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UAE residents find medical insurers needn t pay claims on what TPAs promise

Dubai: Some UAE residents are finding what they can claim – and can’t claim – from insurers the hard way. Anjana Sunilan is the latest to feel aggrieved. She had been told verbally and in writing by her TPA (third-party administrator) that all hospital expenses related to her delivery would be covered by the insurer. Even the co-payment charges – typically 10 or 20 per cent of the final bill – were to be waived. (TPAs are the entities responsible for processing claims related to medical insurance, and are the point-of-contact between the insured and insurer.) As per those conditions, she only needed to pay Dh500 out-of-pocket, and the rest of the expenses, totaling Dh7,500, would be for the insurer to pick up. But it wasn’t how it turned out to be.

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