Insurance Companies Should Not Involve TPAS In Claim Settlement : Mumbai High Court

06 March Mumbai

The Bombay High Court has asked the Insurance Regulatory and Development Authority (IRDA) to ensure that insurance companies did not involve Third Party Administrators (TPAs) in the claim settlement.

The TPAs act as intermediaries between hospitals, insurers and consumers.

A division bench headed by Chief Justice Mohit Shah said that IRDA shall inform insurers to implement (Health Insurance) Regulation 12 in letter and spirit to see that the decision for rejecting or allowing claims are taken by the companies and not the TPAs.

The court was hearing a PIL highlighting the problems faced by mediclaim policy holders and lack of transparency in claim settlement.