Health Insurance TPA of India Ltd (HITPA), a third-party administrator (TPA) promoted by four public-sector general insurers, continues to face questions over the extent of business entrusted to it, more than four years after the Comptroller and Auditor General (CAG) flagged its underutilisation and recommended higher allocations.

A 2022 CAG report found that HITPA had adequate capacity and performance parameters comparable to leading TPAs, yet received only a fraction of the business handled by its promoter insurers. However, responses to Right to Information (RTI) applications filed with the four insurers do not establish whether allocations have increased significantly or what action has been taken on the audit recommendation.

New India Assurance and Oriental Insurance declined to disclose information sought across the questions, invoking Section 8(1)(d) of the RTI Act, which exempts commercial confidence and trade secrets where disclosure could harm competitive interests. Section 8(2), however, permits disclosure where public interest outweighs the protected interests.

United India Insurance and National Insurance provided some operational information available on their websites but withheld financial and performance-related details. None of the four insurers furnished a clear account of action taken on the CAG’s recommendation to revisit business allocation to HITPA.

The available disclosures offer a snapshot of its workload. United India reported that HITPA had processed 1,18,712 claims and administered 48,525 policies covering 67.99 lakh lives as of March 31, 2026. National Insurance reported 1,55,137 policies covering 8,52,444 lives. However, neither disclosure established the premium value allocated to HITPA or its share of the insurers’ overall TPA business.

Underutilisation despite capacity

Incorporated on August 14, 2013, HITPA is a joint venture of New India Assurance, United India Insurance, Oriental Insurance and National Insurance, with state-owned reinsurer General Insurance Corporation of India (GIC Re) also holding a stake. It was registered with the Insurance Regulatory and Development Authority of India (IRDAI) in June 2014.

According to the CAG, HITPA had paid-up capital of ₹120 crore as of March 31, 2021. Each of the four insurers contributed ₹28.50 crore, while GIC Re held the remaining ₹6 crore.

The audit found that capacity utilisation, measured by lives serviced against available capacity, declined from 5.34% in 2017-18 to 3.68% in 2019-20. HITPA’s share of the total premium allocated to TPAs by its promoter insurers, meanwhile, rose from 0.92% in 2016-17 to 6.19% in 2019-20. These were the latest allocation figures cited in the report.

HITPA had approached the General Insurance Public Sector Association (GIPSA) in March 2018, seeking at least 10-15% of health insurance claims-processing work. GIPSA’s governing board agreed in September 2018 to transfer 10% of the work handled by the five largest TPAs to HITPA. The decision, however, was not implemented.

The insurers attributed the low allocation to HITPA’s limited geographical presence, competition from established TPAs and reluctance among group clients. The CAG rejected these explanations, pointing out that HITPA had adequate capacity and a presence in 10 major cities, including all four metros.

Asked about follow-up action, National Insurance said, “The matter related to the cited report is under review, therefore, the information does not exist at present.” United India said, “The subject matter is under process, information sought does not exist as on date.”

Business growth, unanswered questions

HITPA’s FY2024-25 annual report, the latest available on its website, shows a profit after tax of ₹15.03 crore. It earned around ₹73 crore in servicing fees and ₹17.24 crore in other income, servicing premiums worth approximately ₹2,543 crore and covering 30.1 lakh lives.

Yet, the allocation made by each promoter insurer and the change in HITPA’s share since the CAG report remain undisclosed.

HITPA’s leadership did not respond to queries on business allocation, capacity utilisation, technology investments, claims-processing performance, reported system disruptions, employee attrition or the status of its IRDAI registration renewal. Its website lists the registration as valid until June 5, 2026.

Published – November 11, 2026 06:30 am IST