Policy advisory: Provide expert guidance on LIC health insurance policies and their integration with TPA processes.
Claims oversight: Monitor claim settlements, ensure accuracy, and advise on escalations.
Compliance assurance: Ensure adherence to IRDAI regulations, LIC guidelines, and contractual obligations.
Stakeholder coordination: Act as a liaison between LIC, TPAs, and healthcare providers for smooth operations.
Process improvement: Recommend workflow enhancements and best practices for claim management and insurer coordination.
Training and mentoring: Conduct sessions for TPA staff on LIC-specific processes and compliance requirements.