Third party administrators (TPAs) need to do a much better job on medical claims management throughout the international private medical insurance (IPMI) sector, according to James McGrigor, director of McGrigor Group.
With medical inflation running at 10% or higher in many regions of the world, the issue of managing medical claims and costs is a particularly important one for the sector.
Speaking at the Health & Protection IPMI Summit this week, McGrigor (pictured) explained TPAs were “critical” to the value chain in IPMI.
“From time to time the insurers are on top and then the TPAs are on top. It depends on the region,” he said.
“There are big gaps in the world, for example there are virtually no regional TPAs in Asia and there are virtually no regional TPAs in Europe.
“There’s big TPAs in the Middle East as we know, but there’s been quite a lot of action in the Middle East – it’s a very busy area because there’s a lot more work to be done.”
‘Still doing what it’s done’
McGrigor suggested that with a lack of advancements in this part of the market there were likely to be new entrants or provider developments.
“Really, without having a go at TPAs, but also having a bit of a go at TPAs, they need to do a better job,” he said.
“I don’t sit alongside the insurers or brokers, but really there’s a lot more that can be done on medical management in this industry, a tonne more and it just hasn’t happened.
“It’s still doing what it’s done – pay, pay pay. It just needs to be better and therefore a few people will come and try and do more things here.”
