi Toll Free No.: 1800 209 8884
   
Chief Executive Officer Email: shiva.belavadi@uhcpindia.com 
  Website: www.uhcpindia.com
MDIndia Health Insurance TPA Private Mr. Suresh V. Karandikar For senior citizens: 020-25300126
   
Chief Executive Officer Toll Free No.: 1800 233 1166
  Fax : 1860 233 4449
   
  Email: skarandikar@mdindia.com
Vision Digital Insurance TPA Private Limited Ms. Priyanka Jain Toll free no: 1800-419-9982
  Ph. No.: 0124-4003171
Chief Administrative Officer  
  Email: priyanka.jain@visiontpa.in
   
  Website: www.visiontpa.in
Ericson Insurance TPA Private Limited Dr. Krishna P. Jaiswal, MD Senior Citizen Helpline No.: 022-25280208
Ph. No.: 022-25280280
Toll Free No.: 1800 22 2034
 
Email: krishna@ericsontpa.com
 
Website: www.ericsontpa.com
Anmol Medicare Insurance TPA Limited Mr. P. S. Kshatriya Toll Free No.: 1800 233 1999
   
Chief Executive Officer Ph. No.: +91-79-61609926, 61609930
   
  E-mail: prithvi@anmolmedicare.com
Park Mediclaim Insurance TPA Private Limited Mr. Anurag Bhatnagar Toll Free No.: 1800 11 55 33
   
Chief Executive Officer Ph. No.: 011-43191000
   
  Email: anuragbhatnagar@parkmediclaim.co.in
   
  Website : www.parkmediclaim.co.in
Good Health Insurance TPA Limited Ms. Saigeeta Dikshit, Senior Citizen Toll Free No.: 1800 102 9919
  Toll Free No.: 1860 425 3232
Chief Administrative Officer  
  Email: saigeeta@ghpltpa.com 
   
  Website: www.ghpltpa.com 

Note: The data in the above table has been sourced from the official IRDAI website.

Conclusion

Lastly, TPA’s are also responsible for the proper management and investigation of the cases. However, it should be noted that they are just the medium to get your claims settled and don’t have any major say in the claim settlement process.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

Health Insurance Coverage Calculator

Who do you want to insured ?

  • Individual
  • Couple
  • Family
  • Parents

Age of eldest insured member ?

Where do you live ?

Metro
Non-Metro
Disclaimer : Actual Coverage might vary basis your location, age and number of members

Health Insurance News

Must BuyMust Buy

Why to Buy Health Insurance Policy Online from InsuranceDekho

  • Tax benefit upto 75,000*
  • Claim support everyday 10AM-7PM
  • 80 Lacs+ happy customers

Latest Health Insurance Articles