TPAs and Insurance

Health Insurance has become an integral part of our lives. Specially in India it is very important in the absence of any social health related safety net.

Third Party Administrators are known as TPA’s.  They administer the health insurance for the insurance companies.  They will issue a health insurance identity card to the insurance holder. They enter into an MOU with the various hospitals in the country to provide service to their insured clients.   

The Suraj Eye Institute is recognised by and has MOU’s with the following TPA’s and insurance companies.

  1. Anmol TPA Medicare
  2. Alankit Healthcare
  3. Apollo DKV
  4. Apollo Munich
  5. Bajaj Allianz Online
  6. Bajaj Life Insurance
  7. Cholamandalam MS General Insurance
  8. Dedicated Healthcare
  9. E-Meditek(TPA)Services Ltd
  10. Ericson TPA Health Care Pvt Ltd
  11. Family Health Plan
  12. Focus Healthcare Private Limited (FHPL)
  13. Future Generali
  14. Genins India TPA Ltd.
  15. Good Healthplan Ltd.
  16. HDFC ERGO General Insurance Company Limited
  17. Health India TPA
  18. Health Insurance TPA of India Ltd.
  19. Heritage Health TPA Pvt. Ltd
  20. ICICI Lombard Healthcare
  21. IFFCO-Tokio
  22. Max Bupa Health Insurance
  23. MD India Healthcare (TPA) Services Pvt. Ltd.
  24. Med Save Health Care TPA Ltd.
  25. Mediassist
  26. Mediassist Offline
  27. Medicare TPA Services (I) Pvt. Ltd.
  28. Paramount Health Services (TPA) Pvt. Ltd.
  29. Raksha TPA Pvt. Ltd.
  30. Reliance General Insurance Company Ltd
  31. Religare Health Insurance Company Limited
  32. Rothshield Healthcare(TPA) Services Ltd.
  33. Star Health Insurance
  34. United Healthcare TPA
  35. Vidal Health TPA
  36. Vipul MedCorp TPA Pvt. Ltd

As an insured person, you may approach  us if you  are registered with any of the above TPA and in some instances even if you are registered with other TPA’s.  

You will generally be entitled to undergoing medical treatment and surgery without paying to the hospital. The hospital will then recover the payment from the insurance companies and TPA’s.

To enable this process, when you are diagnosed with a particular ailment, your details with a request for authorisation to treat you will be sent to the TPA. They will then issue a letter authorising your treatment.

Sometimes the response in the presence of proper documents, including current and policy papers is very fast.  At othe times there may be some delay.

Following the authorisation, you will be entitled to undergo treatment on a ‘Cashless’ basis. In addition if you choose a package which is not acceptable to the TPA, they will cover part of the costs and the remaining part of the cost may be paid by you.

If  authorisation is not received in a timely manner, you may still undergo surgery on a payment basis.  You will later be able to claim it from your insurance company.