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66 THE GAZETTE OF lNDlA
INDIA : EXTRAORDINARY III— S e c . 4]
[ P a r t lll-SEc.
[PART
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68 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III— e cC.. 4]
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74 THE GAZETTE OF INDIA : EXTRAORDINARY [PART
[P a rt III-SEC.
III— S e c . 4]
4]
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[[WT.
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Ill— ~ 4]
4] ,:IT«! cfiT ~ : 3lm'l:ffi:UT *ntcT =FT TFsm ; 3TOTWT
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76 THE GAZETTE OF INDIA : EXTRAORDINARY [PA Rr III
[P art S e c.
m-— SE 4)
c . 4]
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY
NOTIFICATION
2013
Hyderabad, the 16th February, 2013
Insurance Regulatory and Development Authority

(Health Insurance) Regulations, 2013
F. No. IRDA/Reg./14/72/2013.—
IRDA/RegJt4n2/2013.-ln o f the powers conferred under Section 1114A
In exercise of o f the Insurance Act 1938 and
14A of
IRDA Act 1999 and in consultation with the Insurance Advisory Committee, the
o f the 1RDA
Section 14 read with section 26 of
Authority hereby makes the following regulations, namely:-
1. Short title and commencement.
a. These Regulations may be called Insurance Regulatory and Development Authority (Health Insurance)
2013
Regulations, 2013
b. They come
shall com
They shall e into force from
into force date oof
the date
from the f their publication in
their publication Official
the O
in the Gazette oof
fficial Gazette f the Government
the Government
off India.
o
c. Unless
Unless otherwise
otherwise provided by this
provided by nothing in
Regulation, nothing
this Regulation, this Regulation
in this shall deem
Regulation shall to invalidate
deem to the
invalidate the
health insurance contracts entered prior to these Regulations coming into force
d. and health insurers,

These Regulations are applicable to all licensed life insurers, non-life insurers and insurers,
conducting health insurance business as defined under these regulations in India.
2. Definitions. In these Regulations, unless the context otherwise requires, ~

requires,--
a. “Act” means the

"Act" means Insurance Act,
the Insurance 1938.
Act, 1938.
b. "Agreem ent" means
"Agreement" means an an agreement prescribing the
agreement prescribing terms and
the terms conditions oof
and conditions f services, which may
services, which may bebe
rendered to the holders o off health policies ooff an Insurance Company entered into between
i. a Third Party Administrator (TPA
i. (TPA)) and an insurance company ; or
ii. a Network provider and an Insurance Company, which may include a TPA as asa third party.
third party.
iii. a Network provider, a TPA, and the insurer.
c. “ "Authority"
Authority” means means the Regulatoryand
Insurance Regulatory
the Insurance Authority established
Development Authority
and Development sub
under sub
established under
section 1I ooff section 3 oofthe
f the IRDA Act 1999.
d. “ "Break policy"occurs
Break ininpolicy” endo of
theend
occursatatthe theexisting
f the term,when
policyterm,
existingpolicy premiumdue
thepremium
whenthe duefor renewalonon
forrenewal
a given policy is not paid on or before the premium renewal date or within 30 30 days thereof.
e. "Cashlessfacility”
“Cashless meansa afacility
facility"means extendedbybythe
facilityextended insurertotothe
theinsurer insuredwhere
theinsured payments,o of
thepayments,
wherethe the
f the
costs ooff treatment undergone by the insured in accordance with the policy terms and conditions, are
directly made to the network provider by the insurer to the extent pre-authorization approved. approved .
f. “"File andUse
File and UseProcedure” meansaaprocedure
Procedure"means followedfor
befollowed
proceduretotobe forhealth insuranceproduct
healthinsurance approvalby
productapproval the
bythe
Authority.
insurers in accordance with guidelines/circular issued by the Authority.
g. “"Health insurancebusiness”
Health insurance meansthe
cover" means
"healthcover”
business" oror“health effectifigoof
theeffecting insurancecontracts
f insurance provide
whichprovide
contractswhich
medical , surgical or hospital expense benefits, including assured benefits and
for sickness benefits or medical,
long-term care, travel insurance and personal accident cover.
[•RFT III— 4]
Tl
77
h. "Health Services by TPA"T P A " means the services rendered by a TPA to an insurer under an agreement in
connection with health insurance business but does not include the business of o f an insurance company or
the soliciting either directly or indirectly, ofo f health insurance business or deciding on the admissibility of of
a claim or its rejection.
i. "Health
“Health plus Life Combi Products"
Products” mean products which offer the combination of o f a Pure Term Life
Insurance cover of o f a life insurance companies and a Health Insurance cover offered by non-life and/or
standalone health insurance companies.
jj.. "Network
“Network Provider"
Provider” means hospitals or health care providers enlisted by an insurer or by a TPA and
insurer together to provide medical services to an insured on payment by a cashless facility.
k. "Portability"
“Portability” means the right accorded to an individual health insurance policyholder (including
family
fam ily cover), to transfer the credit gained for pre-existing conditions and time bound exclusions,
from one insurer to another insurer or from one plan to another plan of o f the same insurer, provided the
previous policy has been maintained without any break.
I. "Senior
1. “ Senior citizen"
citizen” .rieans
means any person who has completed sixty or more years of o f age as on the date of of
commencement or dr renewal ofao f a health insurance policy.
m. “Third
"Third Party
Party Administrators
Administrators or or TPA
TP A means
means any
any person
person who
who isis licensed
licensed under
under the
the IR
!RDA (Third Party
D A (Third Party
Administrators - Health Services) Regulations,2001 by the Authority, and is engaged, for for aa fee
fee or
or
remuneration by an insurance company, for the purposes of o f providing health services.
All words
n. All or expressions
words or expressions notnot defined
defined in
in these
these Regulations
Regulations but
but defined
defined in in the
the Insurance
Insurance Act
Act 1938
1938 oror
Insurance Regulatory and Development Authority Act 1999 shall ~hall have the same meanings respectively
assigned to them in those Acts.
3. Registration and Scope of Health Business
a. Health Insurance products may be offered only by entities with a valid registration under the Insurance
Regulatory and Development Authority (Registration of o f Indian Insurance Companies) Regulations 2001.
200 I.
b. Life
L ife Insurance Companies may offer long tenn term health products but the premium for such products shall
remain unchanged for at least a period of o f every block ofo f three years, thereafter the premium may be
reviewed and modified as necessary.
, c. NNon-Life and Standalone
on-Life and Standalone Health insurance companies
Health insurance companies may may offer
offer individual
individual health
health products
products with
with aa
minimum tenure of o f one year and aa maximum
maximum tenure
tenure ooff three
three years,
years, provided
provided that
that the
the premium
premium shall
shall
remain unchanged for the tenure.
d. Group
Group Health
Health Insurance
Insurance Policies
Policies may be offered by any insurance company, provided that all such
products shall only
only bebe one
one year
year renewable contracts. However, the non-life and standalone health
insurers may offer group personal accident products with term less than one year also to provide
coverage to any specific events.
e. Overseas or Domestic Travel Insurance policies may only be offered by non-life and standalone health
insurance companies, either as a standalone product or as an add-on cover to an existing health policy,
provided that the premium for the add-on cover is approved by the Authority under File And Use
Procedure.
4. File and Use Procedure for health insurance products
a. No health insurance product shall be marketed by any insurer unless it has the prior clearance of
o f the
Authority accorded as per the File and Use Procedure.
b. Any subsequent revision or modification of o f any approved health insurance product shall also require the
prior clearance of
o f the Authority as per the guidelines issued from time to time.
i.
1. Any revision or modification in a policy which is approved by the Authority shall be notified to
each policy holder at least three months prior to the date when such revision or modification
comes
conies into effect.
effect. The notice sha ll set out the reasons for such revision or modification,
shall modification. in
particular the reason for an increase in premium and the quantum of o f such increase.
ii.
11. The possibility a revision or modifi cation ooff the terms of
modification o f the policy including the premium must
be disclosed in the prospectus.
c. File & Use application for the prior approval of

o f the Authority shall be certified by the Appointed
Actuary and the CEO of
o f the insurance company and shall be in such fonnats
formats and accompanied by such
documentation as may be stipulated by the Authority from time to time.
II ............ ■• ■. . •- ...I:.. ■ . .:...

/
/
J
78' THE GAZETTE OF INDIA : EXTRAORDINARY [PART
[Iâ rt III-SEC.
III— S e c . 4]
d. Insurance Product
Withdrawal of Health lnsunrnrc
i. To withdraw
To withdraw aa health
health insurance
insurance product,
product, the
the insurer
insurer shall
shall take
take prior
prior approval
approval ooff the
the Authority
Authority
by giving reasons for withdrawal and complete details of o f the treatment to the existing ,-
policyholders.
ii. The
The policy
policy document
document shall
shall clearly
clearly indicate
indicate the
the possibility
possibility ooff withdrawal
withdrawal ooff the
the products
products in
in the
the
future and the options that would be available to the policyholder on withdrawal of o f the
products.
iii. IIf the existing

f the existing customer
customer does
does not
not respond
respond to
to the
the insurer’s
insurer's intimation,
intimation, the
the policy
policy shall
shall be
be
withdrawn on the renewal date and the insured shall have to take a new policy avail~le available with
the insurer, subject to portability
pottability conditions.
iv. The withdrawn

The withdrawn product
product shall
shall not
not be
be offered
offered to
to the
the prospective
prospective customers.
customers.
e. All particulars of
o f any product shall after introduction be reviewed by the Appointed Actuary at least
once a year. If I f the product is found to be financial unviable, or is peficient
deficient in any particular the
Appointed Actuary may revise the product appropriately and apply for revision under File and Use
procedure.
f. Five years after a product has been accorded File and Use approval, the Appointed Actuary shall review
the performance of o f the product in terms of
o f morbidity, lapse, interest rates, inflation, expenses andj
an^ other
relevant particulars as compared to the original assumptions made while designing such product and
seek fresh approval with suitable justifications or modifications ofo f the earlier assumptions made.
5.
5. General Provisions relating to Health Policies
Ge~eral j
a. Health insurance product may be designed to offer various covers
i. To
To specified
specified age
age or
or gender
gender groups
groups
ii. To
To different
different age
age groups
groups
iii. To
To treatment
treatment in
in all
all hospitals
hospitals throughout
throughout the
the country,
country, provided
provided the
the definition
definition oof hospital isis met
f hospital met
1v.
iv. To treatment in specified hospitals only, provided
provide~ the morbidity rates used are representative
v. To treatment in specified geographies only, provided the morbidity rates used are representative
etc
i
provided, such specifications are disclosed upfront and cle~rly

clearly in the product prospectus, documents and
sale process.
b. Insurer shall not compel the insured to migrate to other health insurance products, if it is to the
disadvantage of
o f insured.
c. Insurers shall ensure adequate dissemination of o f product information on all their health insurance
products on their websites. This information shall include a description of
o f the product, copies of
o f the
prospectus as approved under the File and Use Procedure, proposal form, policy document wordings and
premium rates inclusive and exclusive of
o f Service Tax as applicable.
d. Nomination and Assignment •

1.i. All health insurance policies shall provide for a nomination registered at the time of
o f the
proposal in accordance with Section 39 of
o f the Insurance Act, 1938.
ii.
11. No assignment of o f health insurance policies shall be allowed irrespective of
o f whether the
coverage provided under such policies are indemnity based or benefit based. Provided that, in
Life-Health Combi products, assignment may be allowed only for the life insurance component
of
o f the product in accordance with Section 38 of
e. Entry and Exit Age
i. Except
Except as
as provided
provided forfor in regulation j,
in regulation j , all
all health
health insurance
insurance policies
policies shall
shall ordinarily
ordinarily provide
provide for
for
an entry age of
o f at least up to 65 years.
[ ’TFT III— 4] nrer ^ t TT3TO : smrwm 79
ii. Except
Except travel
travel insurance
insurance products
products and for products
products in accordance
accordance with Regulation jj and 44 (d)
with Regulation (d)
herein, once a proposal is accepted and a policy is issued which is thereafter renewed
periodically without any break, further renewal shall not be denied on grounds (>fthe
p f the age of
o f the
insured.
f. Renewal of Policies
i. A health insurance policy shall ordinarily be renewable except on grounds of

o f fraud, moral
hazard or misrepresentation or non-cooperation by the insured.
ii. The re!1~wal

renewal of
o f a health insurance policy sought by the insured shall not be denied arbitrarily. If
If
denied, the insurer shall provide the policyholder with cogent reasons for such denial of of
renewal.
iii.
111. A insurer shall not deny the renewal of
o f a health insurance policy on the ground that the insured
had made a claim or claims in the previous or earlier years, except for benefit based policies
where the policy terminates following payment of o f the benefit covered under the policy like
critical illness policy following payment of
o f the critical illness benefit, the policy terminates.
1v.
iv. The insurer shall provide for a mechanism to condone a delay in renewal up to 30 days from the
due date of
o f renewal without deeming such condonation as a break in policy. However coverage
need not be available for such period.
v.
v. The promotion material and the policy document shall explicitly state the conditions under
which a policy terminates, such as on the payment of
o f the benefit in case of
o f critical illness
benefits policies.
policies.
g. Free Look Period
i. All
All Health
Health insurance
insurance Policies
Policies shall
shall have
have aa free
free look
look period.
period. The
The free
free look
look period
period shall
shall be
be
applicable at the inception of
o f the policy and:
I.
1. The insured will be allowed a period of
o f at least 15 days from the date of
o f receipt of
o f the
policy to review the terms and conditions of o f the policy and to return the same ifi f not
acceptable
2. If
I f the insured has not made any claim during the free look period, the insured shall be
entitled to-
a. A refund of
o f the premium paid less any expenses incurred by the insurer on
medical examination of
o f the insured persons and the stamp duty charges or; or;
b. where
where the
the risk
risk has
has already
already commenced
commenced and
and the
the option
option oof return oof
f return the policy
f the policy
is exercised by the policyholder, a deduction towards the proportionate risk
premium for period on cover or;
c. Where
Where only
only aa part
part oof the risk
f the risk has
has commenced,
commenced, such
such proportionate
proportionate risk
risk
premium commensurate with the risk covered during such period.
d. In respect of
o f unit linked policy, in addition to the above deductions, the
insurer shall also be entitled to repurchase the unit at the price of
o f the units as
on the date of
o f the return of
o f the policy. (
/"
h. Cost of pre-insurance health check up
i. The
The cost
cost of
o f any
any pre-insurance
pre-insurance medical
medical examination
examination shall
shall generally
generally form
form part
part of
o f the
the expenses
expenses
allowed in arriving at the premium. However in case of o f products with term of o f one year and less,
if
i f such cost is to be incurred by the insured, not less than 50%
5 0 % of
o f such cost shall be borne by
the insurer once the proposal is accepted, except in travel insurance policies where such costs
need not be reimbursed.
80 THE GAZETTE OF INDIA : EXTRAORDINARY [PP,RT
[Part III- III— SEC.
S e c . 4]
------ i,-------------------------
Insurers shall
ii. Insurers shall maintain
maintain aa list
list of,
of, and
and the
the fees
fees chargeable
chargeable by,
by, institutions
institutions where
where such
such pre
pre-
insurance medical examination may be conducted, the reports from which will be accepted by
them. Such list shall be furnished to the prospective policyholder at the time of pre:insurance
o f pre-insurance
medical examination.
•
i. Cumulative bonus
i.
1. Insurers may offer cumulative bonuses on indemnity based health insurance policies, which
shall be stated explicitly in the prospectus and the policy document.
ii. If
I f a claim is made in any particular year, the cumulative bonus accrued may be reduced at the
same rate at which it is accrued;
f
iii. Cumulative bonus shall not be allowed on benefit based policies,

