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Health Insurance TPA of India formed, for govt general insurers

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The common in- house third party administrator ( TPA) of public sector general insurers, named Health Insurance TPA of India, recently held its first board meeting. It was incorporated on August 14.

Officials involved said the operationalisation would happen by April 2014. This common TPA to process health claims has National Insurance Company, New India Assurance Company, National insurance Company, Oriental Insurance Company and General Insurance Corporation of India as stakeholders. While the first four have 23.75 per cent stake each, GIC has five per cent.

This TPA will look into health claims and would handle a majority of the claims received by these general insurers. The common TPA has been proposed to prohibit large- scale leakages while settling insurance claims in the health segment. Further, it is intended to process claims of public general insurers in- house, rather than handling by an external agency.

Those in the sector said this common TPA was expected to speed the claim- settlement process, as well as reduce the claims ratio of insurance companies. This move is expected to reduce costs for these insurance companies, which pay a commission of approximately six per cent of premiums to TPAs to settle claims.

Presently, most claims in the health segment are handled by external players, which has increased the time taken to settle claims.

PK Bhagat was appointed additional director at the company's first meeting, on September 4. G Srinivasan, chairman and managing director of New India Assurance, is chairman of the board of this company, based in New Delhi.

When the TPA comes into operation, the claims handling and processing from external agencies will gradually be transferred to the new entity. Health Insurance TPA of India has been formed with an authorised capital of ₹ 300 crore and paid- up capital of ₹ 10 crore.

According to details sourced from company filings with the ministry of corporate affairs, the incorporation document said the parties shall at all times be committed to increase the share capital of the company till at least ₹ 200 crore, if the board of directors so decides.

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