Third Party Administrators (TPA) - A Helping Hand in Claim Settlement

Nutan Gupta

06 Sep 2017

Untitled Document

With soaring medical bills and hospitalization cost, you buy health insurance to live a stress-free and healthy life. But at the time of claim, you are not sure whom to contact for claim settlement or what is the process to file an insurance claim. In such cases, Third Party Administrators (TPA) comes to your rescue. You can coordinate with TPA anytime for any query or concern related to your claim settlement.

A Third Party Administrator (TPA) is an Insurance Regulatory Development Authority (IRDA) registered company or an organization that processes insurance claims on behalf of insurance companies. TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims. TPAs ensure that in cash-less hospitalization the preauthorization is done within 90 minutes of receipt of claim request from customers.

You would be surprised to know about the various tasks performed by a TPA, all of which aims towards making claim settlement convenient for the customers:

1.  TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims

2. TPAs ensures that in cash-less hospitalization the preauthorization is done within 90 mins of receipt of claim request from customers

3. In case of any medical emergency, TPAs should be immediately informed. The concerned authority there would assist you over the steps to be taken to file an insurance claim against the same.

4. The purpose of a TPA is to help process insurance claims of various insured customers. Hence, you should contact the TPA only regarding a claim process issue. In case of claim settlement problems, you should directly contact the insurance company.

5. If it so happens that the Third Party Administrator (TPA) takes more than 2 days to process your claim, you can straightaway contact the insurance company for further update regarding any development in your claim request.

6. It is the duty of a TPA to provide its customers with a friendly customer service. They are liable to respond to any insurance claim process related query that the customer produces.

7. A TPA has to provide the policy owners with an information guide. This guide contains details about the TPA’s role in helping the customers, right from the start to the end of the claim process.
8. One other interesting fact about a TPA's working is that they do not charge a single penny for the service they provide to the policyholders.

9. Third Party Administrators often have a widely branched network in various hospitals around various cities. As a result, they can provide you referrals of different surgeons and specialists, which will ease the burden of searching for a 'good' doctor. Apart from this, TPAs also helps you connect with different Ambulance services to tackle emergency situations.

10. Another interesting service that TPAs provide is the flexibility with which the insured can be shifted to another hospital during an ongoing treatment; without troubling the patient or their family members

List of TPAs:


Sr No

Insurer Name

TPA List

Contact Details

Email ID

1

Religare

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

2

Cigna TTK

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

3

Apollo Munich

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

 

 

 

4

Bharati Axa

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Paramount Health Services TPA

022 666 20808

contact.phs@paramounttpa.com

 

 

 

5

National Insurance

E-Meditek TPA Services

1800 102 3242 / +91 - 124 - 4980555

customercare@meditek.com

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

6

New India Assurance

Paramount Health Services TPA

022 666 20808

contact.phs@paramounttpa.com

Heritage Health Insurance TPA Pvt Ltd.

1800 345 3477 / 033 - 22487179

heritage_health@bajoria.in

 

 

 

7

Max Bhupa

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

8

Oriental Insurance

E-Meditek TPA Services

1800 102 3242 / +91 - 124 - 4980555

customercare@meditek.com

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

 

Summary
Though TPAs make the entire claim settlement process convenient, customers must follow the claim process and documentations properly to ensure that they get the maximum claim benefits without any dispute or delays


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Why to Choose Mutual Funds Instead of Directly Investing Into Equities?

Whether to invest in equities or mutual funds is a question that has plagued every investor. As someone who needs the best value for his/her investment should you invest in equity directly or via mutual funds?

Let’s start by first understanding what these two terms ‘equities’ and ‘mutual funds’ stand for-

Equities- Equities generally represent ownership of a company. If you own any equity in a company, you are a part owner of the said company (depending on how much equity you own).

Mutual Funds – It is an investment scheme which is professionally managed by an asset management company. It pools together the resources of a group of people and invests their money in equities, debentures, bonds and other securities.

Why choose mutual funds over equities?

For people who’ve never invested in either stocks or mutual funds, it is hard to know which is better and where to start. Broadly speaking, if you are a novice investor, mutual funds are not only less risky but also way easier to manage. Here are some ways in which investing in mutual funds is beneficial as opposed to investing in equities -

Diversification

Mutual funds provide more diversification as compared to an individual equity stock. When you invest in equity, you are investing in a single company which has its inherent risk. For example, if you invest Rs.20,000 in buying equities of one company, you could face a total loss if that particular company performs poorly in the market.  

