Third Party Administrators (TPAs)

Third Party Administrators (TPAs)
Making their services mandatory for conducting medical examinations and
special medical reports at the time of proposal and also revival of lapsed
policies


Third Party Administrators (TPAs) have been appointed at all the Divisional Offices. At present both the existing system of empanelled doctors / diagnostic centers and the TPA system have been kept open for conducting medical examinations and special reports.

It has now been decided to make the services of TPAs mandatory at all divisional headquarters and other major cities where TPAs have become fully operational in the following cases:

i. Where sum under consideration (SUC) is Rs. 10 lacs and above

ii. Where the age last birthday of the proposer is more than 45 years and SUC is more than Rs. 8 lacs

iii. In respect of revival of lapsed policies where sum at risk is above Rs. 2 lacs

Needless to add that in the above cases if FMR is done by DMR, the same will be acceptable.

Regional Managers (Actl) may circulate the list of TPAs allotted to their zones mentioning the cities where their services are being made mandatory. Before making their services mandatory, an undertaking may be obtained from the concerned TPAs that they are fully operational and are in a position to conduct medical examinations and special reports efficiently in the geographical area of the cities of Divisions under their jurisdiction. Their services may be made mandatory in other places as and when they become fully operational in those areas.

A copy of the circular issued by R. Ms (Actl) will be sent to CUS for their information.