Impact of claim settlement procedure of health insurance companies on customer satisfaction during the pandemic: A case of third-party administrators

The claim settlement process is one of the most critical aspects health insurance. Many policyholder grievances often surface during settlement, which will likely shape insurer’s reputation. Hence, this study aims to evaluate relationships between hypothesized factors concerning third-party administrator’s as perceived by policyholders. paper used data policyholders from Delhi/NCR, India, who have availed cashless claims in last three years. In process, a total 790 questionnaires were sought be. methodology was extractive factor analysis comprising KMO test, reliability assessment with Cronbach’s Alpha, and correlation assessment. attempted all contributing that behavior settlement. Therefore, different identified (themes A, B, C, D). reported significant relationship insurance company perceptions (0.162), network hospital (0.182), product design (0.180), agent (0.332), communications (0.114), disclosure (0.122), internal practices (0.143), TPA prospects across Indian perspective. contextual impacts on individual group decision-making must be monitored accommodated effective public policy management claims. findings could help insurers create business models leading better customer satisfaction congruence agents, policyholders, TPAs, companies.