Policyholders Awareness and Perception towards TPA’s in Indian Health Insurance Industry- A Comparative Study of Public and Private Players

Abstract

In the present Covid-19 pandemic, the concept of health insurance has gained a lot of importance. In the current scenario, persons are exposed to various health related problems. Hence to meet financial expenses towards hospitalization people started thinking of Health Insurance. It is an important mechanism in pooling risks and finances catering health-care needs of population. Health insurance is insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over a large number of persons. In India various companies offer health insurance policies. In the year 2001, Insurance Regulatory Development Authority (IRDA) introduced the concept of Third Party Administrators (TPAs). TPAs acts as intermediary between patients, hospitals and insurance-company, infused a new management-system of streamlining costs and quality health-care service issues. TPAs ensure that the established code of conduct for both insurer and insured is met with. But even today TPAs are not institutionalized which is major setback. There is confusion among the policyholders about the concept of TPAs and health insurance agents.

A modest attempt is made to study the policyholder’s awareness and perception towards services provided by TPAs in Indian Health Insurance sector. It also compares the awareness among the public and private sector policyholders.