Do you agree with the statement that the roles played by a third party administrator and a surveyor in the matter of after-sales service of an insurance product are the same? Discuss.

A surveyor and a Third Party Administrator (TPA) both come into picture for a claim settlement purpose for insurance products but their roles are quite different. The Primary responsibility of a Surveyor is to estimate the liability of the loss incurred by the policyholder who has take insurance cover, to enable the assurance company to arrive at the amount to be indemnified to the policyholders under the terms of the insurance contract. A surveyor has to be a qualified person both academically as well as technically with experience in the field in which he is required to offer his services for survey. Surveyors come into the picture when estimated losses are in excess of ₹50,000 for a motor insurance claim and over ₹1 lakh in other insurance claims, such as for fire or marine insurance. Third Party Administrator (TPA) is a person (generally a company) complying with certain requirement as stipulated under the Act. TPAS are appointed by an insurance company to render services in connection with health insurance business. TPAS are also required to deal with the claim settlement process in case of health insurance policies but they do not act like surveyors as they do in case of general insurance business. A person can act as a TPA only with a valid licence issued by IRDAI to perform the functions of a TPA. It is generally only a company registered under the Companies Act which is allowed the licence to act as a TPA. The main object of the Memorandum of the company should provide for carrying out of the business as TPA in the health services. Further engaging in any other business than IPA is prohibited. The company must have minimum paid up capital of ₹1 crore at all times. Thus the role of surveyor for a general insurance (motor, marine and fire) and role of TPA for health insurance come under after sales services of the insurers and before and during the settlement of claim. Prima facie the roles look to be the same, but functionally their roles are quite different. The surveyor only assesses the quantum of the claim and reports to the insurer whereas the TPA besides offering health related services also processes the documents for the health insurance claims and communicates with the insured on behalf of the insurer.