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Third Motor Insurance Directive, Directive 90/232

Requires mutual recognition within all EC states of compulsory motor insurance arranged in another EC state. Where a vehicle is involved in an accident in another member state and the compulsory insurance requirements of the two states are at different levels, the higher level will apply. Road Traffic Act 1988, s.145(3), provides that compulsory insurance must cover UK liability and that of another EC state where an accident occurs.

Third Non-Life Directive 1992

Completed the move to a single market by creating freedom of establishment. It abolished the right of an EC state to insist upon authorising the activities of an insurer established in another state whether established in the host state or selling directly into it from an establishment elsewhere in the EC.

Third party

UK: 1. Someone other than the policyholder who has been injured or whose property has been damaged. 2. Person brought into legal proceedings by the defendant as being a person considered wholly or partly liable for the loss, e.g. retailer joins manufacturer in a product liability case. See CIVIL LIABILITY (CONTRIBUTION) ACT 1978; THIRD PARTY PROCEEDINGS.
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A person who is not a party to a contract. Someone other than the insured and insurance company. As used in Aviation Insurance the term does not include passengers in the Insured’s own aircraft.
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MEDICAL, US: Entity that processes insurance claims for patients (e.g., private insurance companies, Medicare fiscal intermediaries).
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Someone other than the insured or his insurer who has suffered injury or loss.
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US: The claimant under a liability policy. So called because the person making the claim is not one of the two parties, insured and insurer, to the insurance contract.

Third Party Administrator (TPA)

A firm or institution which provides administrative services for insurers and other associations having health insurance policies. The TPA in addition to being the liaison between the insurer and the insured is also involved with certifying eligibility, preparing reports and processing claims. TPA offers such services at a cost. Only a company with a share capital and registered under the Companies Act 1956 can function as a TPA whose primary object shall be to carry on business in India as a TPA in the health services and on being licensed by the Authority the Company for the purpose. The minimum paid up capital in equity shares amounting to Rs. 1 crore. At least one of the Directors shall be a qualified Medical Doctor. The aggregate holdings of equity shares by a foreign company shall not at any time exceed 26% of the paid up equity capital.

Third Party Administrator (TPA) for Health Insurance

Health Services by TPA” means the services specified in Regulation (3) of IRDAI (Third Party Administrators-Health Services) Regulations, 2016. “Third Party Administrators or TPA’’ means any person who is registered under the IRDAI (Third Party Administrators – Health Services) Regulations, 2016 notified by the Authority, and is engaged, for a fee or remuneration by an insurance company, for the purposes of providing health services as defined in those Regulations. 3 which provide Servicing of claims under health insurance policies by way of pre-authorization of cashless treatment or settlement of claims other than cashless claims or both, as per the underlying terms and conditions of the respective policy and within the framework of the guidelines issued by the insurers for settlement of claims.Servicing of claims for Hospitalization cover, if any, under Personal Accident Policy and domestic travel policy.Facilitating carrying out of pre-insurance medical examinations in connection with underwriting of health insurance policies: Provided that a TPA can extend this service for life insurance policies also.Health services matters of foreign travel policies and health policies issued by Indian insurers covering medical treatment or hospitalization outside IndiaServicing of health services matters of foreign travel policies issued by foreign insurers for policyholders who are travelling to India: Provided that such services shall be restricted to the health services required to be attended to during the course of the visit or the stay of the policyholders in India.Servicing of non-insurance healthcare schemes as mentioned in Regulation 22 (3) of these Regulations g. any other services as may be mentioned by the Authority.While performing the services as indicated at Regulation 3 (1) of these regulations, a TPA shall not Directly make payment in respect of claims Reject or repudiate any of the claims directlyHandle or service claims other than hospitalization cover under a personal accident policyProcure or solicit insurance business directly or indirectlyOffer any service directly to the policyholder or insured or to any other person unless such service is in accordance with the terms and conditions of the policy contract and the agreement entered into in terms of these regulations.A TPA can provide health services to more than one insurer. Similarly an insurer may engage more than one TPA for providing health services to its policyholders or claimants.