policies.
j. Option to migrate to suitable health insurance policy
i.
1. Insurers
Insurers offering
offering health
health covers
covers specific
specific to
to age
age groups
groups such
such as
as maternity
maternity covers,
covers, children
children under
under
family floater policies, students etc, shall offer an option to migrate to a suitable health
insurance policy at the end of
o f the specified exit age or at the renewal ofo f the policy by providing
suitable credits for all the previous policy years, provided the policy has been maintained
without a break. rf
k. All health insurance policies shall allow the portability of
o f any policy in accordance with Schedule: 1 1
I.1. AYUSH
A YUSH Coverage:
i.
1. Insurers may provide coverage to non-allopafhic treatments provided the treatment has been
undergone in a government hospital or in any institute recognized by government and/or
accredited by Quality Council of
o f India/National Accreditation Board on Health or any other
suitable institutions.
ii.
11. For benefit based products, (i) sh al I not be applicable.
shall applicable,
ni. Disclosures/Declarations:
m.
i.
1. Subject
Subject to
to the
the' provisions
provisions of
o f these
these regulations,
regulations, prospectus
prospectus of
o f health
health insurance
insurance policy
policy shall
shall
mandatorily contain all the information regarding: *'
disclosures about
1. disclosures aboutthe
theterms
termsoof itsrenewal.
f its renewal.
2. coverageand
coverage and premium
premium applicable
applicableasa'iper
perthe
the'age
•ageprogression
progression
3. disclosure
disclosureoof themaximum
f the maximum age
ageup
uptotowhen
whenthe
therenewal
renewal would
wouldbebeavailable,
available, i fif product
product
is offered to specified age groups and the option available to migrate to other policies
policies
in all such cases.
4. any changes
any changes in
in the
the scope
scope ooff the
the cover
cover after
after certain
certain duration
duration ooff the
the policy
policy or
or after
alter aa
ce1tain age- such as including but not limited to coverage for pre-existing diseases;
certain .
5. whether renewal
5. whether renewal premium
premium would
would be
be guaranteed
guaranteed or
or subject
subject to
to revision;
revision;
6. details ooff specific

details specific circumstances,
circumstances, ifif any.
any. where
where premium
premium could
could be
be loaded
loaded (or
(or discount
discount
withdrawn) by the insurer and also to the extent to which it could be done;
7. procedure
procedureand
andterms
termsfor
forenhancing
enhancingthe
thesum
suminsured
insuredororscope
scopeoof
f ccover,
o v e r, i fifany;
any;
8. all
allthe
theexclusions,
exclusions.cancellation
cancellationconditions
conditionsand
and
9. other aspects in accordance with the extant regulations, guidelines, circulars etc on
advertisements and disclosure requirements.
[[ *~WT
F T III-
I I I — '(9U.S 4]
4] W TRT? : 3T O T W T 81
8!
ii. Declarations
Declarations shall
shall only
only form
form part
part oof the proposal
f the proposal form
form and
and shall
shall not
not be
be included
included in
in the
the policy
pol icy
document. The standard declarations in the proposal form shall be:
I “"I/We hereby declare,

I/We hereby declare, onon my
my behalf
behalf and
and on
on behalf
behalf ooff all
all persons
persons proposed
proposed to
to be
be
• insured.
insured, that the above statements, answers and/or particulars given by me are true and
complete in all respects to the best ofo f my knowledge and that I/We am/are authorized
to propose on behalf of
o f these other persons.
,.,2. I Iunderstand
understandthat
thatthe
theinformation
informationprovided
providedby
byme
mewill
willform
formthe basisoof
thebasis theinsurance
f the insurance
policy, is subject to the Board approved underwriting policy of
o f the insurance company
and that the policy will come into force only after full receipt of o f the premium
chargeable.
3. I/ We further declare that I/we will notify in writing any change occurring in the
I/We
occupation or general health of
o f the life to be insured/proposer after the proposal has
been submitted but before communication of o f the risk acceptance by the company.
4. I/We declare
I/We declare and
and consent
consent to
to the
the company
company seeking
seeking medical
medical information
information from
from any
any
doctor or from a hospital who at anytime has attended on the life to be
insured/proposer or from any past or present employer concerning anything which
affects the physical or mental health of o f the life to be assured/proposer and seeking
information from any insurance company to which an application for insurance on the
life to be assured/proposer has been made for the purpose of o f underwriting the proposal
and/or claim settlement.
5. I/We authorize
I/We authorize the
the company
company to
to share
share information
information pertaining
pertaining to
to my
my proposal
proposal including
including
the medical records for the sole purpose of o f proposal underwriting and/or clai ms
claims
settlement and with any Governmental and/or Regulatory authority."
authority.”
n. Standard Definition of terms in health insurance policies
i.
1. Phrases and terms used in all health insurance policies shall carry the meaning attached to them
as set out in 'Standard
‘ Standard Definitions',
Definitions’, if
i f any, issued by the Authority from time to time.
o. Standard Nomenclature and Procedures for Critical Illnesses
i. The
The nomenclature
nomenclature and
and procedures
procedures incorporated
incorporated into
into policies
policies offering
offering 'critical
‘ critical illness
illness cover'
cover’
shall be as defined by the Authority from time to time.
p. Standard List of Excluded Expenses in Hospitalization Indemnity policies
i. Hospitalization indemnity policies shall generally exclude from cover the Standard list of
of
excluded items as may be stipulated by the Authority from time to time.
ii.
11. However insurers may offer to cover as part of o f hospitalization expenses, items in the Standard
excluded list or exclude items not in the list, provided that such modification is shall clearly
stated and such modified list is annexed to the policy document.
q. Special Provisions for Insured Persons who are Senior Citizens
i. The premium charged for health insurance products offered to senior citizens shall be fair,
justified, transparent and duly disclosed upfront. The insured shall be informed in writing of
of
any underwriting
unden"riting loading charged over and above the premium and the specific consent ofo f the
policyholder for such loadings shall be obtained before issuance ofa
o f a policy.
ii. All health insurers and TPAs, as the case may be, shall establish a separate channel to address
the health insurance related claims and grievances of
o f senior citizens.
r. Multiple Policies
i. lftwo
I f two or more policies are taken by an insured during a period from one or more insurers, the
contribution clause shall not be applicable where the cover/benefit offered:
f6°
6 6 ° Gt/ ri - ..21
82 THE GAZETTE OF INDIA : EXTRAORDINARY [[PART
P a rt Ill- -SEC.
III— S e c . 4]
I.
1. is fixed
is nature;
in nature;
fixed in
2. does
does not
not have any relation
have any the treatment
to the
relation to costs;
treatment costs;
ii. In case of off the insured event

o f multiple policies which provide fixed benefits, on the occurrence o
11.
claim
in accordance with the terms and conditions ooff the policies, the insurer shall make the claim •
payments independent o off payments received under other similar polices.
iii.
111. IIff two or more policies are taken by an insured during a period from one or more insurers to
indemnify treatment costs, the insurer shall not apply the contribution clause, but the
policyholder shall have the right to require a settlement ooff his claim in terms ooff any ooff his
policies.
1.
I. In all such
In all the insurer
cases the
such cases who has
insurer who the chosen
issued the
has issued policy shall
chosen policy obliged to
be obliged
shall be settle
to settle
the claim without insisting on the contribution clause as long as the claim is within the
o f and according to the terms o
limits of off the chosen policy.
2. If
If the
the amount to be
amount to claimed exceeds
be claimed the sum
exceeds the insured under
sum insured single policy
under aa single after
policy after
choose
considering the deductibles or co-pay, the policy holder shall have the right to choose
insurers by whom the claim to be settled. In such cases, the insurer may settle the
claim with contribution clause.
clause.
Except in
3. Except
3. benefit policies,
in benefit in cases
policies, in where an
cases where insured has
an insured policies from
has policies more than
from more one
than one
insurer to cover the same risk on indemnity basis, the insured shall only be
indemnified the hospitalization costs in accordance with the terms and conditions ooff
the policy.
6. Underwriting
a. All Company's shall

Insurance Company’s
All Insurance shall evolve Health Insurance
evolve aa Health Underwriting Policy
InsuranceUnderwriting which shall
Policy which approved
be approved
shall be
by the Board o off the Company. The policy should among other matters prescribe the proposal form in
which prospects may apply for purchasing a Health Policy. Such form should capture all the information
necessary to underwrite a proposal in accordance with the stated Policy o off the Company.
b. The Underwriting
The Policy shall
Underwriting Policy filed with
be filed
shall be Authority.The
the Authority.
with the Company retains
The Company the right
retains the modify the
to modify
right to the
Policy as it deems necessary, but every modification shall also be filed with the Authority.
c. Any
Any proposal
proposal for
for health insurance may
health insurance may be accepted or
be accepted denied wholly
or denied based on
wholly based the Board
on the approved
Board approved
underwriting policy. A denial of o f a proposal shall be communicated to the prospect in writing, recording
the reasons for denial.
ct.
d. The
The insured
insured shall
shall be informed oof
be informed f any underwriting loading
any underwriting over and
charged over
loading charged above the
and above premium and
the premium the
and the
specific consent ooff the policyholder for such loadings shall be obtained before issuance ooff a policy.
e. IIf
f an
an insurance
insurance company requires any
company requires further information,
any further such as
information, such change oof
as change f occupation, any
occupation, atat any
subsequent stage o off a policy or at the time ooff its renewal, it shall
i.
1. prescribe standard forms
prescribe standard be filled
to be
forms to up by
filled up insured and
the insured
by the shall make
and shall part oof
forms part
these forms
make these the
f the
policy document
ii. Clearly
Clearly state
state the which will
events which
the events submission oof
the submission
require the
will require f such information.
such information.
iii.
111. Clearly
Clearly state
state the
the conditions in such
applicable in
conditions applicable event.
such event.
f. Insurers
Insurers may
may devise
devise mechanisms incentives toto reward
mechanisms oror incentives for early
policyholders for
reward policyholders continued
entry, continued
early entry,
mechanism
renewals, favourable claims experience etc with the same insurer and disclose upfront such mechanism
or incentives in the prospectus and the policy document, as approved under FileFile and Use.
7. Principles of Pricing of Health Insurance Products
premiumfor
Thepremium
a. The insurancepolicy
healthinsurance
for aahealth bebased
shallbe
policyshall on,
basedon,
i. for individual
for individual policies, completed age
the completed
policies, the o f the
age of on the
prospect on
the prospect date of
the date inception of
o f inception the policy
o f the policy
or on the date ofo f its renewal..
['IWT Ifl- ~0 ^ 4]
[ ’TFT III—' *tKcT TTJTClf : 3TO TW JT 83
ii. for under famil

o f cover under
for provision of family floater, the impact of
y floater, o f all
o f the multiple incidence rates of
family members proposed to be covered.
policypremiums
Thepolicy
b. . .The unchanged
shallbebeunchanged
premiumsshall
i. for all
for group products
all group and travel
products and insurance products,
travel insurance for the
products, for entire period
the entire o f cover.
period of cover.
11.
ii. for all
for individualand
all individual familyfloater
andfamily products,other
floaterproducts, thantravel
otherthan insuranceproducts,
travel insurance least:
products, for at least:
I.
1. a period of o f one year renewable policies and
o f one year in case of
2. for the period of and 3(c)

o f the tenure as stipulated in Regulations 3 (b) and herein in the
3(c) herein the
policies ..
off multi-year policies..
case o
c. For period oof

Foraaperiod f three afteraaproduct
years after
threeyears has been
producthas under File
cleared under
been cleared and Use
Fileand Procedurethe
UseProcedure premiums
the premiums
filed shall ordinarily not be changed. Thereafter the insurer may vary the premium rates depending on
experience, such rate shall not be changed for a period ooff at least one year from the date ooff clearance
the experience,
from the Authority.
d. Changes rates will

Changes inin rates applicable from
be applicable
will be date oof
the date
from the approval by
f approval bythe Authority and
the Authority be applied
shall be
and shall only
applied only
prospectively thereafter for new policies and at the date of renewals.
o f renewal for renewals.
e. The reasonableness oof

The reasonableness the pricing
f the as arrived
pricing as by the
arrived atat by insurer will
the insurer be assessed
will be having regard
assessed having the
regard toto the
financial sustainability and viability o off the product with respect to the rates, loadings, guarantees and
discounts, and the accuracy o off the assumptions underlying the pricing model adopted.
f. At timeoof
thetime
Atthe f filing the product
filingthe underthe
product under and Use
File and
the File procedure,the
Use procedure, insurershall
the insurer provide:
shall provide:
i. complete pricing details including the methodology adopted to arrive at the premiums, together
with the data sources utilized;
ii. claim frequency and claim severities across age

assumptions made shall include the expected claim
bands, expected expenses, lapse rates etc;
etc;
111.
iii. specific loadings, if any, allowed;
iv.
iv . the profit margin at various model points or the expected loss ratios and the expected combined
ratios across various model points across the entire portfolio;
v.
v. the underwriting capacity required for the product and the actual capacity available with the
insurer;
vi. the retention capacity to manage the business
vii .
vii. measures. iiff any, required to offer the proposed product and
internal capacity building measures,
v111.
viii. any other relevant metric for the product proposed.
g. Applications
Applicationsfor revisionoof
forrevision f premium ratesshall
premiumrates befiled
shallbe theAuthority
beforethe
filed before forapproval
Authorityfor underthe
approvalunder File
theFile
and Use Procedure and shall encompass
i. justification for the revision in price;

the justification
ii.
11 . the claims experience ooff the three immediately preceding years compared to the expected
experience duly explaining the variations, and the experience o similar
off any sim ilar product.
iii.
111. the expected claims experience, the assumptions underlying the proposed pricing along with an
o f how the proposed pricing would address the adversities experienced sustainably.
analysis of
h. Loadings
Loadingson Renewals:
onRenewals:
1.i. The loadingson

