THIRD-PARTY ADMINISTRATORS (TPAs)

Third-Party Administrators (TPAs): 

• TPAs are IRDAI-licensed third-party entities who provide management solutions to health insurance companies.
  
  
• They act as an intermediary between the insurance company and policyholder. A range of services are offered by TPAs in health insurance segment from administering services to handling claims.
  
  
• The first set of regulations governing the TPAs were issued by IRDAI in 2001. This also marked the introduction of the concept of TPAs in the health insurance space,
  
  

Recent changes suggested by IRDAI in the regulations governing TPAs-Health Services:

• For greater competition, it is proposed to allow the policyholders to choose the TPA of their choice from those engaged by the insurer.
  
  
• The IRDAI has also proposed a set of qualifying norms for TPA promoters, including those pertaining to their shareholding.
  
  
• Further, it has suggested a change in the wordings to increase the scope of health services provided by TPAs to policyholders of foreign insurers visiting India.