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Third Party Administrators are the backbone of the insurance industry in India. This article will give you a general idea on their system's workings.

What is the role of the TPA?
The role of the TPA is to do whatever the insurance company wishes it could do, but can’t because of lack of infrastructure!

The TPA takes under its wing a database of policy holders and then handles all their policy related issues, including cashless claim settlements, providing a 24-hour helpline to policy holders, a list of hospitals where a patient can get treatment with insurance benefits, information about health issues, specialized consultation information - the list goes on and on.

How does the TPA system work?
A well-organized TPA network can prove to be a boon when stresses are at their peak. A TPA relieves you of a lot of running around, by handling the financial aspects of your treatment directly with the hospital – almost like a benevolent father paying the bills while the kids play. Well – almost.

Here’s how it works Value addition is now just a telephone call away! The TPA network is at your beck and call, 24x365! If for some reason, your claim gets rejected by the TPA and the insurance company, you can take the matter further to what is called an Ombudsman. It is an effective system of redressal for insurance claims formulated by our government. You can learn more about it in our article on Ombudsmen.