Theloadings renewalsshall
onrenewals beininterms
shall be o fincrease
termsof ordecrease
increaseor premiumsoffered
decreaseininpremiums forthe
offeredfor the
claim experience.
entire portfolio and shall not be based on any individual policy claim
84
84 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III— S e c . 44)]
[ P a rt lll-SEc.
11.
ii. The
The discounts
discounts and
and loadings
loadingsoffered
offered shall:
shall:
I.
1. not be
not be at
at the
the discretion
discretion oof the insurer;
f the insurer;
2. be based
be based on
on an
an objective
objective criteria;
criteria;
3. be disclosed upfront in the prospectus and policy document along with the objective
•
criteria, and shall be as approved under the File and Use.
i. Upper Limit/Maximum Cover offered under a contract:
i. If
I f in
in aa benefit
benefit based
based health
health insurance
insurance policy
policy the insurer has
the insurer has prescribed
prescribed any
any upper
upper limit
limit for
for any
any
specified benefit or cover, the insurer shall not accept accept any
any proposal
proposal for
for aa cover
cover beyond
beyond suchsuch
upper limit, unless the premium for such cover is separately
separately charged.
charged.
11.
ii. Complete
Complete pricing
pricing details
details on
on how
how such
such inbuilt limits are
inbuilt limits are considered
considered in
in arriving
arriving atat the
the total
total
premium shall be provided under the File and Use.
111.
iii. If
I f any
any proposal
proposal is
is accepted
accepted beyond
beyond such
such upper
upper limit,
limit, the
the insurer
insurer shall
shall not
not deny claimon
deny aclaim on the
the
ground that the policy exceeds the upper limit prescribed for that policy.
1v.
iv. However,
However, the
the insurer
insurer may
may cancel
cancel the
the cover beyond such upper
upper limit and shall return
andshall return the
the
proportionate premium, provided that
I.
1. the policyholder, at the time o off proposal, has not disclosed the existing and
simultaneous policy details in the proposal form and
2. the existence of
o f such policy is revealed only subsequently resulting in the cover
accepted beyond the upper limit, and
3. Such other policy has been underwritten by another insurance company.
8. Protection of Policyholders'
Policyholders’ Interest
a. Unless otherwise provided, the IRDA (Policyholder Protection ooff Interest) Regulation, 22002
0 0 2 is
applicable to all health insurance policies.
b. Every insured shall be provided with a Key Information Sheet setting out in simple language briefly but
clearly all the important features of
o f the policy, its claim limits, disallowances. The authority may
prescribe such document.
c. The insurer shall establish necessary systems, procedures, offices and infrastructure to enable efficient
issuance of
o f pre-authorisations on a 24 hour basis and the prompt settlement o
off claims and grievances.
d. Settlement/Rejection of claim by insurer:
i.
1. An insurer shall settle claims, including its rejection, within thirty days ooff the receipt ooff the last
'necessary'
‘necessary’ document.
ii. Except in cases where a fraud is suspected, ordinarily no document not listed in the policy
terms and conditions shall be deemed ‘necessary’
'necessary'.. The insurer shall ensure that all the
documents required for claims processing are called for at one time and shall not call for the
documents in a piece meal manner.
iii.
111. The infonnation
information that the insurer has captured in the proposal form at the time ooff accepting the
proposal, the terms & & conditions offered under the policy, the medical history as revealed by
earlier claims, if any, and the prior claims experience shall all be maintained by the insurer as
an electronic record and shall not be called for again from the policyholder/insured at the time
of
o f subsequent claim settlements. If called, for such information
infomrntion will not be deemed ‘necessary.’
'necessary.'
1v.
iv. If
I f the claim event falls within two policy periods, the claim
claimss shall be paid taking into
[ ’ TFT I I I — T s F 5 4 ] ’ TKfl ^fST W T S f : 3rarsrRDT 85
85
consideration the available sum insured in the two policy periods, including the deductibles for
claim amount to be payable to the insured shall be reduced to
each policy period. Such eligible claim
the extent of off premium ooff health insurance
o f premium to be received for the renewal/due date o
policy, iiff not received earlier.
Insurer may
v. Insurer stipulate aa period
may stipulate which all
within which
period within necessary claim
all necessary documents should
claim documents furnished
be furnished
should be
by the policyholder/insured to make a claim claim.. However, claims filed even beyond such period
should be considered iifthere
f there are valid reasons for any delay.
e. Minimum Disclosures in Policy Document: In addition to the requirements stipulated in IRDA IRDA
o f Policyholders'
(Protection of 2000 the policy document shall contain:
Policyholders’ Interest) Regulations, 2000
List oof
1.i. List f disclosures required as
disclo~ures required perthis
as per regulation.
this regulation.
ii. Procedure
11. claims submission,
for claims
Procedure for time lines
submission, time and possible
lines and course oof
possible course action, iif
f action, time lines
f time for
lines for
claim submission are not adhered to along with all the claim claimss documents required for claimclaim
processing.
processing.
iii. Sub-limits applicable on

Sub-limits applicable any oof
on any f the covers offered
the covers the health
offered inin the insurance product
health insurance the
and the
product and
o f such sub-limits on other covers provided in the product, if
impact of if any, shall be clearly spelt
out.
iv. Penal
1v. interest provision
Penal interest shall invariably
prov1s1on shall be incorporated
invariably be in the
incorporated in policy document
the policy per
as per
document as
o f (Protection of
9 (6) of(Protection
Regulation 9(6) Policyholders' Interests) Regulations, 2002.
o f Policyholders’
v. The TPA(s)
The TPA (s) details, any along
details, ifif any with complete
along with address and
complete address contact numbers
and contact shall be
numbers shall attached
be attached
1 to the
to document and
policy document
the policy shall be
and shall updated as
be updated when there
and when
as and change in
there isis aa change the TPA
in the (s).
TPA (s).
9. Administration of Health Policies
a. Subject to
Subject the terms
to the f aa policy,
terms oof insurers shall
policy, insurers all policy
extend toto all
shall extend holders aa cashless
policy holders facility for
cashless facility treatment atat
for treatment
specified establishments or the reimbursement ooff the costs ooff medical and health treatments or services
availed at any medical establishment.
b. Cashless facility
Cashless shall be
facility shall offered only
be offered at establishments
only at have entered
which have
establishments which into an
entered into Agreement with
an Agreement the
with the
insurer to extend such services. Such establishments will be termed as Network Providers. Reimbursement
shall be allowed at any medical establishment. All such establishments must licensed or
mustbebelicensed as may
registered as
or registered may
applicable.
be required by any Local, State or National Law as applicable.
c. administration oof
The administration
The all health
f all plus life-combi
health plus products shall
life-combi products be inin accordance
shall be with the
accordance with provisions oof
the provisions f
Schedule II to this Regulation as may be amended from time to time by the Authority.
d. Except
Except inin emergencies cashless facility
emergencies aa cashless may require
facility may Pre-Authorisation toto be
require aa Pre-Authorisation issued by
be issued the Insurer
by the an
or an
Insurer or
appointed TPA to the Network Provider where the treatment is to be undergone. The Authority may may
prescribe a Standard Pre-Authorisation form and standard reimbursement claim claimss forms which shall be used
for this purpose, as applicable.
To avail
e. To benefit oof
the benefit
avail the cashless facility,
f cashless insurers shall
facility, insurers an Identification
issue an
shall issue the insured
Card toto the
Identification Card within 15
insured within 15
days from the date o off issue oofa
f a policy, either through a TPA TPA or directly.
f. The identification
The shall, atat the
card shall,
identification card minimum, carry
the minimum, details oof
carry details the policyholder
f the and the
policyholder and logo oof
the logo f the insurer.
the insurer.
The validity of
o f card shall coincide with the term o renewed from time to time.
off the policy and mayasrenewed Insures
time. Insures
may issue a Smart Card instead of o f an Identity Card.
Where aa policyholder
g. Where has been
policyholder has pre-authorisation for
issued aa pre-authorisation
been issued theconduct
forthe f aa given
conduct oof given
procedure inin aa given
given procedure
hospital or if the policyholder is already undergoing such treatment at a hospital, and such hospital is
proposed to be removed from the list of o f Network Provider, then insurers shall provide the benefits o cashless
off cashless
facility to such policy holder as iiff such hospital continues to be on the Network Provider list.
,660 G:1./13-:),1
86 INDIA : EXTRAORDINARY
THE GAZETTE OF INDIA: P a r t T I I — S e c . 44]]
[[PAKr'lll-SEC.
h. Insurer
insurer shall
shall keep
keep the
the insured
insured informed
informed oof the list
f the list oof Network Providers
f Network Providers and
and display
display the
the same
same on
on their
their website
website
and the appointed T TPA's
P A ’s office. Such list shall be updated as and when there is any change in the Network
providers.
i. The insured
The insured shall
shall have
have access
access to
to all
all the
the Network
Network Providers
Providers oof an insurer
f an insurer to
to avail
avail cashless
cashless facility
facility as
as long
long as
as
the insurer has a valid service agreement with the Network Provider and such Network Providers shall
remain unchanged irrespective of o f change in TP
T P As.
jj.. An insurance company may enter into arrangement with other insurance companies for sharing of o f Network
Providers, transfer of
o f claim & transaction data arising in areas beyond their service areas.
'/
t
IO: Agreement between Insurers, Network Providers and TPAs

10: TP As
a. Insurance companies may offer policies providing cashless services to the policyholders provided:
i.
1. The services are offered in network providers who have been enlisted to provide medical
services either directly under an agreement with the insurer or by an agreement between health
services provider, the TPA and the insurer.
ii. The Authority may, from time to time, prescribe clauses to be included in such agreements as
f
stipulated in (b). j
iii. the Agreements which shall be entered into between insurers, network providers/TP
providers/TPAs
As shall
cover the following

follow ing amongst others:
1.
1. the ta
the tariff applicable with
riff applicable with respect
respect to
to various
various kinds
kinds ooff healthcare
healthcare services
services being
being provided
provided
by the network provider.
2. aa clause
clause empowering
empowering the
the insurer
insurer to
to cancel
cancel or
or otherwise
otherwise modify
modify the
the agreement
agreement in
in case
case
of
o f any fraud, misrepresentation, inadequacy of
o f service or other non-compliance or
default on the part of

o f TP
TPAA or network provider; provided no such cancellation or
modification shall be done by the insurer unless the concerned TP
modifi~ation A/ network provider
TPA/
is given an opportunity of
o f being heard.
3. aa standard
standard clause
clause providing
providing for
for continuance
continuance oof services by
f services by aa network
network provider
provider to
to the
the
insurance company if the TPA is changed or the agreement with TPA is terminated.
4.
4 . aa clause
clause providing
providing for
for opting out oof
opting out network provider
f network provider from
from aa given
given TP
TPAA for
for reasons
reasons oof
f
inadequacy of
o f service rendered by the TPA
TP A to the network provider.
5. aa clause
clause specifying
specifyingthe
the fees
fees and
and other
other charges
charges leviable
leviable by
by an
an insurance
insurance company
company to
to the
the
TPA for services rendered.
6. aaclause
clausespecifically
specificallyrequiring
requiringonly
onlythe
the insurance
insurancecompany
companythe
the power
powertotodeny
deny aaclaim.
claim.
7. aa clause
clause enabling
enabling insurer
insurertoto inspect
inspectthe
the premises
premises oof the network
f the network provider
provider atat any
any time
time
without prior intimation.
b. The Authority
The Authority may
may from
from time
time to
to time
time prescribe
prescribe standard
standard clauses
clauses to
to be
be included
included in
in such
such agreements.
agreements.
c. The insurance
The insurance company
company shall endeavour toto enter
shall endeavour enter into
into Agreements
Agreements with
with adequate
adequate number
number oof both public
f both public
and private sector providers with adequate geographical spread.
Payments to Network
11. Payments Network Providers
Providers and Settlement
Settlement of
of Claims
Claims of Policyholders:
Policyholders:
a. For the
For the purpose
purpose oof claim settlement,
f claim settlement, insurer
insurer shall
shall make
make direct
direct payments
payments to
to the
the Network
Network provider
provider and
and to
to
the policyholders by integrating their banking system platform with the network provider or the insured,
III— ~ 44]
'IWI III-
[[*TFT ] ’ TITcT T R q jJ : 87
as the case may be. Provided that, iiff a claimant opts for payment through a cheque or Demand Draft, the
insurer shall not deny such request.
12. Services offered by

bv TPA in relation to Health Insurance Policies
' a.a. The

Theinsurer mayenter
insurermay intoanan Agreement
enterinto provisionoof
theprovision
forthe
Agreementfor definedservices
f defined with aa TP
services with TPA holding aa
A holding
lRDA (Third Party Administrators) Regulations, 2001 as may
valid license issued in accordance with the IRDA
be amended from timtimee to time.
b. The services offered by a TPA shall not include
i. Claim settlements and rejections with respect to the health insurance policies; However, TPATPA
payment of
may handle claims admissions and recommend to the insurer for the payment the claim
o f the claim
to the
settlement, provided a detailed guideline is prescribed by the insurer to for claims
TPA for
the TPA claims
assessments && admissions in terms ooff capacity requirements, internal control requirements,
claim
claim assessment && admissions procedure requirements etc under the agreement.
ii.
ii . Any services directly to the policyholder or insured or to any other person unless such service is
in accordance with the terms and conditions o off the Agreement entered into with the insurer.
c. The TP A shall have in place the infrastructure necessary to extend the health services as required to the
TPA
policyholders at all times.
d. Settlement and Denial of Claims:
i. All documents submitted to TPA shall be electronically collected and shall be forwarded to the
claim rejections.
lnsurers for taking a decision on the claim settlements or claim
Insurers
ii. TPA
TPA shall, in the correspondence to the policyholder with respect to settlement/denial ooff the
following :
claims, state clearly the following:
“As oer the instructions of

" As per o f the insurer <Name o off the Insurer>. the claim is being
settled/denied for Rs. <amount> on account of o f <specifics of
o f treatment/grounds o f denial>.
treatment/Rrounds of denial>.
insurer."
clarifications. you may directly contact the insurer.”
For any further clarifications,
iii.
111. The above statement shall form the mandatory part o to the
sent to
off the communication toto be sent the
off settlement or denial ooff the claims.
policyholder in every case o
iv.
1v. The insurer and the TPA shall be responsible for the proper and prompt service to the
policyholders at all times.
e. Bar on Non-insurance healthcare schemes
i. The TPA
The TPA shall offer health
shall offer services only
health services in accordance
only in with the
accordance with (Third Party
IRD A (Third
the IRDA Party
Administrators) Regulations, 2001 and shall not provide any services:
1. directly or indirectly to non-insurance healthcare schemes or
2. directly to health insurance schemes promoted, sponsored or approved entities not

approved by entities not
being insurance companies, such as Governments, PPSU's
S U ’s etc.
3. directly or indirectly to the policyholder or insured, except the health services as per
the agreement with the insurer.
1 3 .. Agreement between a TPA and an Insurance company

13
a. The insurer and the TP

TPAA shall themselves define the scope ofo f the Agreement, the health and related
TP A and the remuneration therefor. Provided that there shall be a
services that may be provided by the TPA
clause in the Agreement for its termination by either party on grounds ooff mutual consent or any fraud,
misrepresentation, inadequacy ooff service or other non-compliance or default fraud. Provided further
that, there shall be no element in the Agreement which dilutes, restricts or otherwise modifies the
88 THE GAZETTE OF INDIA : EXTRAORDINARY [PART lII- SSEC.
[P art til— ec. 4]
stipulations of
o f the IRDA in respect of
o f Policy Holder welfare, protection, service standards and turn-
turn
around-time parameters. ·
b. The remuneration to the TPA shall be based on the services rendered to the insurer and shall not be
related to the product/policy experience or the reduction of
o f claim costs or loss ratios of
o f the insurer.
c. A copy of
o f the Agreement entered into between the TPA and the Insurance Company or any modification
thereof, shall be filed, within 15 days of
o f its execution or modification, as the case may be, with the
Authority.
d. More than one TPA may be engaged by an insurance company and, similarly, a TPA can serve more
than one insurance company.
e. T-he
The Authority from time to time may prescribe minimum standard clauses to be included in the
agreement between insurer and TP A.

