Norms for common TPA may be ready in 3 months

The proposed regulations for common Third Party Administrator (TPA) to check excess mediclaim bills by private hospitals is expected to be ready in the next three months. Accordingly, a common TPA is expected to help insurance companies control both health insurance premiums and claims.

Last year, the four general insurers namely National Insurance Company, New India Assurance, Oriental Insurance and United India Insurance had decided to set up a common TPA as a joint venture to manage health insurance claims. Concerned about over-billing, the insurers had even barred about 150 private hospitals from the list of preferred provider network (PPN) offering cashless medical facility. But, later the services were resumed by some providers after a dialogue between the hospital administrators and the insurance regulator, Insurance Regulatory and Development Authority (Irda).

‘‘With the formation of a common TPA, the health insurance business will come together and we will be able to negotiate better with service providers. We hope that it should be ready in the next three months,’’ G Srinivasan, CMD, United India Insurance Ltd, said. He was in the city here for signing an MoU with State Bank of Hyderabad (SBH) to provide free personal accident insurance to provide ‘‘group Janata personal accident insurance coverage’’ to all individual operative savings bank account holders of the bank.

Typically, TPAs are companies to which insurers outsource servicing of health insurance claims. They are approved and regulated by Irda and undertake a majority of the back office work including networking with healthcare providers after the insurance company issues a policy. They charge about 5% of the premium as fee to process a policy. Over 27 TPAs are so far registered with Irda....