If you invest the same amount in mutual funds, it will be invested in different kinds of stocks and financial instruments, high-risk and low-risk both, so you might not face total loss even if one company does poorly.

Scale of Investment and Lower Costs

For an individual investor buying and selling stocks is a difficult task due to its high price. Thus, any gains made from stock appreciation are nullified if the overall trading costs are considered. Comparatively with mutual funds, as the money is pooled from a large number of investors, the cost per individual is lowered.  

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Third Party Administrators (TPA) - A Helping Hand in Claim Settlement

Nutan Gupta

06 Sep 2017

Untitled Document

With soaring medical bills and hospitalization cost, you buy health insurance to live a stress-free and healthy life. But at the time of claim, you are not sure whom to contact for claim settlement or what is the process to file an insurance claim. In such cases, Third Party Administrators (TPA) comes to your rescue. You can coordinate with TPA anytime for any query or concern related to your claim settlement.

A Third Party Administrator (TPA) is an Insurance Regulatory Development Authority (IRDA) registered company or an organization that processes insurance claims on behalf of insurance companies. TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims. TPAs ensure that in cash-less hospitalization the preauthorization is done within 90 minutes of receipt of claim request from customers.

You would be surprised to know about the various tasks performed by a TPA, all of which aims towards making claim settlement convenient for the customers:

1.  TPAs come into direct contact with customers and operate 24*7 to ensure faster processing of claims

2. TPAs ensures that in cash-less hospitalization the preauthorization is done within 90 mins of receipt of claim request from customers

3. In case of any medical emergency, TPAs should be immediately informed. The concerned authority there would assist you over the steps to be taken to file an insurance claim against the same.

4. The purpose of a TPA is to help process insurance claims of various insured customers. Hence, you should contact the TPA only regarding a claim process issue. In case of claim settlement problems, you should directly contact the insurance company.

5. If it so happens that the Third Party Administrator (TPA) takes more than 2 days to process your claim, you can straightaway contact the insurance company for further update regarding any development in your claim request.

6. It is the duty of a TPA to provide its customers with a friendly customer service. They are liable to respond to any insurance claim process related query that the customer produces.

7. A TPA has to provide the policy owners with an information guide. This guide contains details about the TPA’s role in helping the customers, right from the start to the end of the claim process.
8. One other interesting fact about a TPA's working is that they do not charge a single penny for the service they provide to the policyholders.

9. Third Party Administrators often have a widely branched network in various hospitals around various cities. As a result, they can provide you referrals of different surgeons and specialists, which will ease the burden of searching for a 'good' doctor. Apart from this, TPAs also helps you connect with different Ambulance services to tackle emergency situations.

10. Another interesting service that TPAs provide is the flexibility with which the insured can be shifted to another hospital during an ongoing treatment; without troubling the patient or their family members

List of TPAs:


Sr No

Insurer Name

TPA List

Contact Details

Email ID

1

Religare

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

2

Cigna TTK

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

3

Apollo Munich

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

 

 

 

4

Bharati Axa

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Paramount Health Services TPA

022 666 20808

contact.phs@paramounttpa.com

 

 

 

5

National Insurance

E-Meditek TPA Services

1800 102 3242 / +91 - 124 - 4980555

customercare@meditek.com

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

6

New India Assurance

Paramount Health Services TPA

022 666 20808

contact.phs@paramounttpa.com

Heritage Health Insurance TPA Pvt Ltd.

1800 345 3477 / 033 - 22487179

heritage_health@bajoria.in

 

 

 

7

Max Bhupa

Vidal Health Insurance TPA

020 - 25530394 / 020 - 25530398

care@vidalhealthtpa.com

 

 

 

8

Oriental Insurance

E-Meditek TPA Services

1800 102 3242 / +91 - 124 - 4980555

customercare@meditek.com

Medi Assist

1800 425 9449 / 1800 208 9449 

info@mediassistindia.com

 

Summary
Though TPAs make the entire claim settlement process convenient, customers must follow the claim process and documentations properly to ensure that they get the maximum claim benefits without any dispute or delays