TPA.
14. Change of TPAs

TP As for servicing of Health Insurance Policies
a. A change in the TPA by the insurer shall be communicated to the policyholders 30 days before giving
effect to the change.
b. The contact details like helpline numbers, addresses, etc. of o f the new TPA shall be made immediate~
immediately
available to all the policyholders in case of
o f change of
o f TPA.
c. The insurers shall take over all the data in respect of

o f the policies serviced by the earlier TPA and make
sure that the same is transferred seamlessly to the newly assigned TPA, i f any. It shall be ensured that no
TPA , if
inconvenience or hardship is caused to the policyholders as a result of o f the change. In this regard, the
following aspects shall receive special attention:
i. Status of
o f cases where pre-authorization has already been issued by existing TPA.
ii. Status of
o f cases where claim documents have been submitted to the existing TPA for processing.
iii. Status of
o f claims where processing has been completed by the TPA and payment is pending with
the insurer/ TP A.
TPA.
15. Data and related issues:
a. The TP
TPAA and the insurer shall establish a seamless flow of
o f data transfer for al
allI the claims.
b. The respective files shall be handed over to the insurer within 15 days of
o f the claim settlement or
rejection.
16. Submission of Returns to the Authority

a. All insurance companies carrying on health insurance business shall furnish the Returns to the Authority
in accordance with Schedule-Ill.
17. Transitory Provisions
a. Withdrawal of o f Products
i. The Appointed Actuary shall examine every Health product, Group and Individual, in the
1.
Company's
Company’s portfolio and list out those products which are not inincompliance compliance with the the
provisions in every particular of o f these Regulations. Such list shall be certified by the Appointed
Appointed
Actuary, counter signed by the CEO and submitted to the Authority on or before 30.06.2013.
Products not
ii. Products
11. not in
in compliance
compliance with
with this
this Regulation
Regulation shall
shall all
all stand
stand withdrawn
withdrawn andand shall
shall not
not be
be sold
sold
I.
1. In the case of o f Group Products, from I" Is' July 2013
st
2. In the case of o f Individual Products, from I1st October 2013
iii. No new members shall be enrolled into the existing group policies once the product stands
withdrawn.
1v. Products which
iv. Products which have
have been
been filed
filed andand are
are awaiting
awaiting the the approval
approval oof the Authority
f the Authority shall
shall all
all be
be
returned to the applicant to be refilled afresh after due examination for compliance
b. Remedial Measures
[[ W
'!WT I I I — ' U.S 4]
T IIl~l9 4] 'GT«! ~ (I
'HKcl y;j 3!BT~
:: S T fn m T 11! 89
89
i.
Insurers
Insurers may
may on on their
their own
own modify
modify product
product features
features other
other than
than those
those relating
relating to
to any
any benefits
benefits
offered, premium bases, loading levied or discounts discolflts offered in the products. IIff such
modifications suffice to render the product compliant in every particular ooff this Regulation,
then on the basis of o f a certificate to that effect by the Appointed Actuary and the C CEO,
EO , the
Authority will record such change and allot the unique identification number where after such
product may be introduced. The Authority reserves the right, in such cases to take appropriate
action if it is established that this assertion ooff the Company was not well founded.
ii. Products which cannot be covered under the provisions o off (i) above shall be appropriately
modified and filed for a fresh approval under the File and Use. Such application shall be in a
tabular format setting out the current provision and the revised provisions to render the product
in compliance with this Regulation together with an analysis ooff the implications on pricing,
reserving, profit margin and other relevant metrics.
iii. At renewal, all Group Policies shall be given an option
111.
1. toto switch
switch over
overto to aa modified
modified approved
approved version
version oof the group
f the group product,
product, or
or
2. toto continue
continue to to be
be renewed
renewed under
under the
the extant
extant policy,
policy, provided
provided that
that in
in such
such case
case no
no
st
new members shall be enrolled after 11st June 22013
0 1 3 and the specific written consent
consent
is obtained by the group policyholder to continue in the old policy.
c. All the insurers shall inform the prospective policyholders about the possible changes in the products
being sold during the transition period and give an option to the existing policyholders including
prospective policyholders to switch over to the modified version iiff any, once introduced.
18. Repeal and Savings:
a. All the guidelines/clarifications/circulars/letters issued earlier in respect ooff the health insurance products
shall abate from the date this regulation comes into force.
b. Unless otherwise provided by these regulations, nothing in these regulations shall deem to invalidate
the health insurance contracts entered prior to these regulations com coming ing into force.
Schedule: I
Portability of Health Insurance Policies offered by Life and General Insurers:
I.
1. AA policyholder
policyholder desirous
desirous oof porting his
f porting his policy
policy toto another
another insurance
insurance company
company shall
shall apply
apply toto such
such insurance
insurance
company, to port the entire policy along with all the members ooff the family, iiff any, at least 45 days before the
premium renewal date of
o f his/her existing policy.
2. Insurer
Insurer may
may not
not be
be liable
liable to
to offer
offer portability
portability ififpolicyholder
policyholderfails
fails toto approach
approach the
the new
new insurer
insurer at
at least
least 45
45 days
days
before the premium renewal date.
3. Portability
Portability shall
shall be
be opted
opted by
by the
the policyholder
policyholder only
only as
as stated
stated in
in (1
(I) above and
) above and not
not during
during the
the currency
currency of
o f the
the
policy.
4. InIn case
case insurer
insurer isis willing
willing toto consider
consider the
the proposal
proposal for
for portability
portability even
even iif the policyholder
f the policyholder fails
fails to
to approach
approach
insurer at least 45 days before the renewal date, it may be free to do so.
5. Where
Wherethe
the outcome
outcomeoof acceptanceoof
f acceptance portability isis still
f portability still waiting
waitingfrom
from the
thenew
new insurer
insureron
on the
thedate
dateoof renewal
f renewal
a. the existing policy shall be allowed to extend, if requested by the policyholder, for the short period by
accepting a pro- rate premium for such short period, which shall be ooff at least one month and
b. shall not cancel existing policy until such time a confirmed policy from new insurer is received or at
the specific written request of
o f the insured
c. the new insurer, in all such cases, shall reckon the date of
o f the commencement off risk to match with
com mencem ent o
date of
o f expiry of
o f the short period, wherever relevant.
£ 6 0 GJ-Z-/ J 3-:13
66~
90 INDIA : EXTRAORDINARY
THE GAZETTE OF INDlA [P art III
[PART S e c . 4]
Ill-— SEC. 4)
d. iiff for any reason the insured intends to continue the policy further with the existing insurer, it shall be
allowed to continue by charging a regular premium and without imposing any new condition.
6. In case
In case the
the policyholder
policyholder has
has opted
opted as
as in
in 55 (a),
(a), and
and there
there isis aa claim,
claim, then
then existing
existing insurer
insurer may
may charge
charge the
the
balance premium for remaining part of
o f the policy year provided the claims is accepted by the existing insurer.
In such cases, policyholder shall be liable to pay the premium for the balance period and continue with existing
insurer for that policy year.
7. On receipt
On receipt oof such intimation,
f such intimation, the
the insurance
insurance company
company shall
shall furnish
furnish the
the applicant,
applicant, the
the Portability
Portability Form
Form as
as set
set out
out
in Annexure 'I'
T to these guidelines together with a proposal form and relevant product literature on the various
health insurance products which could be offered

offered..
8. The policyholder shall fill in the portability form along with proposal form and submit the same to the
insurance company.
9. On receipt of
o f the Portability Form, the insurance company shall address the existing insurance company
seeking necessary details of

o f medical history and claim
claim history ooff the concerned policyholder. This shall be
done through the web portal of
o f the IRDA.
10. The insurance company receiving such a request on portability shall furnish the requisite
reQuisite data in the data
format for porting insurance policies prescribed in the web portal ooff IRDA within 7 working days ooff the receipt
of
o f the request.
11. In case the existing insurer fails to provide the requisite data in the data format to the new insurance company
within the specified time frame, it shall be viewed as violation o
off directions issued by the IRDA and the insurer
shall be subject to penal provisions under the Insurance Act, 1938.
12. On receipt of
o f the data from the existing insurance company, the new insurance company may underwrite the
proposal and convey its decision to the policyholder in accordance with the Regulation 4 (6) ooff the IRDA
IRDA
(Protection of Policyholders' interest) Regulations, 2002.
o f Policyholders’
13. If
I f on receipt of
o f data within the above time frame, the insurance company does not communicate its decision to
the requesting policyholder within 15 days in accordance with its underwriting policy as filed by the company
with the Authority, then the insurance company shall not retain the right to reject such proposal and shall have
to accept the proposal.
14. In order to accept a policy which is porting-in, insurer shall not levy any additional loading or charges
exclusively for the purpose of
o f porting.
15
15.. No commission shall be payable to any intermediary on the acceptance ofa
o f a ported policy.
16. Portability shall be allowed in the following cases:
a. All individual health insurance policies issued by non-life insurance companies including family
floater policies
[[■RFT III— ~
'IWT III- 44]
] ’TTOT TT3PT=T : 3TCTr*ITCirr 91
91
b.
b. Individual members, including the family members covered under any group health insurance policy
o f a non-life insurance company shall have the right to migrate from such a group policy to an
of
individual health insurance policy or a family floater policy with the same insurer. Thereafter, he/she
shall be accorded the right mentioned in 1I above.
17. For any health insurance policy, waiting period with respect to pre-existing diseases and time bound exclusions
follows:-
shall be taken into account as follow s:-
s.
S. No of years of continuous Waiting period to be served with new insurer in number of
No insurance cover with previous days/years
insurer (s)
YY
Y Y Days 1I Year 22 years 3 years 4 years
I. X
XX (X X -n o of
X Days at inception (XX-no of (YY-XX)
(Y Y -X X ) NIA
N/A NIA
N/A NIA
N/A NIA
N/A
days as per the policy document) Days
II. For 1I year period exclusion:
1
I year NIA
N/A Nil 1
IYYear
ear 2 Years 3 Years
III.
Ill. For 2 year period exclusion:
1
I year NIA
N/A Nil 1I Year
Year Years
22 Years 33Years
Years
2 years NIA
N/A Nil Nil 1I Y
Year
ear 2 Years
IV. For 3 year period exclusion:
1
I year NIA
N/A Nil 1I Y
Year
ear 2 Years 3 Years
2 years NIA
N/A Nil Nil 1
IYYear
ear 22 Years
3 years NIA
N/A Nil Nil Nil 1I Y
Year
ear
V. For 4 year period exclusion:
1
I year NIA
N/A Nil 1I Year Years
22 Years Years
3 Years
2 years NIA
N/A Nil Nil 1I Y
Year
ear Years
22 Years
3 years NIA
N/A Nil Nil Nil 1I Y
Year
ear
4 years NIA
N/A Nil Nil Nil Nil
Note 1: In case the waiting period for a certain disease or treatment in the new policy is longer than that in the
earlier policy for the same disease or treatment, the additional waiting period should be clearly explained to the
incoming policy holder in the portability form to be submitted by the porting policyholder.
member's shall be given credit as per the table

2 : For group health insurance policies, the individual member’s
Note 2:
above based on the number of

o f years of policy
o f continuous insurance cover, irrespective of, whether the previous policy
had any pre-existing disease exclusion/time bound exclusions.

92 THE GAZETTE OF INDIA : EXTRAORDINARY [[PART
P art III e c . 4]
HI-— SSEC.
18.. The portability shall be applicable to the sum insured under the previous policy and also to an enhanced sum
18
insured, iiff requested by the insured, to the extent of
o f cumulative bonus acquired from the previous insurer(s) under
the previous policies.
For e.g. - IIff a person had a SI o 21akhs and accrued bonus ooff Rs 50, 0000
off RS 2lakhs 0 0 with insurer A; when he shifts to
B has to offer him SI ooff R

B and the proposal is accepted, insurer B
insurer B 2.50lakhs by charging the premium
Rss 2.501akhs
applicable for Rs 2.501akhs. If
I f insurer B
B has no product for Rs 2.501akhs, B would offer the nearest higher
2.50lakhs, insurer B
slab say Rs 3lakhs to insured by charging premium applicable for Rs 3lakhs SI .However, portability would be
available only up to Rs 2.501akhs.
2.50!akhs.
19. Insurers shall clearly draw the attention of

o f the policyholder in the policy contract and the promotional material
an y form whatsoever, that:

Iiterature or any other documents in any
like prospectus, sales literature
a. all health insurance policies are po1table;

portable;
b. off portability, well

policyholder should initiate action to approach another insurer, to take advantage o
before the renewal date to avoid an off the

anyy break in the policy coverage due to delays in acceptance o
proposal by the other insurer.

Annexure-I
Annexure-1
Portability Form
PART-I
I)
1) o f the Policyholder // insured (s)
Name of
2) Date of
o f Birth/Age
3) o f the policyholder/insured
Address of
4) o f existing insurer
Details of
i.
I. o f the product
Name of
ii. Sum Insured
iii.
Ill. Cumulative Bonus
iv.
IV. Add-ons/riders taken
V
V.. Policy number
5) o f the proposed insurance

Details of
i.
I. Name o
off the product proposed/intend to take
ii.
II. Sum Insured Proposed
iii. W hether Cumulative Bonus to be converted to an

Whether
enhanced sum insured
6) Reason(s) for portability
[ ’TFT III— *sF § - 4 ] *riTcr 93
7) I No. ooff family member to be included I the policy to be ported.

Enclosure: Photocopy of the.existing
o f the existing policy documents
I
Date: Signature ooff the policyholder
P A R T -II
PART-II
I.
1. Whether the PED exclusions / / time bound exclusion have longer exclusion period than the existing policy:
(Please indicate Y Yes / NO):
es /
2. IJfyes,
f yes, please give written consent to the declaration below:
F
m aware that the waiting period for the following disease(s)/treatment(s) is .....
“I am days/yearsmore
......days/years morethan
thanthe
theprevious
previous
cy terms.
policy tenns. I hereby agree to observe the additional waiting period for the follow
following
ing disease(s)/treatment(s)
Signature of
o f the policyholder
Schedule: IIII
Administration of Health Plus Life Combi

Corn bi Products
I.
1. The product of
o f this class shall be named as 'Health
‘Health plus Life Combi Products’
Products' referred as 'Combi
‘Combi Products’
Products'
hereinafter in this schedule.
2. This schedule does not apply to Micro Insurance Products which are governed by IRDA
IR D A (Micro
(M icro Insurance)
Regulations, 2005.
3. All insurance companies that promote 'Health
‘ Health plus Life Cambi products' shall adhere to the following:
Combi products’
a. Scooe of Combi Product Class:

Scope
i) The ‘Combi
'Combi Products’
Products' may be promoted by all Life Insurance and N
Non-Life
on-Life Insurance Companies.
ii) The 'Combi Product' shall be the combination of

‘Combi Product’ o f Pure Tenn
Term Life Insurance cover offered by life insurance
companies and Health Insurance cover offered by non life insurance companies/stand alone health insurance
companies.
iii) The Products offered under the combi products shall be individually cleared under the File and Use
procedure.
iv) Riders // Add-on covers may be offered subject to File and Use clearance.
v) off both risks are to be separately identifiable and disclosed to the policyholders at
The premium components o
both pre-sale stage and post-sale stage and in all documents like policy document, sales literature.
vi) The product may be offered both as individual insurance policy and on group insurance basis. However in
respect ooff health insurance floater policies, the pure term life insurance coverage is allowed on the life ooff one
off the earning members ooff the family who is also the proposer on health insurance policy subject to insurable
o
interest and other applicable underwriting norms of

o f respective insurers.
()4
94 . THE GAZETTE OF INDIA : EXTRAORDINARY
EXTR1\.ORDINARY [ P art III— Sf.c. 4]
vii) The integrated premium amount of 'Combi Product'

o f the ‘Combi Product’ shall be basis for reckoning the thr~shold
threshold limit //
applicability of
o f extant Regulations, guidelines and circulars etc. issued by the Authority or any other
statutory body.
viii) Commission and Claim payouts in respect of
viii)Commission o f 'Combi
‘Combi Products'
Products’ shall be by respective insurers only.
only.
ix) 'Combi product ' shall have a free look option as outlined in IRDA (Health Insurance Regulations) 2010.
‘Combi product’
Free Look option is to be applied to the 'Combi Product' as a whole.

