Page 26 - The Insurance Times August 2024

Third Party

Administrator (TPA) -

Need to Strengthen

the Pillars of Health

Insurance Claims Dr. Seema Arora

Deputy Director
School of Insurance Studies,
Management National Law University, Jodhpur,
Rajasthan, India

The liberalisation of the Insurance sector and formation of Insurance and Development authority
of India in 2000 has completely transformed the Indian Insurance Industry in the last two decades.
There are currently 60 registered Insurers (including 7 standalone health Insurers) having physical
presence with approximately 22,000 offices throughout the country.

Introduction next few years. During 2022-23, the General and Health
insurance companies have covered 55 crore lives under 2.26
The liberalisation of the Insurance sector and formation of
Insurance and Development authority of India in 2000 has crore health insurance policies (excluding policies issued under
completely transformed the Indian Insurance Industry in the PA and Travel Insurance). They have settled 2.36 crore
last two decades. There are currently 60 registered Insurers number of health insurance claims and paid an amount of Rs.
70,930 crore for the same. The incurred claim ratio for the
(including 7 standalone health Insurers) having physical
year 2022-2023 stood at 89 %. With the expansion of health
presence with approximately 22,000 offices throughout the
country. Further, with technological development the insurance business and large number of claims settled by the
Insurers, the services provided by the third party
Insurers spread the gospel of Insurance in every nook and
corner of the country through online presence. The Health administrators have become more significant in building up
insurance sector witnessed the emergence of the concept the trust and reputation of the Insurance Industry.
of Standalone health insurers and a new set of professional
body namely the TPAs (Third Party Administrators) in the last The success story of increasing health insurance awareness
two decade. and the trust of the public on the insurance companies for
getting the benefit of cashless hospitalisation and relieving
Health care and health Insurance awareness has them from the double burden of sickness and financial
tremendously increased Post-Covid in our country. Health hardship, thus depends on the ability and performance of
insurance has become the most prominent segment in the the TPA working for it.
insurance space today comprising 38% of the Non-Life
Insurance business. Health Insurance Segment reported a This study discusses the role assigned to the TPAs in the
growth of 21.32 percent in 2022-23 with the premium current health insurance market, the role actually being
amounting to Rs. 97,633 crore (including personal accident) performed by them and some measures to improve their
and the sector is further expected to grow significantly in the performance.

24 August 2024 The Insurance Times