Future Generali scraps TPA system for health insurance business  

April 19, 2010

With the appointment of Dr Sheeraj Deshpande as Future Generali’s new health insurance head, a position specially created for him, the general insurance company seems to be heading in a new direction. In a surprising move, the company also plans to do away with third-party administrator (TPA) services from its portfolio.

“We have done a significant amount of group health insurance business and have started making our presence felt in the retail health business. We felt that it is important for us to recognise health as a major line of business and provide enough infrastructure to ensure quality service to our customers,” KG Krishnamoorthy Rao, Future Generali India’s managing director and chief operating officer, told Moneylife.

In a move to ensure customer satisfaction, the company would now have its own in-house team to service health policies, instead of customers dealing with TPAs who facilitate medical insurance payouts. The company, which is still using about 10 TPAs, will switch over to the in-house team by the end of this year, after the required infrastructure is put in place.

“TPAs have not been able to live up to the service standards that had been expected from them when they were introduced. This has led to various issues, including some doctors and hospitals refusing to work with them. For us, as an insurer, it would be better if we have our own team which can interact both with the customers and hospitals directly, to ensure that our clients are getting prompt service. This will help us to address customer issues much faster,” Mr Rao said.

In the middle of February, policyholders who were admitted to Mumbai hospitals were trapped in the midst of a raging battle between city-based doctors and TPAs, owing to doctors’ unhappiness with the low consultancy fees being allowed by a couple of TPAs for reimbursement under medical insurance plans.

Dr Deshpande will be responsible for increasing Future Generali’s presence in the health insurance space, with special focus on the retail market. He will also concentrate on growing Future Generali’s corporate health portfolio by providing tailor-made solutions.

— Aaron Rodrigues