‘Combi Product’
x) The Health portion ooff the 'Combi

‘Combi Product'
Product’ shall entitle its renewability at the option of
o f policy holder
from the respective N

Non-Life / standalone health Insurance Com
on-Life / pany
Company
b. Tie uo
up between insurers:
i) It is mandatory that insurance companies offering the 'Cambi Product' shall have in place a Memorandum of
‘Combi Product’ of
Understanding covering the modus operandi of

o f marketing, policy service and sharing of
o f common expenses.
ii) Insurers forming the tie-up shall obtain prior approval of

o f IRDA by duly filing the copy of
o f the agreement
entered in this regard. Approval may be obtained by any one of

o f insurers. '
iii) A tie up is permitted between one life insurer and one non-life insurer only. Thus a life insurer is permitted to
tie up with only one non-life insurer and vice-versa.
iv) Between these two Insurers any number of
o f 'Combi
‘Combi Products'
Products’ may be promoted.
I
v) Insurance companies shall carry out an appropriate due diligence before establishing the business
relationship for the purpose of
o f promoting 'Cambi
‘Combi Products'.
Products’ . Insurers are also expected to have a long-term
understanding for effective policy service of

o f the proposed 'Com bi Products'.
‘Combi Products’ .
vi) Withdrawal from the tie-up is generally not desirable. However, in exceptional cases where insurers desire to
off the Authority.
withdraw from MOU they shall obtain prior permission o
vii) There shall be specific !ime

time frames // Turn around Times (TAT}
(T A T ) to be agreed between the insurance
companies as part of
o f MOU for effective policy service, transmission of
o f premiums received etc. at various
stages of
o f policy i.e., at pre-sale stage and post-sale stage.
viii) ilin g the advertisements in accordance with IRDA (Insurance Advertisements and Disclosures) Regulations,
v iii)FFiling
I
2000 within 30 days from the date of
o f issuing the advertisement with Authority.
ix) Proposed procedures

Proposed for obtaining
procedures the prior
for obtaining the approval of I RDA
prior approval for issuing
o f IRDA Joint Sale
for issuing Joint Advertisements along along
Sale Advertisements
with the common corporate agents.

x) The modus operandi of
o f proposed policy service at various stages of
o f the policy viz., proposal stage, policy
servicing, premium collection arrangements and claims service etc.

xi) The Information Technology systems put in place for supporting the sale and policy service of
o f the 'Combi
‘Combi
Products'.
Products’ .
xii) Agreement on reimbursement of

o f expenses in consideration of
o f common services rendered by each other of
of
insurance companies.
xiii) Distribution Channel wise maximum commission allowed under the 'Combi
‘ Combi Products'.
Products’.
xiv) h e manner in which premium is proposed to be collected subject to provisions of

x iv )TThe o f Section 64 VB
V B of
of
Insurance Act, 1938.

xv) TheThe
procedures put put
procedures in place for expeditious
in place transfer
for expeditious of the
transfer portion
o f the of premium
portion that that
o f premium pertains to the
pertains other
to the other
insurer of
o f the product.
xvi) Operational procedures put in place for updating premium on policy data base on a real time basis.
L’ TFT I I I — 4] 'RRcT =R : 3T?TT^liul 95
95
xvii) Options available to policyholders ooff 'Combi

‘Combi Products'
Products’ to discontinue either portion ofrisk
o f risk coverage
while continuing with the other portion, subject to the extant law, regulations, guidelines etc.
xviii) Copy of
o f proposed common Sales Literature // Sales Illustrations, proposal form to be issued
issued by
by both
both the
the
insurers in respect of
o f 'Combi
‘Combi Products',
Products’ , subject to the conditions that these documents cleared under File and
Use procedure are not modified.
xix) Common Advertisements of

Common Advertisements o f'Com bi Products',
‘Combi Products’, subject
subject to
to the
the condition
condition that
that this
this sh al I be
shall be restricted
restricted to
to the
the
features, terms and conditions of

o f the 'Com bi Product'.
‘Combi Product’ .
c. Lead
Lead Insurer:
Insurer:
i) As two insurance companies are involved in offering the 'Com bi Product'
‘Combi Product’ one of
o f the insurance companies
may be mutually agreed to act as a lead insurer in respect of

o f each 'Combi
‘Combi Product'
Product’ marketed with agreed
terms, conditions and considerations.
ii) The Lead Insurer for this purpose is the insurance company mutually agreed by both the insurers to play a
critical role in facilitating the policy service as a contact point for rendering various services as required for
combi products. The lead insurer may play a major role in facilitating underwriting and policy service.
iii) The role of
o f lead insurer shall not deter in relying upon the existing operational infrastructure of
o f the partner-
insurance company for effective policy servicing of

o f 'Combi
‘Combi Products'.
Products’ .
iv) Either of
o f the insurers shall not be absolved of
o f their responsibility of
o f proactive settlement of
o f claims and other
pbligations in accordance with the terms and conditions of

obligations o f their respective policies.
4. Underwriting: Under the

Underwritinl!::Under the ‘Combi
'Com bi Product’,
Product', underwriting
underwriting oof respective portion
f respective portion oof risk shall
f risk shall be carried out by
by
respective insurance companies, that is; Life Insurance risk shall be underwritten by Life Insurance Company and the
Health Insurance portion of

o f risk shall be underwritten by Non-Life/stand-alone health Insurance Company.
5. File
File and
and Use:
Use:
a. The life insurance product and the health insurance product to be offered as a combi product shall have prior
approval under Fi le and Use procedure.
File
b. Both the independent approved products shall be integrated as a single product and shall be filed with a common
brand name.
c. The single
The single product
product shall
shall be
be offered
offered without
without making
making any
any modifications
modifications to
to the
the cleared
cleared products.
products.
d. ‘Combi
'Combi Product’
Product' isis toto be
be filed
filed atat the
the stage
stage oof integrating for
f integrating for getting
getting File
File and
and Use
Use approval
approval irrespective
irrespective oof the
f the
earlier approval to either of

o f products.
e. 'Combi
‘Combi Product'
Product’ filing shall follow the File and Use guidelines in vogue and all such guidelines that would be
issued from time to time.

f. Combi Product'
Product’ is to be filed with Actuarial Department of
o f Authority in File and Use formats that are in vogue.
g. The
TheCombi
Combi Product
Product shall
shall be
be approved
approved by
bythe
theAuthority
Authorityatat File
File and
and Use.
Use.
h. The
The File
File and
and Use
Use application
application oof the ‘Combi
f the 'Combi Product’
Product' shall
shall also
also specify
specifythe
the follow
following:-
ing:-
i) Lead Insurer for the 'Combi Product’ and demarcation of

‘Combi Product' o f functions between insurers for carrying out
activities
ii) Procedures proposed for issuance of
o f the premium notices, where applicable and final lapse notices in terms
of
o f Section 50
5 0 of
1938.
iii) Where the servicing is to be necessarily attended by the original insurer, the lead insurer shall facilitate the
policy servicing. As far as the policyholder is concerned lead insurer shall be made as the single nodal point
for receiving the servicing requests, fulfilling the services and issuing acknowledgements.
96 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III— SEC.
[P art III- S e c . 4]
iv) Results of
o f feasibility study, iiff any, in giving a limited access to the policy data base of
o f policjes-for
policies for effecting
over-the-counter policy service requests to the lead insurer.

v) The results of
o f the cost benefit analysis carried out by both the insurers and the possibility of
o f offering any
discounts on the premium in the com bi product.

combi
vi)
6. Lead insurer in settlement of
o f claims
claim s shall ensure:-
a. Based
Based on the type
on the type oof claim,
f claim the other
, the other insurer
insurer shall
shall also
also take
take proactive
proactive measures
measures for
for settlement
settlement oof claims. In
f claims. In no
no
case, the Lead insurer shall guarantee the settlement of
o f claim on behalf of
o f the other insurer. '
b. The risks
The_ risks accepted
accepted by
by one
one insurer
insurer un
under 'Combi Product’
der‘Combi Product' shall
shall not
not affect
affect the
the business
business oof other insurance
f other insurance
company.
c. As far
As far as
as health
health portion
portion oof 'Combi PPolicies'
f ‘Combi are concerned,
olicies’ are concerned, the
Lhe extant
extant regulations
regulations and
and guidelines
guidelines shall
shall apply.
apply.
d. Where
Wherethe
thepolicies
policies are
are serviceable
serviceabledirectly,
directly, the
the lead
lead insurer
insurershall
shall play
playaa facilitative
facilitative role.
role.
e. The operational
The operational procedures
procedures proposed
proposed to
to be
be put
put in
in place
place for
for timely
timely dispatch
dispatch oof the policy
f the policy bond
bond oof 'Combi
f ‘Combi
Products'..
Products’ f
7. Channel:
Distribution Channel: 1
a. The sale of
o f 'Combi
‘Combi Product'
Product’ shall be solicited through:-
i) D irect Marketing channels

Direct ,
ii) Brokers and

iii) Composite Individual and Corporate Agents, common to both insurers
b. 'Combi
‘Combi Products'
Products’ shall not be marketed through 'Bank
‘ Bank Referral'
Referral’ arrangements.
c. Insurers shall ensure that the 'Combi

‘Combi Product'
Product’ is not marketed by those insurance intermediaries who are not
authorized to market either of

o f the products of
o f either ofthe
o f the insurers.
8. Mandatory Minimum Disclosures-:

Mandatorv Disclosures:
' ■’*% . *
a. The
The mandatory
mandatory ·.;;inimum
minimum disclosures
disclosures for
for aa Combi
Combi Product
Product shall
shall be:
be: j
i) The product is jointly offered by "abc

“abc insurance company"
company” (specify non-life/ stand-alone health insurer
I
name) and "xyz
“xyz insurance company"
company” (specify life insurer name). ,
ii) The risks of

o f this 'Combi Product’ are distinct and are assumed I/ accepted by respective insurance companies.
‘Combi Product'
iii) The liability to settle the claim vests with respective insurers that is for health insurance benefits "abc
“abc
insurance company"
company” (specify non-life/ stand-alone health insurer name) and for life insurance benefits "xyz
“xyz
insurance company"
company” (Specify life insurer name).
iv) The legal/quasi legal disputes, if any, shall be dealt with the respective insurers for respective benefits.
v) The policy holders of

o f the 'Combi Product' under reference shall be eligible to continue with either part of
‘Combi Product’ o f the
policy, discontinuing the other during the policy term.
vi) Where guaranteed renewability of

o f health insurance plan is allowed, the health insurance portion of
of
this 'Combi
‘Combi Product'
Product’ is entitled to that facility.
vii) Specific Disclosures

D isclosures on the available premium payment options on these 'Combi
‘Combi Products'.
Products’ .
viii) Specific
Specific Disclosures
Disclosures about
about the
the available
available Policy
Policy Servicing
Servicing facilities
facilities for
for these
these ‘Combi
'Combi Products’.
Products'.
[■RFT III— Tgrrg- 4] 'lfficf
mrcT ~ : 3rnl'tffi"UT
qiT TF5FT3 3 ^ *1 1 ^ 97
o f these policies under both the risks.

ix) Specific Disclosures about the proposed claims service of
x) Specific Disclosures on the availability of

o f services of
o f 'Third
‘Third Party Administrators (TPAs)'
(TPA s)’ for health
insurance portion of
o f risk, iiff available.
xi) Specific Disclosures on the available Grievances Redressal Options including particulars of
o f Ombudsman
under these 'Com bi products’.

‘Combi products'.
xii) Policyholders are to be advised to familiarize themselves with the policy benefits and policy service structure
of
o f the 'Cambi
‘Combi Product'
Product’ before deciding to purchase the policy.
b. Policy documents of'Combi Products’ shall contain the above referred points (iii) to, (xi) as minimum
o f ‘Combi Products'
disclosures.
c. / she has understood the

Declaration from the prospect shall be obtained and attached to proposal form that he /
disclosures mentioned above.
9. In respect of
o f 'Cambi Products’ both the insurers shall comply with the provisions Insurance Act, 1938 and
‘Combi Products'
Regulations notified there under and other guidelines, circulars that are applicable to health insurance business and
life insurance business respectively.
10. For the purpose of

o f these guidelines non-life insurance company includes standalone health insurance Company also.
11. In order to monitor the progress of

o f the penetration of
o f the product class before enlarging the scope of
o f the same all
insurance companies that are marketing 'Cambi

‘Combi Products'
Products’ shall submit the information that is required by the
Authority from time to time.
12. The Authority may stipulate such other terms and conditions from time to time for monitoring activities of
o f insurance
companies offering 'Cambi Products'.

‘Combi Products’.
Schedule: III
Health Insurance Returns to be submitted by Insurance Companies
I. HARi
HARI NARAYAN, Chairman
[ADVT. Hl/4/ 161 /1 2/Exty.]

111/4/161/12/Exty.]
66$
\
98
Health To-:Be'forms
INPUT_HEAlTH_l Annual Audiled - 30th or June 2 Days befo,e the due date IOn due Date
INPUT HEALTH l(a) or
Annual Audited - 30th June 2 Days befo,e the due date On due Date
INPUT HEALTH LI Annual Audited - 30th of June 2 Days befo,e the due date On due Date
INPUT HEALTH 2 Annual Audited - 30th or June 2 Days befo,e the due date IOn due Dale
INPUT-HEALTH_3 Annual Audited - 30th or June 2 Days before the due date On due Date
'NPUT HEALTH_4.l Annual Audited - 30th or June 2 Days before the due date On due Date
NPUT HEALTH 5 or
10th the lollowln1 mooth 2 Days before the due d;ite On due Date
NPUT_HEALTH_6 10th of the followin1 mooth 2 Days befo,e the du• date On du• Date
NPUT-HEALTH_6.l 10th of the following mooth 2 Days before the due date On due Date
NPUT_HEALTH_6 2 10th of lhe followina month 2 Oa~ before the due date On due Oat•
NPUT HEALTH 6.3 Annual Audited - 30th of June Z Days before the due dat• On due Oat,

NPUT_HEALTH_6.4 15th of the mooth followm1 end or quarter Z Oa~ befo,e the due date On due Oat• ~
tT1
NPUT HEALTH 7 15th of the moolh following end or quarter 2 Days before the due date On due Date
~
NPUT HEALTH 8 15th of the monlh follow1n1 end of _quarter 2 Days befo,e the due date On due Date
NPUT_HEALTH_9 2 Oa~ before the due date On due Date
~PUT_HEALTH_lO users
~
~PUT_HEALTH_INOIAN_OFFICE_l end of quarter 2 Oays before the due date On due Date
~PUT_HEALTH_FOREIGN_OFFICE_l Quarterly I 15th ol 1he month followt"I end of quarter 12Days before the due date On du• Date
EP _HEALTH_OFFICE_l Quarterly j lSth of the month following end or quarter J2Days before the due date On due Date 0
EP _HEALTH_OFFICT_2 Quarterty I 15th of the month fotlow1"1 •nd or quarter 12Oa}! bero,e the due dale On due Oat• 'Tl
I 12Oays before the due date
~
EP_HEALTH_OHICf_3 lvearly On due Date
►
~
>-l
~
0
ES
~
~
[P art
1
r
III— S e c . 4]
C/l
"'r,
..::
[ ’ TFT I I I —
tN#pT _HEAL TH_ Foreig
INF^fJT_HEAL n_ O/fice
Foreign^ Office__l
1
odtails of fore
Details ign offic
foreign offices
es
Purpose and Freque
Purpose ncy
Frequency
This form collects the informa tion on the foreign offices classifie
4]
This form collects the inform ation on the foreign offices classified d as represe
representative
ntative offices, branche
branches,
s, subsidiaries,
subsidiaries, agency
agency offices
offices
This is a new form for capturi ng
This is a new form fo r capturing the informa
inform ation offices.
tion on foreign offices.
The frequency of
The frequency o f this return is quarter
quarterly.
ly.
Filters
Filters and
and Parame te-rs
Param eters___ ___ _~
Year
Year j Quarterr
jQuarte
Name of in_s_u_re_r
insurer_ _ _ _ _ __.J
Country
’ TRcT
whethe
w h e th e r
TF5m
regulat
regulated ed
# lp,rt;c ,lm
Particulars No.
Wo.
by local
focal
. authori ty
I
au thority
Column Code a b
No.
No. of
o f represe ntative branche
representative branches s •ôoutside
u tsid e India
!
I No.
No. of
o f branche
branchess ••
* * ~outside
utside India
India ] I
3 t
j No.
No. of
o f subsidiaries •••
subsidiaries * * * outside
outsidejndia
India
- - \N
4 o. of
No. o f agency Offices••-;•
agency Offices * * * * outsid~
outside India
• \Total
Total No. of offices outside India
Note:
A representative office is an office
• A representative office is an office established by
established by a
a compan
companyy to
to conduc
conductt market ing and oth
m arketing er non-transactional
other non-transactional operations,
operations, generally
generally in a foreign country where
in a foreign country where
a
a branch
branch ~ffice
office oro r subsidia ry is not warran
subsidiary warranted.
ted.
A branch of insurance companies is a retail location where
••
** A branch o f insurance companies is a retail location where an insurer offers a wide array o off face to
to face
face and
and autom
automaated
ted services
services to
to its customers.
its customers .
***
••• A subsidia
A ry, in
subsidiary, in busines
business smmatters
atters,, is an entity th
that
a t is control
controlled separate
led by a separat e higher
higher entity
entity
••••
* * * * An
An agency
agency office
office is is an
an entity where the
entity where the busines
business s is carried out by agents ofo f the
the insurance
insurance companies
companies
*
100 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III— S e c . 44]]
[ P a r t Ill-SEC.
INPUT_HEAL TH_ O/fice_3

