TPA data will check healthcare costs; IRDA sets up committee

Chennai: The Insurance Regulatory and Development Authority (IRDA) has constituted an internal committee to decide on the format in which third party administrators (TPA) should submit periodical reports. TPAs are the health insurance claim settling agents for general insurers.

With the healthcare industry largely in the private sector and the absence of uniformity in rates among hospitals and diagnostic laboratories, IRDA () wants to collect the data through TPAs. “We don’t have any control over hospitals and doctors. Hence we have to get the data from TPAs and insurance companies,” says IRDA chairman N Rangachary.

The data collected will help the insurance industry to control its claims outgo and also the authority to formulate strategies for the health insurance sector. “Now the size of the health insurance market is around Rs 300 crore and has the potential to grow to Rs 1,000 crore.”

Rangachary disagreed with the idea of allowing companies to transact just the health insurance business with a start-up capital of Rs 50 crore. “I am not convinced about the viability of insurance operation with a capital that is less than Rs 100 crore. Almost all the new players have infused additional capital.”

About the reason for the Law Commission to do a comprehensive review of all insurance laws, he says: “All these years our goal was to do those things that would allow private players into the insurance sector. Accordingly, the IRDA Act was passed and the Insurance Act 1938 was amended despite stiff opposition.”

Now with the entry of new players, it will be easier to do a full-fledged review of insurance laws and even pass a single comprehensive legislation that would govern the sector.