The TPA system may be soon phased out and insurers asked to handle the business on their own. They are not performing as per customer satisfaction. People who have availed of cashless medical facilities are facing the brunt of inefficient services.
The way TPAs are running their business has posed a threat to the entire health insurance sector. A couple of insurers have stopped outsurcing their business already. More than the insurers it is a concern for end users who are being forced to pay hospital bills despite availing of the cashless facility. If it is not happening it is the customer who is facing the problem and in turn the insurer is facing a huge loss to settle larger claims.
There have been increasing instances where TPAs were found to have forwarded inflated medical bills to the insurers.
1 comment:
I feel we are going back to the post-1986 period when mediclaim was introduced in our country with only the insurer and the customer. Now with the industry better organised with more players and further competition things should work out better.
TPAs in our country are a very good example of the failure of outsourcing in general insurance. Service quality and the time factor are two necessary ingredients to success which are sadly missing. We need to add rampant corruption if we want to find out one important reason. I would like to ask who will do the rethinking of a better business model to ensure competency, competitiveness, and cost effectiveness. And may I add transparency. IRDA by any chance?
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