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Difference between TPA or Non TPA Health insurance policy ?

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03 Dec, 2022 by  dhruv

Hi, recently I was searching to buy Health insurance I got few choices from Care Insurance to HDFC Ergo also TATA AIG.

one of Employee from Care Insurance was explaining his Plan's ad has suggested me not to Buy TPA Based Policy as a Retail Buyer.

Which is better to choose TPA or Non TPA and what's the difference in Claim Procedure ?


below is the definition for one who doesn't know what TPA is

TPA (Third Party Administrator )

“a person or organization that performs administrative services, such as claims processing, adjudication or record-keeping, typically on behalf of an employer that self-insured health benefits,”


1 Answer

03 Dec, 2022
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It is better to choose an insurer which has an in-house claim process rather than an insurer which does claim process via a TPA.

But this shouldn't be your main factor of comparison. First, shortlist plans based on your requirements. If your best shortlisted plan is from an insurer with a TPA claim process, then there's no harm as long as you follow the claim process diligently.

Thank you

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