Page 397 - Misc Ebook IC 78

Miscellaneous Insurance

the event of a claim, the increased percentage is
reduced by 10% of the sum insured at the next renewal,
but can never go below the basic sum insured.

Q5.b) How are the TPAs playing a vital role in the
Health Insurance ?

Ans: The TPA, or the Third Party Administrator acts as a
facilitator for the insured. Instead of contacting directly
with the insurance company for every minute detail, the
insured can go through the TPAs.

The TPAs are dedicated company with specialized and
dedicated staff trained and equipped to handle the
customers. They also have their own network of hospitals
or Nursing Homes from where the customers can avail
cashless benefits.

So, when the insured or his family had to be hospitalized,
he chooses from the list of network hospitals supplied to
him by his TPA. So he can get admission to the hospitals,
avail of the treatment and come back home without
actually paying anything.

Sashi Publications - www.sashipublications.com 393

Copyright@ The Insurance Times. 09883398055 / 09883380339