The exclusive third party administrator (TPA) for public sector health insurers is likely to be operational only after June this year.
“It may take off in the second quarter of next fiscal,” Milind Kharat, Chairman and Managing Director, United India Insurance Company Ltd, told Business Line here during his recent visit.
The proposal to set up a separate TPA to process health insurance claims was mooted by the four state insurers — United India Insurance, National Insurance, Oriental Insurance and New India Assurance — with an aim to reduce fraudulent claims.
It was thought that the agency would be operational in the second quarter of this fiscal, but that has not materialised.
“Yes. It got delayed,” Kharat said, without elaborating on the reasons for the delay. An application has been filed with the Insurance Regulatory and Development Authority and the permission is awaited, the CMD said.
Premium underwritten
The setting up of a captive TPA is significant as public sector insurers have over 50 per cent share in the health insurance pie.
According to IRDA data, health insurance in the country is growing rapidly, with underwritten premium touching Rs 13,092 crore in 2011-12, a growth of 14 per cent over the Rs 11,480 crore premium underwritten in the previous year.
There are 29 TPAs with 78,000 hospitals in their network. The claims received were over 37 lakh.
Though there have been many complaints on the services being provided by TPAs earlier, the regulator now feels that the situation is improving. “The claim settlement performance of TPAs witnessed improvement during 2011-12,” says the IRDA in its annual report for the year 2011-12 released last week.
The physical presence of TPAs was also augmented by opening of new branches at new locations by many TPAs, it added.