IRDAI License No. 010, Period of Certification : 21/03/2017 to 20/03/2020

Concept of Third party Administrators

The Concept of Third party Administrators Focus Health Insurance TPA Private Limited has been introduced by IRDA (Insurance Regulatory and Development Authority) for the benefit of insured and the insurer.

The insurer would get the benefit of transparent hassled free and better services and insurers to be benefited by the reduction of administrative costs, better claim management resulting in bringing down the claim cost with batter services to the client.

TPA maintains insured‘s database by issuing unique identification photo id card and would manage all the claims in the post policy period. TPA’s are required to run 24 hours toll free numbers accessible from any location in India. They would employ trained personals and doctors who are conversant with the claim procedures as well as insurance policies terms and condition.

The policy holder would have the choice of availing treatment in the best of hospitals selected by him out of all the empanelled hospitals list and avail the hassle free treatment .this can be done in case of Emergency by providing photo ID card to get admission in the hospital. The hospital sends the necessary details along with ID card to TPA to get the cashless facility. At the time of discharge the bill is settled by TPA as per the terms and conditions of the mediclaim policy and one has to pay only for those services, items which are not covered under the policy or if the bill exceeds the benefit (sum insured), thus providing cashless treatment to the insured .The insured has no worry for arrangement of money in emergency cases.