Third Party Administrator (TPA)
A third party administrator or TPA is an organisation that works as a middleman between an insurance company and its policyholders. A TPA is not a party to the insurance contract between the insurer and the policyholder. Hence, the name, third party administrator.
Insurance companies engage TPAs to manage tasks like claim settlement, customer support or record keeping. A single TPA can work with multiple insurers and manage their processes.
A third party administrator is an IRDAI regulated entity. Third party administrators must follow the rules, regulations and guidelines given by IRDAI.
Instead of relying on TPAs, some insurers have now set up their in-house teams to manage claim processing and other tasks.
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A
- Accident
- Acute Care
- Acute Condition
- Age Limit
- Agent
- Ambulance Cover
- Annual Health Checkup
- Annual Renewal Date / Renewal Date
- Any One Illness
- AYUSH Treatment
B
C
- Cancer Insurance
- Cashless Facility
- Chronic Condition
- Claim
- Claim Assessment
- Claim Rejection / Claim Repudiation
- Claim Settlement
- Claim Settlement Ratio
- Comorbidity
- Congenital Anomaly
- Consumables
- Continuity Benefit / No-Lapse Benefit
- Contract
- Convalescence Benefit
- Copayment
- Critical Illness
- Cumulative Bonus / No-Claim Bonus (NCB)
D
- Daily Hospital Cash / Daily Cash
- Day Care Treatment
- Deductible
- Discharge Summary
- Domiciliary Hospitalisation
- Durable Medical Equipment
E
F
G
H
I
- Illness
- Indemnity
- Injury
- Inpatient Care / Inpatient Hospitalisation
- Insurance Ombudsman
- Insured Person
- Insurer
- Intensive Care Unit (ICU)
- IRDAI
L
M
N
O
P
- Personal Accident Cover
- Planned Hospitalisation
- Policy Document
- Policy Schedule
- Policyholder
- Portability
- Post-Hospitalisation Expenses
- Pre-Authorisation (of Cashless Claims)
- Pre-Existing Disease (PED) / Pre-Existing Condition
- Pre-Hospitalisation Expenses
- Pre-Policy Medical Check-Up
- Premium
- Proportionate Deduction
R
- Reasonable and Customary Charges
- Reimbursement
- Renewal
- Renewal Premium
- Restoration Benefit / Automatic Restoration
- Rider / Add-on Cover
- Room Rent Limit
S
- Shared Accommodation
- Sub-Limit
- Sum Insured
- Super Top-Up Health Insurance Plan
- Surgery or Surgical Procedure
- Survival Period
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