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Third-Party Administrator TPA is an IRDAI approved organization (since 2001) that acts as an intermediary between the insured and insurer to smoothly process the health insurance claims. They function as outsourced entities that offer claim-assistance and help in other activities on behalf of the insurer. From searching for the nearest network hospital to submitting the required documents for claim settlement, TPAs assist the policyholders and the insurers in every step of the journey.

Read along to find more about TPAs. 

What’s the importance of third-party administrators (TPA) to insurance companies?

Insurance companies partially rely on TPAs for smooth settlement of claims. Other reasons as to why health insurance companies need TPAs are listed below: 

  • Having a dedicated institute to facilitate claim settlement. 
  • Co-ordinating the complete process (from treatment to discharge). 
  • Proper management and investigation of claim requests.
  • Better quality of services.

What are the Benefits of TPA to a Policyholder?

A policyholder can profit from a TPA in the following manner:

  • Avail faster and focused claims management.
  • Ambulance services.
  • 24-hour toll-free helplines.
  • Grab a list of trusted network hospitals of a respective insurer.
  • Tracking claims.
  • Increase the knowledge base of healthcare services. 

How does TPAs work? 

TPAs play an important role in an easy settlement of health insurance claims. They are the major support system of the insurer as they undertake crucial responsibilities on behalf of them. Let’s understand the working of a TPA with the help of the below example:

Ramesh works in Genpact. His wife is diagnosed with a kidney stone and the doctor suggests an immediate operation. He has taken a health insurance policy from HDFC ERGO General Insurance Company. Below are two cases, which will showcase the role of TPAs in health insurance. 

Case 1: Cashless Treatment 

Ramesh plans to go for cashless treatment, gets in touch with the respective TPA of HDFC ERGO, and selects a suitable network hospital with their guidance. At the hospital insurance desk, the TPA guides Ramesh to submit the required documents to avail of the treatment. After approval, the assigned TPA settles the treatment expenses with the hospital. 

Case 2: Non-Cashless Treatment 

Due to some reason, Ramesh decides to visit a non-network hospital. He informs the assigned TPA regarding the same, gets the treatment done, and pays the bills. After discharge, Ramesh files for reimbursement. The TPA guides him with the list of required documents for submission. After the approval, the insurer transfers the claim amount to the registered bank account. 

How TPA Works

List of TPAs in India

According to the IRDAI circular, the policyholder can choose a TPA of his/her choice from a list of TPAs engaged by the insurer. Below is the list of TPAs available in India:

Name of TPA

Contact Person/Address

Contact Details

Medi Assist Insurance TPA Private

Mr. Ganesh K

Chief Administrative Officer

Tower D, 4th Floor, IBC Knowledge Park, 4/1, Bannerghatta Road, Bangalore, 560029

Toll-free for senior citizens: 1800 419 9493

Toll-Free No.: 1800 425 9449

Email:cao[at]mediassist[dot]in

Website: www[dot]mediassist[dot]in

Paramount Health Services & Insurance TPA Private Limited

Dr. Nayan Shah

Chief Executive Officer

Plot No. A-442, Road No. 28, Ram Nagar,

MIDC Industrial Area, Wagle Estate, Thane (W) - 400 604

Senior Citizen Helpline No.: 022 66629813

Toll-Free No.: 1800 22 66 55

Email:nayan[dot]shah[at]paramounttpa[dot]com

Website: www[dot]paramounttpa[dot]com

United Health Care Parekh Insurance TPA Private Limited

Mr. Shiva Belavadi

Chief Executive Officer,

3B/1 Gundecha Onclave, Kherani Road, Saki Naka, Andheri (East), Mumbai – 400 072

Toll-Free No.: 1800 209 8884

Email: shiva[dot]belavadi[at]uhcpindia[dot]co

Website: www[dot]uhcpindia[dot]com

MD India Health Insurance TPA Private 

Mr. Suresh V. Karandikar

Chief Executive Officer

S.No. 46/1 E-space A-2 Building,

3rd Floor, Pune-Nagar Road,

Vadgaon Sheri, Pune – 411 014

For senior citizens: 020-25300126

Toll-Free No.: 1800 233 1166

Fax : 1860 233 4449

Email: skarandikar[at]mdindia[dot]com

Website: www[dot]mdindiaonline[dot]com 

Heritage Health Insurance TPA Private Limited

Mr. Manash Chakraborty,

Chief Administrative Officer

NICCO HOUSE, 5th Floor, 2, Hare Street, Kolkata-700001

Toll-Free No.: 1800 345 3477

Email: mchakraborty[at]bajoria[dot]in

Website: www[dot]heritagehealthtpa[dot]com 

Family Health Plan Insurance TPA Limited

Ms. G. Bharathamma

Chief Executive Officer

No: 8-2-269/A/2-1 to 6, 2nd Floor, Srinilaya Cyber Spazio, Road No. 2, Banjara Hills, Hyderabad – 500 034

