Hospitalisation, health insurance and TPA woes: A first-hand experience

A couple of months back, my Appa (father) was unwell enough to require hospitalisation. It was a very stressful period for all us, but the stress factor came not so much from his illness or hospitalisation or treatment or care and recovery, but from an unexpected source—his health insurance’s Third Party Administrator (TPA), who created delays and blocks at every step, making the actual hospital stay seem almost like a vacation in comparison.

Both my parents are covered in the health insurance plan offered by the organisation I work in, and this was the first time I was availing of medical insurance, which is administered by a well-known TPA. The insurance plan I am covered under offers a “cashless” hospitalisation facility in most of the well-known hospitals in Mumbai. A reason to feel relaxed about and not have palpitations. Right? Wrong !

Appa had been having fever, which showed no signs of abating in spite of medication and care at home, as well as his doctor’s supervision. After a week of battling with the fever, his doctor advised hospitalisation for investigations and focussed treatment at a well-known hospital, close to our house. Once this decision was taken, my brothers and I got into action—while they would get him ready for the hospitalisation, I would get the insurance and TPA formalities sorted out.

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