MAJOR PROJECT

PRESENTATION

A Study on Impact of TPA’s on Health

Insurance & Claimant satisfaction

Internal Guide Presented By;

Dr. BYRAM ANAND, B.Tech, M.B.A VENKATA RAVI KUMAR .CH
PGDCA, Ph.D. MBA (Insurance Management)
Associate professor, 21395010
Dept. of Management,
Pondicherry University,
Karaikal Campus , Karaikal.
Contents
1. INTRODUCTION
2. COMPANY PROFILE
3. OBEJECTIVES OF THE STUDY
4. SCOPE OF THE STUDY
5. LIMITATIONS OF THE STUDY
6. RESEARCH METHODOLOGY
7. DATA ANALYSIS AND INTERPRETATION
8. FINDINGS
9. SUGGESTIONS
10.CONCLUSIONS
11.BIBLIOGRAPHY
INTRODUCTION
A TPA in health insurance is an entity that is a third party in a
health insurance agreement and administers the claim
settlement aspect of the contract between a policyholder and
the insurer. Here are some points that will help you understand
TPA in a better manner.
 TPA is a link between the insurer and the insured in the case
of a hospitalization claim.
 TPA is chosen by the health insurance company.
 TPA’s facilitate the claim settlement process by administrating
tasks such as dealing with documents and settling hospital
bills.
 One TPA can be associated with several insurers.
 COMPANY PROFILE

 NAME ; IFFCO-TOKIO GENERAL

INSURANCE CO LTD
 FOUNDED : 2000
 HEADQUARTER : GURUGRAM
 CEO : H.O. SURI
 BRANCH OFFICES : HYDERABAD
 TAGLINE : MUSKURAATE RAHO
 STATEMENT OF PROBLEM

 Health Insurance plays an important role in the life of an individual a well as

economy of a Nation. At present the health insurance industry in India is
undergoing vast change. Due to Covid outbreak people came to know the
importance of life and health protection, also health insurance industry grown
significantly during this phase of Covid.
 We can expect the same growth in the industry in years to come. The Industry
was liberalized in 2000 and private players started their operation. New
Products, New distribution channels and new strategies have entered the
market.
OBEJECTIVES OF THE STUDY
1. To demonstrate the awareness of TPA’s among health
insurance policy holders.
2. To identify the claimant satisfaction towards claims,
settled by the TPA’s.
3. To know Satisfaction level of customer with net-work
hospitals
SCOPE OF THE STUDY
 The study was undertaken in
Hyderabad, Telangana, so the scope of
the study is limited to Hyderabad only.
 LIMITATIONS OF THE STUDY
 A major constraint was imposed by the time
available for the study, which is six weeks
 Some of the respondents would not have
provided accurate data.
 The area of study is limited to Hyderabad,
Telangana.
 RESEARCH METHODOLOGY
• TYPE OF RESEARCH : Descriptive Research
• SAMPLING TECHNIQUE : Convenience sampling.
• SAMPLE SIZE : 60
• SURVEY METHOD : Interview schedule & Google form responses
• STATISTICAL TOOLS : Percentage analysis

• For the purpose of achieving data effectively the information is

considered of two kinds of data. 

Primary data.
Secondary data  
 The primary data has collected through Questionnaire.
 The secondary data has been collected from various websites.
 RESEARCH GAP
 Some studies have been taken up to evaluate the
awareness on TPA’s among health insurance policy
holders and its impact on claimant satisfaction.
 But few are there to analyze the impact of TPA’s
on retention of customers to the insurer based on
services of TPA’s and the impact on health
insurance. Hence I selected this topic to analyze
the stated objectives in the study.
 Distribution of Demographic Variables
Demography Size No. of percentage Total no. of
Respondents respondents
Male 45 75
Gender 60
Female 15 25
16 – 20 1 1.7
21 – 30 18 31.7
Age 31 – 40 27 45 60
41 – 60 14 23.3
Above 60 0 0
Below 1,50,000 8 13.3
1,50,001- 3,00,000 4 6.7
Income 60
3,00,001- 4,00,000 22 36.7
Above 4,00,00 26 43.3
1–3 8 13.3
Family Size 3–5 50 83.3 60
Above 5 2 3.3
Objective 1;- To demonstrate the awareness of TPA’s
among health insurance policy holders ?

• Simple Percentage:

INTERPRETATION:
• Among 60 respondents 68.3% of policy holders know about TPA’s and
remaining 31.7% were don’t know about TPA’s even they are availing services.
Objective 2 ;- To identify the claimant satisfaction towards
claims, settled by the TPA’s ?

• Simple Percentage:

INTERPRETATION:
• Among 60 respondents 21.7% are highly satisfied with claims
• 50% respondents are satisfied with the claims
• 19.6% respondents are neutral about claims
• 6.5% respondents are dissatisfied with claims
• 2.2% respondents are highly dissatisfied with claims
Objective 3 :- Satisfaction level of
customer with net-work hospitals ?
Simple Percentage
INTERPRETATION
 Among 60 respondents 13.3% are highly satisfied with the
services provided by the network hospitals .
 37.8% respondents are satisfied with the services provided by the
network hospitals .
 40% respondents are Neutral with the services provided by the
network hospitals.
 4.4% respondents are dissatisfied with the services provided by
the network hospitals.
 4.4% respondents are highly dissatisfied with the services
provided by the network hospitals.
MAJOR FINDINGS
 68.3% of policy holders know about TPA’s and
remaining 31.7% were don’t know about TPA’s
even they are availing services.
 50% of people highly satisfied .

 8.8% of respondents are not satisfied with net

work hospitals due to difficulty in accessibility.
 Customers are showing more interest on health
coverage due to Covid-19 outbreak.
 SUGGESTIONS
• Since TPA’s are plays key role on customer
retention, they can improve quality of services
and better claims management.
• Majority of people are interested to take
family floater, it means the insurers
concentrate more on this to make more
innovative and simplify.
CONCLUSIONS

 TPAs mainly act as an intermediary organization between

insurer and the insured for providing cashless health care
services to the policy holder. They are also helpful in bringing
standards in health care services. The current study gave an
idea about the functioning of a TPA and also discussed some of
the current challenges prevail in their operation.
References
Web Sites :-
• https://www.iffcotokio.co.in/about-us
Accessed on 23/10/22
• https://en.wikipedia.org/wiki/Third-party_ad
ministrator
Accessed on 23/10/22

• IC 27 Health Insurance Pdf