SECP issues draft regulations for third party administrators

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ISLAMABAD - Pakistan is among the developing countries where health insurance penetration is one of the lowest, even if compared with its peer countries.

The reasons for this dismal landscape may be due to a variety of factors such as less developed health and hospitals infrastructure, low disposable incomes and a severe lack of awareness.  One of the effective ways to access healthcare facilities by such a large population is through health insurance, which not only endeavours to provide quality care but also attempts to minimise the government’s expenditure on healthcare by transferring the risks to insurance sector.

In its quest to promote health insurance in the country, the SECP, after detailed deliberations with the stakeholders, has proposed the draft regulations for Third Party Administrators (TPA) for supporting the health insurance business.  Conceptually, a TPA is a business unit which processes medical insurance claims on behalf of insurers, often regarded as ‘outsourcing’ where certain tasks and administration activities can be performed in a much efficient and low-cost manner, thus resulting in the overall profitability of the business with improved customer services.

The emergence of TPA in Pakistan, like many other comparable countries, is expected to play an important role in developing the health insurance market and ensuring better services to insurance policyholders.

In order to elicit the public opinion and comments, the SECP has issued the draft TPA Regulations, 2013, which are also available on its website. At the publication of these draft regulations, Mohammed Asif Arif, Commissioner, Insurance, said that the emergence of TPAs in Pakistan is expected to play an important role in the health insurance market by ensuring better services to policyholders as the presence of TPAs is expected to result in addressing the cost and quality issues of the vast number of private healthcare providers in Pakistan by infusing modern management systems and enrichment of knowledgebase of managing healthcare services.

Courtesy:  Nation

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