Following the increasing number of complaints against third-party administrators (TPAs) on the issue of cashless hospitalisation, the Insurance Regulatory and Development Authority (Irda) is looking at issuing fresh regulatory guidelines on them. The guidelines, sources said, would be even tighter and stringent.Presently there are about 25 registered TPAs in the country. The number is likely to increase significantly once the standalone health insurance companies start operations. Irda’s working group, which is currently studying the nitty gritties in the field of health insurance, is of the opinion that TPAs and their way of functioning need to be closely monitored. “We are looking at issuing stricter norms to regulate TPAs, especially in the wake of standalone health insurance companies likely to make a foray into the market,” a source said.However, the source also said the standalone health insurance companies may opt to strike a direct deal with the hospitals, bypassing the TPA route. “In a bid to cut costs and avoid possible confusions, the standalone health insurance companies may directly tie up with the hospitals,” the source added.Meanwhile, the 11-member K.P. Narsimhan Committee, in its report to Irda, has stressed that the minimum required capital base should be fixed below the Rs 100 crore level, which is currently applicable to the insurance companies. According to the report, there should be four different categories, including health and agriculture, besides life and general. At present there are only two categories — life and general. Health insurance in India is currently being covered by the general insurance firms. Interestingly, the insurance premium as a percentage of GDP in India stood at only 3.17 per cent in 2004, according to an Icra report, reflecting an enormous untapped opportunity in the country.
