|
Sr. No
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Annexure No.
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Form No.
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Particulars
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1
|
Annexure - 1
|
TPA - 1
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Application for Grant of Fresh Certificate of Registration to TPA
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2
|
Annexure - 3
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TPA - 1A
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Format for Certificate of Registration
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3
|
Annexure - 4
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TPA - 2
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Declaration and Undertaking with respect to fit and proper criteria
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|
4
|
Annexure - 5
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TPA - 3
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Form for Intimation of appointment or change in Director, or Key Managerial Personnel.
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5
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Annexure - 6
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TPA - 4
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Application for issue of Duplicate Certificate of Registration.
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6
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Annexure - 7
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TPA - 4A
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Format for Duplicate Certificate of Registration
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7
|
Annexure - 8
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TPA - 5
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Application For Change In Shareholding Pattern
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|
8
|
Annexure - 10
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TPA - 6A
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Status of Shareholding Pattern of a TPA Company
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9
|
Annexure - 12
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TPA - 7
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Application for Renewal of Certificate of Registration
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10
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Annexure - 14
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TPA - 7A
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Format for Certificate of Renewal of TPA Registration
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|
11
|
Annexure - 16
|
TPA - 8
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Form for Annual Report by TPA and Schedule 1 to 7 under the said form TPA-8.
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|
12
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Annexure - 17
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TPA - 6B
|
Format for Quarterly and Cumulative Claims data for TPAs
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13
|
Annexure - 18
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TPA - 6C
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Annual Certificate in the matter of Working Capital and income of a TPA Company.
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14
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Annexure - 19
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TPA - 6D
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Annual Declaration and Undertaking by a TPA Company
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15
|
Annexure - 20
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TPA - 6E
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Annual Form on Service Level Agreement Details
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|
16
|
Annexure - 23
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TPA – 6F
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Periodical returns - Half-yearly information on non-insurance health schemes
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17
|
Annexure - 25
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TPA - 6G
|
Format for Half-yearly Information on services rendered in India or in foreign jurisdictions
for policies issued by Indian Insurers
|
|
18
|
Annexure - 26
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TPA - 6H
|
Format for Half-yearly Information on health services rendered to foreign travel
policies issued by Foreign Insurers
|
|
19
|
Annexure - 28
|
TPA - 9
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Form for intimation of opening and closing of the branches or change in office address.
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20
|
2015-16
|
TPA - 8
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Disclosure of Annual Report of TPA.
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|
21
|
2016-17
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
|
22
|
2017-18
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TPA - 8
|
Disclosure of Annual Report of TPA.
|
|
23
|
2018-19
|
TPA - 8
|
Disclosure of Annual Report of TPA.
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|
24
|
2019-20
|
|
Public Disclosures As on 30-09-2019.
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|
25
|
2019-20
|
TPA - 8
|
Disclosure of Annual Report of TPA.
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|
26
|
2019-20
|
|
Public Disclosures As on 31-03-2020.
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|
27
|
2019-20
|
|
Revised Annexure-18 Form TPA_6C for the FY 2019+20.
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28
|
2020-21
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Public Disclosures As on 30-09-2020.
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