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3rd party Providers -For Health Insurance

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05 Jun, 2021 by  Sanjay P

Hi,


Recently i was checking an insurance plan from Royal Sundaram,in that it was asking me to select the third party provider (such as MEdi Assist etc) as the prferred partner to process the claim in case of cashless and other assistance.Just wanted to seek your opinion is this how normally other Insurance company works or is it only specific to Royal Sundaram that they are outsourcing the cashless and other foramlities part to third party.Usually when a third party comes in between there is more problem so wanted your opinion.

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Health Insurance

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07 Jun, 2021

Hello Mr. Sanjay,


Most of the general insurance companies selling health insurance policies depend on the services of TPA for processing the claims. However, most of the standalone health insurance companies and few general insurance companies have in-house claim settlement process and don't rely on services of TPA.


Hope your concerns have been addressed


Stay Safe



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19 Jun, 2021

Hey Sanjay,


Companies such as ICICI Lombard, HDFC Ergo, Star Health, Max Bupa, Religare etc process claims in-house. So they don't ask you to choose a TPA. Rest of the insurers outsource claim processing to third parties (or TPAs).


Your question is right and relevant. I run a claim advisory company SureClaim, and from our experience of claims filed by us, I recommend that one should prefer dealing with insurer directly rather than going via TPA.


To cut cost, insurers add a layer of TPA between themselves and the customer. This makes servicing a nightmare for many customers. If you haven't made up your mind on a specific insurer, I would highly recommend taking insurance from players who process claims in-house.


Anuj

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