INPUT_HEALTH_Office_3
Growth of Offices in Each State - Yearly

Purpose and Frequency
The purpose of
o f this report is to provide a summary
sum mary of the
o f th e distribution of offices across each state.
The frequency of
o f this report is yearly.
Filters and Parameters

Parameters________________________
Year
.-------------.
1 Current
C urrent Year Previous Year Second Previous Year Third Previous Year ' Fourth Previous Y
Year
ear |
IIft '
State
~:::
Nam e
No. of
:::~a~f
Rural
,Of!ic~
Offices
I ~~~:~
I Office_
Officess
No, of
Urban : No. of
::~a~f
R u ra l,
Offices
~~~:~
No. of
: U rban
J Off!ce_
No. of
::;a~f
Rural
Officess _t()ffices
Offices
~~~:~
No. of
; Urban
: Offices
No. of
::;a~f
Rural
Offices
i ~~~:~
No. of
Urban ] No. of
::;:if
Rural
Offices _ ; <Jff_ic_
Offices
I ~~~:~
No. of
Urban
e_s______,_O!fices
Offices
Column
Column I - -j 1 1
Code I a
a I b
b cc d
d e
e f I g
g h
h I i i
Code
,- -~ - -•- - ~ - - - t--- ~ - ----- _J _ _ _ • -•-- -
1 1
Source/C ' INPUT_N
IN P U T N !1NPUT_N
INPUT_N 1NPUT_N
IN P U r_ N :INPUT_N
!NPUT_N ilNPUT_N
INPUT_N :INPUT_N
INPUT_N 1NPUT_N INPUT_N IINPUT_N
INPUTJM i lNPUT_N INPUT_N :INPUT_N
INPUTJM
Source/C
ON LIFE
ON LIFE ION
ON LIFE
LIFE ON
I ON LIFE
LIFE ON UFE
ON LIFE ON LIFE
ION LIFE ION
Ort LIFE
LIFE ION LIFE
ON LIFE ION
ON LIFE ION
LIFE ON LIFE
LIFE ON LIFE
ON LIFE
-1 Offke_l
1·
alculation
olculotion IOffi~e_l
O ffic e _ l -
I
Offke_l
O ffic e _ l O ffic e _ l - IOffi~e_l
O ffic e _ l - Offke_l
O ffic e _ l - O ffic e _ l - IOffke_l
Offke_l O ffic e _ l - Offke_l O ffic e _ l - IOffi~e_l
O ffice _ l - Offi-ce_l O ffic e _ l -
1 Andhra
• I • Pradesh
• .1•
2 ArunachalPradesh
Arunachal Pradesh
3 Assam l
4 Bihar
S
5 Chhattisgarh
6 Goa
7 Gujarat __ J ____ _
8 Haryana
9 Himachal Pradesh
l -- - - + - - - - - - -1 - - - - + -- ---- -
10 Jammu & Kashmir
- - - - - , - ~ --- - - - - - -
11 Jharkhand
12 Karnataka
13 Kerala
14 ~ad~ya
Madhya Pradesh
15 Maharasthra
- - - - - - - - - + - - - - + - - ---+-- - -- + - - -----l
16 M anipur Ij
Manipur
17 _ Meghalaya
18 Mizoram
M izoram
19
19 Nagaland
20 Orissa
21
21 Punjab
22 an
Rajasth_
Rajasthan
23 Sikkim
24 Tamil Nadu
25 Tripura
- - - ----"----'--------'---- - - + - - - -
26 Uttar
U ttar Pradesh
27 Uttrakhand
28 West
W est Bengal
- - - - --- - - + - - - - 1 - - - - --l
29
29 [Andam an &
Andaman 8i Nicobar Is.
30
30 Chandigarh
31 Haveli
Dadra & Nagra H~~i r--- - -,
32 Daman & Diu
33 Delhi l[
34 Lakshadweep_
-'--- - ----l----------1--- - -
35 _ P~ ducherry
Puducherry
# Total
[[ w r iii
'IWT Ill~— 4]
4] ■
htct : aq^rmRwr IOI
101

form collects th
Thts form
This the inform ation on th
e information e office (Branch) details in each state for each insurer.
the
is re-engineered on th
form Is
This form thee basis o the
off th Information.
e existing Form VII of existing Office Inform ation.
.
The frequency o
f ...
off this return Is quarterly.
is q u arterly.
.
<"
Filters and Paramete...r_s_ _ _ _ _ _ _ _ _ _ _~
Parameters_________________________
Year | | Quarter
Q u arte r |
N am e _ _ _ _ _ _ _ _ _ _ __,
Insurer Nam;.;.;.;;e
Busin~ss within
Business w ithin Ind/a
India
o f branche,
No. of branches
\ _______________ ___________
!
N o. o
No. off I
No. o off
branchPs
branches Out
O ut ooff No. ooff No o
No off of
No. of No.
No . of
of
branches I O
Outu t of I
at the inprincipl approvals
approvals branches branches
branchPs No.
N o. of off
No. o 1
e xisting
existing existing
e>cisting
a t th e approvals I
#
ij State
1
ee of
of I approva s I closed
closed at the
at th end
e end offices
offices office s
offices bra nches
branches branches
branches
1
beginning I I o
off this '
of the I approved previous during the
thP o
off th
thee relocatPd
relocated merged
m erg e d in ru ral
rurdl in urban
urban
o f th e q u a rte r
durinr. th
I during thee q u arte r I quartPr I q
quarter quarter
u arte r quarter
q u arte r area
area are:-a
area
q u a rte r
quarter
q u a rte r
quarter
Column
a b c dd e f g
g hh i k
Code
1 Andhra Pradesh
l 2 Arunachal Pradesh
3 Assam
4 Blhar '
B ih a r1
5
5 Chhattisgarh
Chha =a_r~h- - - - + - - - - - - - - - - 1 - - - - - , 1 - - -
_i~sg
_tt
6
6 Goa
Goa I
7
7 Gujarat
Gujarat - -+--- --- ----+-----+-=~--- -- --- -........- - - - + - - - - - + - - - - - - - - - - t f - - - - - - - ,
..le.- - -- 4 - - - -
8
8 Haryana
H~!Jan_a _ J_____t---- - + - - - - - + - - - - - t -- ----t
9 Him achal Pradesh
Hlmachal
10 Jammu & Kashmir
Jamma
11
11 Jharkhand
12 Karnataka
- ------- .................
13 Kerala
14
14 M adhya Pradesh
Madhya ..
15_---+M
1-_ l_S M
_ aharasthra
a_h_ ar..cca_st_h~r_a___ __ ____ -- -i- - - - + - - - - - - t - - --4-- - - - + - - - - - - - - ---+----t---
16
16 M an ip u r ~ I
Manipur
17
17 Meghalaya
M eghalaya
■4 '■;!
18 Mlzoram
M izoram
19
19 Na aland
Nagaland
20
20 Orissa
1-__2 _1_-+-P
21 _u_n-<-ja_b________ __ _
Punjab
22 RaJasthan
Rajasthan
23 Sikklm
Sikkim
24 Tamll
iTam il Nadu
25 Tripura r --+----- - - - - ---- ---- - ---------t----t---------
26 U ttar Pradesh
Uttar
27 Uttrakhand
Uttrakhand
t - - - -- - ' - - - -- - - -·-·- · ·-··----•---·--
28 W est Bensal
West Bengal
29
29
30
30
Andaman
,A ndam an 8i
Ch~ndi_,s_
Chandigarh
& Nicobar Is.
,ar_h_ __
Is.
----- - _,, _________ ..
31
31 Dadra & Nagra Haveli
32
32 Daman 8i & Dlu
Diu
33 Delhi
- · · · - - ---~-- - - ' - - - - ---1
34 Lakshadweep
35 IPuducherr y
w a f ts * -iiCgs gSjjSj5'
Not~:
N ote:
o f business
forr place of
1. Branches stand fo
6 6 ° c;-:c/13-..?6
6'60,
\NPUT_HEAiTH_i(a)
INPUT~HEAL TH_J{o) I Yearly | -
§#*$" '
:;i.,, 'lo~
Details of product performance •- Products with more than 1 year term (To be furnished
furnislied by All insurers having liealth
health products)
Purpose ■and
PurpoH! nd frt!quancy
frequency
To COiiect
To collect product Information
information for
for 111
all products
proch.Jcts having term more th•n
h•vh'II IIM'ffi than 11 year
To repiao
replace the ulst1n1
existing form 0 to o1dd
fOJm D add more data elements Of'I
d■ t ■ !Nemetits on n~
new busJMn
business and
and expected business data
e.pet.1«1 bu1lne11
The
Tht! frequency
fr~uency of the return
return is
11 yearly and as ■and
yearly o111d nd when.
Flltitr1 ■ nd Pllraffll!ten
,_,
Year
Nam*
Insurer Nam.
*
• Particular
P1rt1cular i • | Product
l'rodui t 1 Product J,2
6'ruduct Product
Produ, t 3
J Product 44
Prcdu<t [ Product 5Product'>
Column
Column Code r aa tib • cr dd ■ r ...... e•-.....
| Product Details • • -• . ]
1 1Product Name
Product Nam~
' --------- +----
-)~-----+----- j— ------1---
'1 - - --j
2 UIN H
-l
3a
31 Scope of Cover(l)
SmpeafCov. ~•="',i' - - - - ----+--'--'-~--,....------+--------------
;,.. - -----cl~ - - - - - - ::r:
33
3b T■ r1.t:Cif'cUe,Pc___
Target Group _ _ _ _ _ _ __ +'-"-cC..~ I
---+ W
rr,
-~ 4-
4a
'41
Insured Type
Basis of
IHII of Payout
• Group
- 1,.11,11d!rl>e"-----------+--------+~= Group
G,oup
--1==
I ·-
- -ri Individual
lndlvldu1I
~"~- - - - , - - - - ----'- -- --
—- ~ o
0
~
I j;
,.,.
5S Date
D ■ ta of clearance
de ■ r ■ nc e of product I
5a Minimum Polio,
Minimum Policy P■
Period
riod ,-_ - I fc
m
5b
6a
6
...•
Maximum Policy
M•lrnllm Polity period
Current SblU"l
Curr:enl
Add-on coven
Add-an
p■ rtod
Status of Product
covers lftdudNI
induded
~~
,- No ...
Yes
I
I ;________ ■ . • : 9m
rr,
6b
6c
6d ._
No. of ■add
Total no. or
No. of
on CO\IMI
dd on covers
Whether serviced
Whether 1■rvl~ by TP-A7
of TPA
af policies
TPA?
involved
TPA in'llolwed
issued
' ,.
L
hYes
es
-•’ ■' -
I
' ‘
l ZIIIZZZZIZZIZI
:....................
O
0
'Tl
Tl
Ha. pallcl~ ksued :
----+----+-
: ----
;- ---- --,--- - - - '- - - - - --!
8 Gross Premium•
Premium* Collected
8.1
I.I
arms
Total Premium
Tatll Premium CNl@d
Ceded
CoUH:t~
I p ...................... a
9 No cif
Na of persons/members/ lives covered
persom/members/ JN~ CO'lll!red D a ta to in put D ata to Input 11 >
10 Total Sum
Total Insured
S!Jm lnsuril'd
l ■•ln n1r-ance Commissions
31a
U■ Reinsurance Cammlulan, Received
O.U Km—1 m
,.- ■ .m k - • - : m
■
..
7a
8a
No. of
l Na.
No. ol
~Na.
policies due
Cfnl'IUdH due for
far renewal
of policies renewed
pollct.s renewed ■
======--------l------+----l--------,-
\
- - --: - -----------
X
73
...,
9a
9a.l
10a
Ill■
Total Renewal Premium Collected
\ Tabll Renewal Premium Collected
Total renewal
tl'olll
=No
renewal premium
of persons/members/
cf
·====- - - - - - j - -~-- - + - - - - - l - - - - - -■- ------1------ •- - - - ' - - - - - ---j
premium ceded
No====,·===--------+-----+
persons/members/ lives
lives mV'l!l'ed
covered .,.
- ,.-,.- ,._
- ..--+-.,.,.
- -,.-,.,..,. ,1 -:1 - -----+--------,
- - ,- - - - - - -
D a ta to in put D a ta t o in p u t \
>
iO
111
1U Total Sum
J ITatal Sum Insured
Insured in renewal
in renewal ■ ■* ’ I
lib
Ub ·aReinsurance Commissions Receh1ed
-.1n1uranc• Commissions Received -
.,#
,.
7b No. of policies
Na.afpolicles
..
===- ·- - - - - - - - - + - - - -
- *ta
--+-------<-----+'-----+------+--------~
I i
- . ■
2
>
...••,
9b Gross Premium
Premium Income
1ncom•
,,....
li&,011
9b.i
====-
Total premium
premium cedld
ceded
- - - - - - - + - - - - - + - - - - , - - - -i- - - - - - - + - - - - - - + -- - ------
Total I ?
10b -.ia No ofof DerJ;Ons/m_rmbt!rs,I
persons/members/ H'ltlas
lives covered
covered D a ta t o in put D ata to in put
lib Total 5um
Tatal Sum Insured
Insured
12b
""
— - ■:
I le.I
7c
1c
8ci I
Reinsurance
Jleim1o1r■ oce Commissions
No. 0fcanceU,1tl0n
N0. of cancellation InIn free
Received
CDmmlltlDlll ll•c•N•d
look period
flH look
-
C anc^ tJonD *.
Out ...
--. of Nlw
■
New Bv.ilnl!H
.....
Business I
•
-
No. afcanO!!ll,■
r - . : i i 7 flla.
8c.ll
of cancellation***
Hon••• during
durln1 the
!he policy
policy term
term
Oct al
DIii
~o= ,=_=~=c
of IIINI
New lullness
Business
c:.u~=,.,.,
- ,- - - - - - - + - - - - - - f - - - - - - - + - - - - - ---j
Out of 0Renewal 0Business
____ ■ Expected new bust[*wss flgurel (for next year) .'-~■: ■ ~;.,■,
--~-11■•-.-• :-r
6e
fi■ No. of policies
Na.afpollcles I I
6f . Total Gross
&f Grau Premium
P;-emlum
Total no. of claims
---+------+-- ----j- - - -- - t - - - - - - - + - - - - - -
6h
fi/i Total
Tat:111 amount of claims
cf dalms ’“ i ';:a
"0
6i Claims ratio
.(U.___ Combined ratio •
...~%
.. T
C/5
-
Note: (ll
Noee:
1. only
1. anly predominant
predominant cover
COVH should
shaukl be
be mentioned
mentioned in
In scope
scape of
cf cover.
cover.
m
m
O
•* Grass
Gross premium
premium Is defined as
Is defined H the premium amount
the premium ■ maunl before
before deducting service t,■x
deducting service tax.. 0
•• This section
.. This sect/an is
Is currently
currently optional.
apHana L
.._..
•• other
Other than
th ■ n free lock
look cancellation
cancellation
.
r:__HEAEl'H_U
T_HEAL7H_1.1 I Yearly
ails of product performance In
alls claims development and aging (To be furnished by All insurers having health products)
in terms of claJms
se
s• a ndfreq
and uency
fr11qu1ncy
T
rooco llectcclaims
collect laimsm ovementaand
mo.,,ement ndd aimsaa1ing
daims gingd ata
data
T
roore placeth
replace theeexistingfo
existlflll rmD
form Ototoaadd
ddm ored
more etailedle
detailed velin
level formationo
Information ncclaims
on laimsd ata
data
rh
rheefre quencyo
freQuencv offth
theere turnis
return Is yearlyaand
yearly ndaassaand
ndw hen.
when.
a■ndP
nd ara
P■ meters
ramet us
Y ear
Year ~ - - - - - - - - - ~ C h a n n e l Ty pe J ChannelType
J
Particular
Parl1cular Product11 I
Product Product22
P1oduc1 Product33
Product Product44
Product Product .,
Column
C Cade I
olum n Code aa t b
b j cc d
d 1U B B H
C laimsData
ClalmlOata • . ■ !
[C laimsp
jClaims peen dingaUthe
nding ttheb eg
beg "in nn
'l-' n
"in n1g
'l"" ._o o
::.:f
f_cthh•e
t cc yce•=a•'--rr - - - -- +c=---
'--Y N
Noo .. - -- - + - - - - - - -I- + - - - - -- - - - - ---;l,--------- - -I - " - - - - - -- +I - -- - -- ---1
!_!INew claims r•a lsttred- - - -- - - -- - - t -A mount ---;- - - - -I- - - - - -; - - · - -
Amount | ,; I I -
r l Newclaimsregistered I N
Noo
- ..~ -- I i
r— j] A mount
Amount I I
- I
Claimsrepudiated N
Noo ..
'-:--11_c_
ii C
l•-lm_,_,_•p_u_d_l•-te~d~~~~~~ ~~~~~----~~--------------------~~----~~~,:A
I
---,-----===-·-=- =-====-t-+---
--=:=j :;;;
N
mou
:;;_
o .
o:;;-'
un t________j.
_!_
n ___+,
I
I
I
I _-
laimscclosed
daims losedd dueueto t:;co_coth
thc:e
occ r' .ccre
•cc aso
'•=•.=. soc.cn
n=s•- -- -- - - - - ' - ' ' - - - - - - - + - ---- - + - - - -- - - - -- ~ I
' ! - - - - - - - - - - -- - + I - -- - - -----<
I
---,f--- - - - --- - - - - -- -- - - --sAN__m-'
Am ount
_o~unt _ __ L. __ - - -- -----+--l--------,-- f I
•c ..·
Claimsre opened No 0. ! 1 j I
t____________ _
1 Claims r•opened
'--+= =-~"-= -- - - - -- - -- - - - + , - - -- - + -- - -- ; - - - - - -- - - -- -·-- + - - - - -- - - , - -- - -
A mount I I. . . ... .. .... I
_I_
I
... C la_lms
c_1a im
~ spe p
~en nd _d in
lna ~gat ••_th1_h_e• _e•n_nd
d_ o _fth
of t_he_•_ y ear_r - -- - - - + -NN
•~•-•
Amount
_oo _.._____ .. __j______ ~ I ____________ _ _ I _________
--
_,!
::_;_1-- - -- -- - -- -- - -- - - - + 'A A m
"-oo
-'-m un
'-"u nlt _________ _L_ _- -- - - - -----+ - ________ I _
----------- .
i_iP •en
-i:.P.= naa
:::::.ll.:;
In.:;t•te
ln ::.:'re
es:st
.= ..:t.;.Pa•id
P.= =--
ld - -- - - - -- - ---+-'
1
N
Noo .. I I
A moun~--=--··
t
:..I
iii< .: Amount I I I I ........ ..
_..,_ ......
"- -1-In I ! !
1_|ln<_
.1 cuu_rrre
r_ed _C
d C
_l_ la
a,im
-m·-,-R sR-,a-tiotio- ·- - - - - -- - - --+-- Ii I _ _ _I
Ii C
rc..__--'-'== ombin=ed=~---
Combined R
R~atio tio
- - - -- --,,..,--,-~ - - -- -~-- 1 - - I
~ - - ---- - - -- - - - -- - -- - ~I - - I ____ ___ _J
C laimsR
Cla1rn~ AatiOatio= = (T otalA
(iotjl mou
Amll UOtnto offClal
Claim mssIn curred)/6GWP
Incurred)/ WP
C.On,!iWJ RJ tlO • irot •1 A Nllll'l r,f ClwiK 'nnured , fohf Com~•nv hrw-tu"t Amour,t)/GWP
-- datms* ,,.r ·• ■ - ,. . .
'L
:,i C laimsp
dalms endingfo
pef1dln1 forrle ssth
less than an11m onth
month
N
No. o .
.ii
.ii Amount
[Amount
3 ~N o. - '
~ C
l.J laimsp endingfo fo r greaterth an1m onthaand ndle ssth thaan
n3
daims pendinR r 1reater tha.~J. mo~th less I
.ii m onths 1A mount
:a-
.ii
Iiu C laimsp
Claim, endingfo
J)t!ndin1 forrg 1n~ater
months
reaterth thanan33 m onthaand
month ndle ssth
less than
Amount
an66 No.
No. i . I
>.i
jJ
;:.-
C la
Claims im s p e
pendingn d in g fo
for r g re a
1ruter te
m
m
r
onths
months
th
than
onths
months
a n 66 m o
month n th a n
and d less
leu th a
thann 1
122
A
N
No.
A
mount
Amount
o .
mount
Amount
-· ---
'
.
I
I
I ... .
>
~ .i C laimsp
Claims pendendin inagfo forrg reaterth
greater thanan11 y earand
year andless lessth an22 N
than No. o. I
i.ii y ears
years A mount
Amount I
F
i.11
71.i
-.i -
.ii C laimsp
Clalms pendendin ln1gfo ferrm moreoreth an22 y
than rs
yrs
No.
No.
A mount
Amount
rI
'·"kkoned
onedfro
from md ateo
date offfirstfirstin timatio
intimat ion n
. .- - Aging.. ofse ttledcaims-.............
O~I■■ - -· ··· .r, -·'C. .,;' ....... -_- -·- r·
•.1
2~ C la
Claims im s se ttle
settled d fo
forrle ss
less th
than a n 11m o
month nth
lllilq
N
Noo ..
•tlllil 6
I
22.li.fi A mount
Amount I
33.i.i C laimsse
Claims ttledfo
settled fo r rg reaterth
areater thanan11m onthaand
month ndle ssth
less an33 N
than Noo .. . I
B3.il .ii m onths
months A
Amoumoun ntt I
~ C laimsse ttledfo forrg reaterth an33 m onthaand ndle ssth an66 N Noo .. '
44.11 ,11
55.1.1 Clalms
. dalms
Claimsse
settled
settled ttledfo forrg