Senior Citizen Helpline No.: 1800 102 4273 

Toll-Free No.: 1800 102 4033

Email: bharathig[at]fhpl[dot]net

Website: www[dot]fhpl[dot]net 

Raksha Health Insurance TPA Private Limited

Mr. Pawan Kumar Bhalla

Chief Executive Officer 

C/o Escorts Corporate Centre 15/5, Mathura Road, Faridabad, Haryana – 121 003

Toll Free No.s: 1800 180 1444, 1800 220 456, 1800 425 8910 Email: pawan[at]rakshatpa[dot]com

Website: www[dot]rakshatpa[dot]com 

Vidal Health Insurance TPA Private Limited

Ms. Sudha Suhas Kulkarni 

Chief Administrative Officer

First Floor, Tower No. 2, SJR iPark, EPIP Zone, Whitefield, Bangalore - 560 066.

Toll-Free No.: 1860 425 0251, 080 46267018

Email: sudha[at]vidalhealthtpa[dot]com

Website: www[dot]vidalhealthtpa[dot]com 

East West Assist Insurance TPA Private Limited

Dr. Atul Arora

Chief Executive Officer

38, Golf Links, New Delhi - 110003

Ph. No.: 011-47222666 FAX: 011-47222640 

Email: ceo[at]eastwestassist[dot]com

Website: www[dot]eastwestassist[dot]com 

Medsave Health Insurance TPA Limited

Mr. S. Aravamuthan

Chief Administrative Officer

F-701A, Lado Sarai, Mehrauli, New Delhi - 110030

Senior Citizen Helpline No.: 9319810070

Toll-Free No.: 1800 111 142

Email: s.aravamuthan[at]medsave[dot]in

Website: www[dot]medsave[dot]in

Genins India Insurance TPA Limited

Mr. Subhash Chander Khanna,

Chief Administrative Officer

D-34, Ground Floor, Sector-2 Noida - 201301 (U.P.)

Toll-Free No.: 1800 345 3323

Ph. No.: 0120-4144100 Fax:0120-4144170-71

Email: sckhanna[at]geninsindia[dot]com

Website: www[dot]geninsindia[dot]com

Alankit Insurance TPA Limited

Mr. Bodh Raj Punj

Director & Chief Executive Officer

Alankit House, 4E/2, Jhandewalan Extension, New Delhi - 110055

Toll-Free No.: 1800 11 3300

Ph. No.: 011-42541621-24 Fax:011-42541620-30

Email: alok[at]alankit[dot]com

Website: www[dot]alankithealthcare[dot]com 

Health India Insurance TPA Services Private Limited

Mr. Kamaljeet Gupta 

Chief Administrative Officer

Neelkanth Corporate Park, Office No. 406 to 412, 4th Floor, Kirol Road/Village, Vidya Vihar Society, Vidya Vihar (West), Mumbai-400086

Senior Citizen Toll-Free No.: 1800 2269 70 

Toll-Free No.: 1800 2201 02

Ph. No.: 022-40881000

Email: kamaljeetg[at]healthindiatpa[dot]com Website: www[dot]healthindiatpa[dot]com 

Good Health Insurance TPA Limited

Ms. Saigeeta Dikshit, 

Chief Administrative Officer

Suite 403 - 406A, 4th Floor, Ashoka My Home Chambers, Behind Ashok Bhoopal Chambers, Sardar Patel Road, Secunderabad, Telangana State - 500003

