Sr. No
|
Annexure No.
|
Form No.
|
Particulars
|
1
|
Annexure - 1
|
TPA - 1
|
Application for Grant of Fresh Certificate of Registration to TPA
|
2
|
Annexure - 3
|
TPA - 1A
|
Format for Certificate of Registration
|
3
|
Annexure - 4
|
TPA - 2
|
Declaration and Undertaking with respect to fit and proper criteria
|
4
|
Annexure - 5
|
TPA - 3
|
Form for Intimation of appointment or change in Director, or Key Managerial Personnel.
|
5
|
Annexure - 6
|
TPA - 4
|
Application for issue of Duplicate Certificate of Registration.
|
6
|
Annexure - 7
|
TPA - 4A
|
Format for Duplicate Certificate of Registration
|
7
|
Annexure - 8
|
TPA - 5
|
Application For Change In Shareholding Pattern
|
8
|
Annexure - 10
|
TPA - 6A
|
Status of Shareholding Pattern of a TPA Company
|
9
|
Annexure - 12
|
TPA - 7
|
Application for Renewal of Certificate of Registration
|
10
|
Annexure - 14
|
TPA - 7A
|
Format for Certificate of Renewal of TPA Registration
|
11
|
Annexure - 16
|
TPA - 8
|
Form for Annual Report by TPA and Schedule 1 to 7 under the said form TPA-8.
|
12
|
Annexure - 17
|
TPA - 6B
|
Format for Quarterly and Cumulative Claims data for TPAs
|
13
|
Annexure - 18
|
TPA - 6C
|
Annual Certificate in the matter of Working Capital and income of a TPA Company.
|
14
|
Annexure - 19
|
TPA - 6D
|
Annual Declaration and Undertaking by a TPA Company
|
15
|
Annexure - 20
|
TPA - 6E
|
Annual Form on Service Level Agreement Details
|
16
|
Annexure - 23
|
TPA – 6F
|
Periodical returns - Half-yearly information on non-insurance health schemes
|
17
|
Annexure - 25
|
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
|
TPA - 6H
|
Format for Half-yearly Information on health services rendered to foreign travel
policies issued by Foreign Insurers
|
19
|
Annexure - 28
|
TPA - 9
|
Form for intimation of opening and closing of the branches or change in office address.
|
20
|
2015-16
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
21
|
2016-17
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
22
|
2017-18
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
23
|
2018-19
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
24
|
2019-20
|
|
Public Disclosures As on 30-09-2019.
|
25
|
2019-20
|
TPA - 8
|
Disclosure of Annual Report of TPA.
|
26
|
2019-20
|
|
Public Disclosures As on 31-03-2020.
|
27
|
2019-20
|
|
Revised Annexure-18 Form TPA_6C for the FY 2019+20.
|
28
|
2020-21
|
|
Public Disclosures As on 30-09-2020.
|
29
|
2020-21
|
TPA-8
|
Disclosure of Annual Report of TPA.
|
30
|
2020-21
|
|
Public Disclosures As on 31-03-2021.
|