1reater
grre ■a
m
terth
ater
than
onths
months
an^Sm
than'5
month
onthaand
month ndle
less
ssth
less
than
an11:22 N
than
A
No.
mount
Amount
o. I
----
5r-
~ -n m onths
months A
Amoumoun ntt I
66.1.1 I C laimsse ttledfo forrg reaterth an11 y earaand ndle ssth an22 No. .
~
Claims settled 1reater than year less than ...
6.ii 1
6Jil y ears
years Amoun nlt
,1.17.f 1 r ia im c caH iaH m n r a l k a n 7 u rc
rt ,.1,...c c•ttl,,rl fA, frtrmt,- theft 1 v n: N
No. o. I r----------
.
lAm ount
dcortedfromthedJfeofreceiptoflastrequirement
d:oned from tlie-ate of receipt of Lut requirement S
u
Claimsrwpudlamd
Claim■ repudiatedfDr forless
lessUliln
than11m onth
ntDl"lth
■No.
ii Amount
l.i Claimsrepudiatedforgreaterthan1monthandlessthanw
J 3months Amount
Li C
L, laimsr1pudlatecl
daims repudiatedfar1reater
forgreaterthanthan33month
monthandandluslessthan No. ----'1-------+------------+------+--------'-- ---''------f
thane::No=-.
iiii 66 months
months Amount
Amount
Claimsrepuillated
î_ Claims
..i repudiatedforforgreaterthan
1rnter thanIi6m onthaincl
month ndle No. -------,1-------+------------+------+-------+---------f
ssthan~No=--
lessdan
3.ff 12months Amount
12 monlll■'---------4'-'""'°"=::":.:.'---l----+-----------t--------1----------+---------I
Claimsre
i.i Claims pudiatedfor
repudiated for1realer1hln
greaterthan11y earaand
year ndless
lessthan
than22N o. ------,1-------+------------+------+-------+-- - - -----f
fCNo=-.
J years
yHrS Amount
Amount
'.i
Claimsrrepudiated
Claims epudiatedfo forrmore
morethin
than22 y rs
yrs
No.
Na.
ii A mount
A"""'nt
•ckonedfro
-ctoned md
from ateo
date offreceiptofoflast
rKeipt lastre quirement
requireml!nt
-l
THE
::c
jrre
med dC laimsratio=
daims ratio=T otalin
Total curredcdaim/
incurred laim/T otalEarned
Total EarnedP remium
Pn!!mlum tTl
nbinedR
nblned atio=(T
Ratio= otalcclaims
(Total laimsp aid+otheroperatin1
paid+other operatingee,:pense}/total
xpense)/totalp remiumeurned
premium arned a
GAZETTE
p roductw illbl!
bepopulated
populatedb asedon
onthe
thesselection
electionofofth
theeta rgetg roup
~
product will based ta(let 1roup
tTl
-l
-l
tTl
.,.,
OF INDIA
0
J0 %
'''"v “V
, K, ' 4 ;," .. » 8® | Oescrlpti zc::,
1en.bWDI.atii. Form '• Tabtotome |P.D«t«' Type'•j ....... - . . . Maxtor,? FWdTyp.. ■ ■• ’ ' BuslswssLock on
i Claimspendingatthebeginningoftheyear
1)No. Enable Numeric 20 Yes Input
ClosingoflastyearwillbebeginninDatabase
Database
►
: EXTRAORDINARY
Input
i 2)Amount Enable
Enable Numeric
Numeri:: 2200 Yes
Yes Input
Input Database
Database tTl
i Newclaimsregis tered
lstered Database
Database
X
Numeric 20 Yes Input -l
1)No. Enable Numeric 20 Yes Input Database
~
Enable Database
2)Amount
i 2)Amounl Enable
Enab6e Numeric
Null'll!!ric 2200 Yes
Yes Input
Input Database
Database
ClaimssettN!d
i Claims settledftJUy
fullyw ithoutg
without rievance
grievanc:e Database
Oat..lbase 0
l)N o. Enable Numeric 20 Yes Input Database
~
1· No. En.able Null'll!!ric 20 Yes Input Database
1 22) A mount Enable
Enable Numeric
Numeric 20
20 Yes
Yes Input
Input Database
Database
i Oalms
Amount
Claimssettled
1)No.
settledfuUy
fullyssub~uent
ubsequentto tc grievance
rievance
Enable Numeric 2200 Yes Input
Database
Database
Database
z
2
l)No
) Am
i 2)Am0t.1nl o
u n t
Enable
Enable
Numeric
Numeric 20
Yes
Yes
Input
Input
Oalabase
Database ►
~
Enable NumfrlC 20 Yes lnp.Jt Database
Claimsfirst
a Oaims first rejectedand
rejech!d andssubsequently
ubsequentlyse ttledfu
sett1ed lly
fully
Database
Databa5e
1!)No.
)No. Enable
Enable Numeric
Numeric 20
20 Yes
Yes Input
Input Database
Database
7) Amount
2] Amount Enable
Enable Numeric
Numeric 20
20 Yes
Yes Input
Input Database
Database
C laimsfirs
Claims fJrs1tpartiallyssettled
partially ettledand
andssubsequently
ubsequentlys~ttled
ettled
fully
b fully Database
Database
11 )N o.
No. Enable
Enabll! Numeric
Numeric 20
20 Yes
Yes Input Database
Database
2)Amount
2)An'IGUnt Enable
Enable Numeric
Numeric 2200 Yes
Yes Input D atabase
Database
Claimspartialf\,
Cblms partiallysettled
settled Database
Database
1l)No.
)No, Enable
Enablo Numeric
Num@ric 2200 Yes Input Database
[P
Yes D,1tabase ':;,
» 22)A mount Enable
Enable Numeric
Numeric 20
20 Yes
Yes Input Database
Database
art
~
Amounl
Claimsr•pudlatl!d
Cllilll! repudiated , Database
Database
Numeric 20 Yes Input
Enable Database
r
11No. Enable Numeric 20 Yes lnput Datatir.ise
III— S e c . 4]
lW o .
i 221""-nl
)Amount Enable
Enable -- Numeric
Numeric 2200 Yes
Yes Input
Input Database
Database
Claimsdosed
ClaJms doseddue
duetotootherre
atl,er asons
reasons Database
Database
1l)Na.
)No. Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
Input -^
~
> - Database
Database [./]
22}A mount
Amount Enable
Enable Numeric
Numl!rk 2200 ■•s. Yes
Yes Input
Input Database
Database 0
Claimsr11opened
reopened Database
Oalnll
11)Na.
)No. Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
Input
Datab.ise
Database
DatabaSI!! .:=
8s.n.N 2)Amount
21Amounl Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
1.,..., Database
Database
,.....,
Claimspendingattheendoftheyear Database
9CJJ.1 dalrm pl!ndlna at thlP end cf the ','Mr
l)No.
111111. Enable
EnaW.
En■able
ble
Numeric
NlJmeric
Numeric
2200
2200
Yes
Yos
Yes
In put
1"11111
Input
Database
Database
Database
Database
1
9.H
u 2)Amount
2 Amount En Numeric Yu Input Database
lO.i PenalInterestPaid Database
~
lllJ 111ml ln.. ,■st Paid 0atabaH!
1)No. Enable
Enablo Numeric
Numeric 2200 Yes
Ye, In put
Input ' ' Database
Databa.se
lO.ii
10.li Enable
Enable Numeric
Numeric 2200 Yes
Yes In put
lni:iut Database
Database
ll.i
11.1 IncurredClaimsRatio Enable
Enablo Numeric
- Numerk: Database
O..tabase
11ii
IIJI Enable
Enable Numeric
NumertC Database
Database
~
.......
-
Agmserfp«„dlnoeUlmt- . Rt r TaW
eName ' Wyp. ’ ' D^V.,U
. Mandate*?; ’ FieldType Database
12.1 Claimspendingforlessthan1month Database
1)No. Enable Numeric 20 Yes Input Database
12.11 2)Amount
12.D Enable Numeric 20 Yes Input Database
Database
Claimspend
Claims pendinIregfor
for1reater
greaterth an11month
than monthand
andless
lessthan33
than
*■ •
13.1 m
UI onths
months Database
Daftbase
1)No.
!INo. Enable
Enable : Numeric
Numeric 2200 Yes
Yos Input
Input Database
Database
IB.ii 22)Amount
13.il Amount Enable
Enable Numeric
Numeric 2200 Yes
Vos Input -»
Input Database
Database
Claimsp
Claims endingfo
pendin1 forr1reater
greaterthan
than33 month
monthand
andless
lessthan
than66
14.i months
14.1 months Database
Oatab.is@
l1)N o.
No. Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
lni:iut Database
Database
14.ii 22)A
IU mount
Amount Enable
Enable Numeric
Numerk: 2200 Yes
Yos Input
Input Datab
Data ase
base
Claimsssettled
Claims ettledfor
forg reaterth
greater an66month
than monthand
andle ssth
less an1212
than
1IS.I months
5.1 months Database
D.atabase
l)N
1 o.
No. Enable
Enable Numeric
Numeric 2200 Yes
Yos Input Database
Database
1.5.R
i5.n 22)Amoont
Amount Enable
Enable Numeric
Numeric 2200 Yes
Yes Input Database
Oatab.ise
Claimsssettled
Cblms ettledfoforr1reater
greaterth an11year
than yearaand
ndle ssthan
less than22 ■
16.1 years
16.i Database
Database
'"
11)No.
)No. Enable
Enable Numeric
NurnertC 2200 Yes
Yos Input Database
Datilbase
16.ii 22)A
16.11 mount
Amount Enable
Enabll Numeric
Numeric 2200 Yes
Yes Input
lni:iut Database
Database
Claimssettled
17.i Clalffl:!i
17.i settledfor
formore
moreth an22yrrss
than Database
Database
l)N o
!)No. Enable
Enablo Numeric
Numeric 2200 Yes
Yes Input
lnpu1 Database
Database
Enable Numeric Yes Input
I
17.ii 2)2)A
17.li mount
Amount Enable Numeric
■ 220° Yes Input Database
Database
a
i — — I— m i I M i -l l l l l l l
j’.i. l l S f ; HE3H
Claimssattlad
12.1 Claims
12.1 settledfor
for•n
lessth an11month
th.in month Both
Both
1}No.
!)No. Enable
Enablo Numeric
Numeric 2200 Yes
Ye• Input
Input Both
Both
12.11 2)Amount
12J 1JArrounl Enable
Enable Numeric
Numertc 2200 Yes
Yes input
Input Both
Both
Claimssettled
Oalms settledfo
forr1reater
greaterth an11mDnttl
than monthaand
ndle ssth
IMs an33
than
months
i3.i months
13.I Both
Both
1)No. Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
Input Both
Both
13.ii 22)A
13.11 mount
Amount Enable
Enable Numeric
Numeric 2200 Yes
Yos Input
Input Both
Both
Claimsssett~
Claims ettledfor
for1reater
greaterth an33month
thin monthaand
ndless
lessthan
than66
14.i months
IU Both
Both
1)No. Enable
Enable Numeric
Numeric 2200 Yes
Vos Input
Input Both
Both
14.H 2)Amount
IU Enable
Enablo Numeric
Numeric 2200 Yes
Ye, Input
Input Both
Both
Claimssented
Oairns settledfor
for1reater
greaterth an66month
thiln monthand
andless
lessth an1212
tlian
months
1IS.I5.i months B oth
Both
1)No.
llNo. Enable
Enable Numeric
Numerk 2200 Yes
Yes Input
Input 3lath
oth
15.il 22)Amount
15.il Amount Enable
Enable . Numeric
Numerk. 2200 Yes
Vos Input
Input B oth
Both
daimsssettled
dllms ettledfar
forg reaterthan
greater than11Yl!U
yearaand
ndle ssthan
less than22
years
16.1 Yl!!ars
16.I B oth
Both
1)No.
!JNo. Enable
En.Ohio Numeric
Numerk: 2200 Yes
Yu Input
Input B oth
Both
16.tf 2)2)Amount
16.~ Amount Enable
Enable Numeric
Num&ric 2200 Yes
Yes In put
lflll(JI B oth
Both
ClaimsssetUed
17.i Clalmi
11.1 ettledfor
form oreth
more an22yrs
than yrs B oth
Both
1I )No.
No. Enable
Enable Numeric
Numuk: 2200 Yes
Yes Input
Input B oth
Both
17.«i 22)Armunt
11.11 Amount Enable
Enable . ____ __ Numeric
Numeric 2200 Yes
Vos Input
Input B oth
Both s
i:-J~~•uo1·~;~~-- ;~!W~f-*~1•111r..t
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: ■ -■
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.
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s repudiated for greater than6m
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l 1 1
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•C
sa. 1
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c c
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l l l 1 20j
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-
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1
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Ic J=
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|
aU
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-
j ~ i
>
a
■6
I ! !1rput
1
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3
Enable
V
--~moric
:=
1J
~
-
0
'Tl
0
z
►
tTl
...,><
~
0
::a:,
0
z
►
~
-, II
[P a r t
?-
III— Sec.
TCJ)
Pl
4]
~
[ ’ TFT
be fumish1!d by.Ali insurers
I I I — Isl^S
Purpose and frequency
Tocollect
To collectproductin
product formationfo
information forrall
allp roductsh
prodocts avingte
havi1111 rm11y
term earo
year orrless
lessth anI1y
than ear
year
ToreplacetheexistingformDtoaddmoredataelementsonnewbusinessandexpectedbusinessdata
To replace the existin1 form Oto add more data elements an new busin~ and expected business clata
Thefrequencyofthereturnisyearlyandasandwhen.
The ln,quency of the return is yearly and IS and when.
4]
P
.,_
FIiters and Parameters
Filters a r a m e t e r s _____________________________________
InsurerName
lnsuR!r Name
Product 3 -Product4 Product 5

