IRDA / Now insured will be able to choose third party administrator, circular issued

Utility desk. The Insurance Regulatory and Development Authority of India (IRDA) has given the flexibility to choose a Third Party Administrator (TPA), giving relief to the insured. After this change, if you buy insurance policy or renew it now, then you will be able to choose a third party administrator (TPA) according to you. IRDA has issued a circular on Tuesday saying that the insured can choose the TPA of his choice regarding health services, with which the insurance company has a service level agreement. However, the policyholder has to choose TPA from the TPA provided by the insurance company.

What is circular?

While selling the policy, the insurance company will provide the customer with a list of all the TPAs ​​he has, from which he will choose the TPA of his choice. If the insurance company terminates the TPA service, it will provide a list of all the TPAs ​​it holds to the insured, out of which the insured will choose the TPA of his choice. Even at the time of renewal of the policy, the insured will have the right to choose the TPA of his choice.

What is third party administrator?

The third party administrator acts as an intermediary between the insurer and the person taking the insurance. Its main function is to assist in the claim and settlement process. The TPA issues a card to the person taking insurance, which can be treated as cashless treatment in a hospital only by showing it. At the time of making a claim, the person taking the insurance informs the TPS first. He is then asked to go to the concerned hospital. It is the hospital of the insurance company’s network. Apart from this, if the customer gets treatment in another hospital, then he can get the cost through reimbursement.