Third Party Administrator

Topics: Insurance, Insurance in India, Disability insurance Pages: 23 (5472 words) Published: December 29, 2010
PROJECT ON
STUDY OF TPAs IN INDORE

2008 - 2009

[pic]
515 Udyog Vihar, Phase V, Gurgaon-122016
Tel: +91-124-2438270-75 Fax: +91-124-2438276
E-mail: info@vipulmedcorp.com

SUBMITTED TO:- SUBMITTED BY:-

PROF. B.K. ARUN VINIT JAISWAL BBA 5TH SEM SEC. A SCHOLAR NO. 088

CONTENTS

1. Acknowledgement
2. Objectives
3. History of insurance
4. Introduction
5. Process of TPA
6. What a TPA is?
7. List of TPAs in India
8. Conclusions drawn
9. Bibliography

PROJECT

1. Inter- relationship between Patients,
Insurance Company and TPA
2. TPA v/s Simple Mediclaim Policy
3. Flowchart of working procedure

ACKNOWLEDGEMENT

“NOTHING IS MORE KNOWLEDGEABLE THAN EXPERIENCE.”

I am deeply indebted to Mr. Sankalp Nagar, Branch Manager, Vipul Med Corp. Pvt. Ltd., Indore, for taking deep interest and providing opportunity to work under his guidance. I would like to thank Mr. Vikas Sonwani ,without whose cooperation the completion of the study would not have been possible. I would also like to thank Prof. B.K.Arun , for his immence guidance and support throughout the project. A special mention needs to be made about the personnels from all the TPAs I visited who helped me in successful conduction of the study.

OBJECTIVES

1. To study in depth working of TPAs in Indore.
2. To know the scope of TPA in health care industry.
3. To know the hospital networking and their attachments to the TPAs.

HISTORY OF INSURANCE IN INDIA:

In India, insurance has a deep-rooted history. It finds mention in the writings of Manu ( Manusmrithi ), Yagnavalkya ( Dharmasastra ) and Kautilya ( Arthasastra ). The writings talk in terms of pooling of resources that could be re-distributed in times of calamities such as fire, floods, epidemics and famine. This was probably a pre-cursor to modern day insurance. Ancient Indian history has preserved the earliest traces of insurance in the form of marine trade loans and carriers' contracts. Insurance in India has evolved over time heavily drawing from other countries, England in particular.  

   1818 saw the advent of life insurance business in India with the establishment of the Oriental Life Insurance Company in Calcutta. This Company however failed in 1834. In 1829, the Madras Equitable had begun transacting life insurance business in the Madras Presidency. 1870 saw the enactment of the British Insurance Act and in the last three decades of the nineteenth century, the Bombay Mutual (1871), Oriental (1874) and Empire of India (1897) were started in the Bombay Residency. This era, however, was dominated by foreign insurance offices which did good business in India, namely Albert Life Assurance, Royal Insurance, Liverpool and London Globe Insurance and the Indian offices were up for hard competition from the foreign companies.  

     In 1914, the Government of India started publishing returns of Insurance Companies in India. The Indian Life Assurance Companies Act, 1912 was the first statutory measure to regulate life business. In 1928, the Indian Insurance Companies Act was enacted to enable the Government to collect statistical information about both life and non-life business transacted in India by Indian and foreign insurers including provident insurance societies. In 1938, with a view to protecting the interest of the Insurance public, the earlier legislation was consolidated and amended by the Insurance Act, 1938 with comprehensive provisions for effective control over the activities...

Bibliography:  
      An Ordinance was issued on 19th January, 1956 nationalising the Life Insurance sector and Life Insurance Corporation came into existence in the same year
power to frame regulations under Section 114A of the Insurance Act, 1938 and has from 2000 onwards framed various regulations ranging from registration of companies for carrying on insurance business to protection of policyholders ' interests.
 
    In December, 2000, the subsidiaries of the General Insurance Corporation of India were restructured as independent companies and at the same time GIC was converted into a national re-insurer
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