InsuranceFinancial Glossary
TPA (Third Party Administrator)
Definition
An intermediary licensed by IRDAI that processes health insurance claims on behalf of insurance companies. TPAs handle cashless authorization, claim documentation, and settlement. Major TPAs in India include Medi Assist, Paramount Health Services, and FHPL.
Why It Matters
The efficiency of your TPA directly affects your claim experience. A slow TPA can delay cashless approvals, causing hospitals to demand deposits. Some insurers now handle claims in-house without TPAs, which often results in faster processing. When comparing health plans, checking the TPA's reputation is as important as checking the insurer's claim settlement ratio.