Senior Citizen Toll-Free No.: 1800 102 9919

Toll-Free No.: 1860 425 3232

Email: saigeeta[at]ghpltpa[dot]com Website: www[dot]ghpltpa[dot]com 

Vipul Medcorp Insurance TPA Private Limited

Mr. Rajan Subramaniam 

Chief Executive Officer

515, Udyog Vihar, Phase 5, Gurgaon, Haryana – 122 016

Senior Citizen Toll-Free No.: 1800 120 3348

Toll-Free No.: 1800 108 7477, 1800 102 7477

Ph. No.: 0124-4833900 Fax: 0124-4699611

Email: rs[at]vipulmedcorp[dot]com 

Website: www[dot]vipulmedcorp[dot]com

Park Mediclaim Insurance TPA Private Limited

Mr. Anurag Bhatnagar

Chief Executive Officer

702, Vikrant Tower, Rajindra Place, New Delhi-110008

Toll-Free No.: 1800 11 55 33

Ph. No.: 011-43191000

Email: anuragbhatnagar[at]parkmediclaim.co[dot]in 

Website: www[dot]parkmediclaim[dot]co[dot]in 

Safeway Insurance TPA Private Limited

Mr. Mahesh Sharma

Chief Executive Officer

815, Vishwa Sadan, District Centre, Janakpuri, New Delhi-110058

Toll-Free No.: 1800 102 5671

Ph. No.: 011-45451300

Email: ceo[at]safewaytpa[dot]in

Website : www[dot]safewaytpa[dot]in 

Anmol Medicare Insurance TPA Limited

Mr. P. S. Kshatriya

Chief Executive Officer 

2nd Floor, NBCC House, Opp. Ahmedabad Stock Exchange, Ambavadi, Ahmedabad – 380015, Gujarat

Toll-Free No.: 1800 233 1999

Ph. No.: +91-79-61609926, 61609930

E-mail: prithvi[at]anmolmedicare[dot]com

Website: www[dot]anmolmedicare[dot]in 

Grand Insurance TPA Private Limited

Mr Bibhutosh Chattopadhyay Chief Administrative Officer Grand House, 45A, Hindustan Park, Kolkata 700 029 (West Bengal)

Toll-Free No.: 1800 102 4747

Ph. No.: 033-40274747 Fax: 033-40043344

Email: cao[at]grandtpa.co[dot]in

Website: www[dot]grandtpa[dot]co[dot]in 

Rothshield Insurance TPA Limited

Ms. Janki M Bhate

Chief Executive Officer

402, Raheja Chambers, Nariman Point, Mumbai 400 021

Toll-Free No.: 1800 228 144

Ph. No.: 022-22048144 Fax: 022-22854415

Email: janki[at]rothshield[dot]co[dot]in

Website: www[dot]rothshield[dot]co[dot]in 

Ericson Insurance TPA Private Limited

Dr. Krishna P. Jaiswal, MD

11-C, Corporate Park, ST Road, Chembur, Mumbai - 400 071 (Maharashtra)

Senior Citizen Helpline No.: 022-25280208

Toll-Free No.: 1800 22 2034

Ph. No.: 022-25280280

Email: krishna[at]ericsontpa[dot]com

Website: www[dot]ericsontpa[dot]com 

Health Insurance TPA of India Limited

Mr. SK Mehra

Chief Executive Officer

2nd Floor, Majestic Omnia Building, A-110, Sector-4, Noida 201301 (Uttar Pradesh)

Toll-Free No.: 1800 180 3600, 1800 102 3600

Email: sk.mehra[at]hitpa.co[dot]in

Website: www[dot]hitpa[dot]co[dot]in 

Vision Digital Insurance TPA Private Limited

Ms. Priyanka Jain

Chief Administrative Officer

Time Square Building 3rd & 4th Floor,

Sushant Lok-1, Block-B,

Gurugram - 122002

Toll-free no: 1800-419-9982

Ph. No.: 0124-4003171

Email: priyanka.jain[at]visiontpa[dot]in

Website: www[dot]visiontpa[dot]in 

What are the limitations of TPAs? 

Though TPAs are quite useful, they do struggle with a few limitations. Here they are-

  • Since TPAs are not the actual health insurance providers, they may not have adequate information. 
  • Customers often get confused between agents and TPAs. 
  • As TPAs are middlemen, they don’t have a major say in claim settlement. 

To sum it up…

TPAs not only make our claim settlement journey easier but also increase our knowledge base of healthcare services. Both the parties (insurer and insured) can easily profit from them if used correctly. 

Health Insurance TPA FAQ

1. If I take the help of an assigned TPA, do I need to pay them in return?

No. TPAs are hired by insurance companies and they only pay their fees/service charges. 

2. Do TPAs play any role in the acceptance and rejection of the claims?

No, they are only responsible for managing the claim settlement process. 

3. What documents are required for making a Health Insurance TPA Claim?

Below is the list of documents required for making a Health Insurance TPA Claim:

  • Aadhar Card of the policyholder. 
  • Health Insurance TPA e-card copy or the insurance certificate copy.
  • Hospital and Pharmacy Bills.
  • Hospital Discharge Summary.
  • Doctor’s Prescriptions.
  • If required, the company may ask for further documents.

4. Can I trust the TPA of my insurer?

Yes, you can. TPAs are IRDAI approved and act as intermediaries between the insurance providers and the policyholders.

Naval Goel is the founder of PolicyX.com. He is an Associate Member of the Indian Institute of Insurance`, Pune. He has been authorized by IRDA to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.
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