1.All general and health insurers registered with IRDAI rendering health services both through TPA and/or in-house shall make the captioned TPA wise public disclosures in the format specified at Annexure -1. The data in the specified format shall be duly signed by either CEO or one of the Whole Time Directors of the Insurer.
2. The information shall be published within a period of ninety days after the close of every financial year.
3. All TPAs shall provide the link of every insurance company where the said information is available. The link shall be made available in respect of the insurers with whom the TPA had a service level agreement.
4. All TPAs shall also provide the requisite data or information to the Insurers, wherever called for, in order to enable insurers publish the above information in their respective websites.
5. The policyholders desirous of knowing the details referred in annexure-1 shall be able to access all the above information on visiting the website of respective Insurer or the TPA.
6. In case of termination of services of a TPA, the Insurer shall publish the same in its website along with the reasons for termination within three days from the effective date of termination.
7. The above directions shall come into force with immediate effect and data as at 31st March, 2020 shall be published by 30th September, 2020.
8. These guidelines are issued under the powers vested with Section 34(1) of the Insurance Act, 1938 read with Regulation 3 (5) of Insurance Regulatory and Development Authority of India (Third Party Administrators – Health Services) Regulations, 2016.
9. This is issued with the approval of the Competent Authority.
