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Feb 14, 2013
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Health insurance firms must settle claims directly with policyholders, rules court
Insurance companies will be required to pay health claims directly to consumers, according to a Bombay High Court judgment delivered on a public interest litigation. Earlier, such claims (reimbursements of cashless settlements) were done through intermediaries called third party administrators (TPAs).Most insurers outsource claims processing to TPAs to save administrative and distribution costs. As TPAs would get a commission for cutting down claims, they often questioned the treatment and tests the insured had to undergo.
Source -
http://www.thehindubusinessline.com
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