c d
IProductName
2~
,ScopeooffCover(l
Cover(l))
r
. ,~-, -""'-
~· tH--------+-----+--------------r---~---
ospitalcare
Care
--r I
7L
I
3a Scope Hosp~al isto
List offsco peo
scape offcoverg
cover ivenaand
given ndis mentionedb
is mentioned elow
below
:_3b 3b-[Target jTargetG roup
Groop '•·\Ol"I Oth
Others
- ers I ■ H os p
Hospital italC a
Carere
4 :In
4 suredTType
11nsured ype ·-
. Individual*aroup
lnd"i.,,id~I+ group Group Group 'IIn dividual I
ndividual
-
I 2. Critical
2. CriticalIllness
Illness
,__4 4aa _ ~e IB_a,_s_ sisls_oo_ffP_Pa_a~yyou o_utt_ _ - - - -- -----,!-------,f-- - -- --+----,-·-- - + - - - - - ---+I_____--1 3.3. Sur1ical SurgicalCashCash
55 jj DateDateo offcle aranceofofp
clearance ro_du
prod c_t _ _ _ _ _ _t-- - -- - + - - - - - - - f - - - -- ;------,--- -- --,l_____---l 4.
uct 4. H ospitalDaily
Hospital DailyCash
Cash
5a ' Minimum
Sa IMinimum Policy
Policy Period
Period i I 5.
5. H ighDeductible
Hitlh Deductible
~ 6b- i~:::~~a~~c;tp:~
5b jMaximumPolicyperiod^ ~---------t----~-t-- ------- 1Launc- he_d_+------<--------+;---- - ~~:6. Outpatientcover
6 CurrentStatusofProduct
1---=--~=====~=----------t---,---:,----,,-------f=-c-'-----'----t---- --+------.,----- -- --.17. Dentalcover
Launched ~~::;~:::~r
66aa :Add-on
!Add-onco versinduded
covers included c'1 ,~. No Yes I 8. H ealthS
Health avings
Savings
6b No.
6b No.ofofadd addo onncocoversvers C'. - I I _J9.D omesticT
Domestic ravel
Travel
6c ijWhether
6c Whetherserviced servicedbybyTPA TPA7? 1 Yes I I 110.0. International
InternationalTravelTravel
6d :Total
6d iTotalno. no.ofTPA ofTPAinvolved involved I I 111.1. International
InternationalComprehensive
ComprehensiveCaver
Cover
t·r _•t•~ .•?i,::., --.,.., ~•-7,,.-. 12. Specified
Spedfieddisease/
disease/disease
diseasem anagementcover
cover(e.g.
{e.g. Cancer,
Cancer, HIV,D iabeteseetc)
tc)
'·"'"" -'.
77 •N
G
No. o.o offp oliciesissu
policies issued ed . .,;'!- .
'"' , ...,_..,,,_~,..." UW :.;:
f
>'lrl•
----
.-...,-,-~·.,;:,r., ' . ;·;::;- •~'."r'"";; ..t ·' 12.
--<---------------< 13. P
13. ersonalAccident
Personal Accident
management HIV, Diabetes
f-_ a__G _rro _o_ss ss_PP re

_re _m m iumm
_ iu_ _'*_CoC ollle
-,- lect_cte
edd_ _ _ _ _ _ _ _ -----~+-------,_[ _ _ _--+------+---- - - ~- I ----- 1 4. Maternity
14. Maternityaand ndFertility
Fertility
~ .i __ITcT
__ot o__taal_Pr
l P_ere_m m_iiu
0
_u_m
m_C,,C _ede
d_ed d_ ___ _ _ _ _ _ _,......__~_ _ _'-_,_____ __ -1- - - - - - + - - - - - - ~- - - - - - - ' _ _ _ _ _ _ 1 5. Long
15. Longte rmca
term re
care
99 ;N Nooo offp ersons/members/liv
persons/members/ lives escovered
covered- - - -t,---,~= •;:;---t-Dal Data
_ __ a toinpul
lo Input IDato
Datatofnpi
to lnp,' J t 16. Disability
16. Disabilityaand ndrehabilitation
rehabilitation
~ 10 -'-!T ;T:.;:o
0;.:ta
ta;:.:ll..=S
S.u
u::.m
;.c_cIn sure d _ _ _~ ______+-· •-'"''" ~'.'--'--,.._ I-_ __ _ _-+-- --+--- --+- - - -- -+------ I - - - 17. 17. Mental
Mental Illn ess
illness
11a !1Reinc.urance
ReinsuranceC
m lnsu
.cc.ccc
red c=....
ommissionsR eceived . ''--'
'I 99.
99. A nyo ther
11:a
7a jN o.oof fpopolicies
Commissions
(~~~:.:CD~. '"-'-' -~•
Ttdesddue uefo rre newal
Received
.. -
Any other
7a 'No. for r~al • I

8a N
8a o.ofpoliciesrenewed____
1No.ofpoliciesrenewed j,. k ' r- -----1-----,-----+-- - - - - -
!
1--= 9a: __cTc.o::.:ta-=,'-R"' en"ewa =-:--lc' Pre -=-m-:--iu'--m~ Col -oc- lect - e-;
d- - - c- ---+--,..,.,-- _, -....,.-,_~+
9a TotalRenewalPremiumCollected i
9 a.i9a.i •Total[TotalRen•wal Renewal Premium PremiumCeded Ceded __ . • ~: ·~,cJ
9,""'~
I
-~ Noofpersons/members/livescovered
o -ol ~rsons/members/lives coverod . -'--':\"'7,,- loa,
c--a - ,o-ln
,-p
- ut
- -----t-=o.c.
- -to
- ,
-i..i
:- ---t-· ---- --J-+--- - - - -
& Data to Input I
1---'l=-+!T
h T:.:oo talSum .::.cIn
:::ta::.:l.::Su.::.m l= su'rre
""' -'eddin
"--i re
=n
'n-'-re nee
.::.w
w
=,aa::.:ll-,---c_ _ __ +►·...;,__ .,. __"..+-------+------+1------+- - - - - - !
<:.,..
lib ' R
llb einsuranceC
Reinsurance ommissionsReceived
Commissions Received ,._,.. ~ f.. ·., I I I
~ :No.ofofccancellation
INo. ancellationd uringth
during theepolicyte
policy rm
tffl'n
I
8b. , ss l
fie IN
6e o.ofofe9licies
No. policies ' Ii '"",;;:.,-_~
V. . ,-.-1
•• I
6f ;GrossPremium J •, ~ '. 1; .... . I
Total110.
6g Tllbl
Iii no. ot.111111,
ofclaims
Totalamaunt
661,h Tatal amountalofdalms claims
6i C
61 laimsratio
Claim, ratio ~,e will be
Com
L---=L-_,_Co=m
.... c:bb inedratio _ _ _ _ _ _ _ _ _.....,.._
:;;;in.;;•c:dcc•:c•t;;;io;..... *■. _ _ _ _ _....._ _ _ _ ____._ _ _ _ _ _ _ ____._ _ _ _ __ ~- ----- np,. tbylnsurrr,.
ClaimsRatio=
Claims Ratio=[Total
(TotalA mounto
Amount offClaims
ClaimsIn curred)/GWP
Incurred)/ GW P
CombinedRatio=
Combined Ratio (TotalA
=(Total mountofofC
Amount laimsIn
Claims curred+Total
Incurred+ TotalCompany
CompanyExpenses
ExpensesAmount)/GWP
Amount}/GWP
ClaimsO
Oaims /sratio~
O/s ratio=T otalcla
Total imsp
claims ending/totiiill
pending /totalcla imsre
claims ported
reported \
Claimssettlement
daims settlementra tio=N
ratio= umbero
Number offcliiilims
claimsse ttied/totalclaims
settled/total claimsreported
reported
Note:
Nole:
1.o
1. nlym
only ainco
main versshould
cover houldbbeementionedin
mentioned scopeo
In scope offcover.
cover.
*Grosspremiumisdefinedasthepremiumamountbeforedeductingservicetax.
• Gross premium is defined as the premium amount before deducting service tax.
£ input_health_2
INPUT_HEAW4_a Ij !j yYearly
eorly II ,....,
^ Details of product
prodqct performance in terms of claims management w.r.t TPA (To be furnished by insurers having health insurance business)
Purpose
Purpo1 ■ and frequency
1
*4^ To capture
c.aptur@ the performance
PHfOtfflilnct of the products
oftl-.e producb inIn terms of daims management
ofdaims manaae,nen1 w.r.t TPATPA
This form
This form isis iia replacement
r1placement of the existing
eidstina form
fomi D Dto gather
lilther more detailed level
more dt!Ulled level lnformiltiDn
Information about TPAcontribution.
ilboulTPA
The
TN! frequency
fre.:iuenq, of tht!
the return
r@turn is
IS yearly
yeiilrly and as and
and as ilnd when.
7 Filters
Fllbr-5 and
.and Parameters
Par■ mnt!n
--
■M v..,
v„r f............ .... ..... ....... 1
--
~ - - - - - - - - - - - - - ~ C a l 2]
m Claims
s Handled Through
Handled Throucti ®i/*house
•lnlh>ule Q pa
0-,A
---- ·-~----
_ _ _,___=:!--I-
-+-------
- - - - + -~ -+----- --t=- -----j
f-- --------
-1
____
I --
1
[
Note:
Note·
1. All
All Im"
the prod
products
ucts which
which have been approved
hilve been approved during
during the period will
1h@ period will be
be covered ir tNl Jonn.
covered ir.
2. Product Typt-
Type can
can be Individual
lndi11idui1I or Group
Group.
3. Current
Current Status of product will be - active,
will be i1Cli11e, inactive
inilctive or withdrawn.
withdrawn
-
|Product
~ ~ l_________________________________________________________
IValues to be entered
E'nt@red separately
s@ .:iriltely for No. of policies serviced=a
No. serviced:a No. of
ol claims
cl.ilms handled=,b,
hanc:lled=,b, Amount
-- ·-- --
Amount of
or claims handled=c.
hilndled.:c, No. of claims
cl.iims settled-d,
sl"ttled-d, Amount of claims settled
-•... -
=e
settled=e
-- .... _ --·
Ift V
"'·
,._
Particular
Name of
Nilmeof
Product
·-
EnabWDisabte Reference Form Table Name Column Name Data Type Size Default Value ..._.,.
Mandatory7 Field Type
Fllld Ul Validations .
Business Logic
Need
Input
on ..
Remarks/Descripti
to Validate
Need to
Input for
Villidi11@ the
for Products
and policies
,md
the
issued
policies issued
_,
level
can
un come from
from Form
Fonn
C Enable
En.ilbi@' VarChar
va/'Char 20
20 Yes
YflS Input
In UI Should not be
Should not be Numeric
Numeric n INPUT Health
IINPUT Health 1 1
Need
Need to
lo Validate
V<11lidi1tl! the
No.
No. of policies Input for
for Products
serviced
J.erviad and policies issued
ilndpciliciesissul!d
can
can come h-om
from FormForm
aa)
Cl•J Enable
En.ilble Numeric
Numeric 20 Yes Should not be Negative # INPUT Heillth
Health 1
No. of claims
No.of cl.aims '" Input Should not M Ne1.nh,'I!' I INPUT Databse
C(b)
Clbl handled
handled Enable
En.ible Numeric
Numeric 20 Yes Input Databse
Amount of
'"
c,
C(c)
m
Cid)
claims handled
claims
Amount
handled
No. of claims
·--,....,
Enable
se Enable
claims SI!!
Amountafof
daims settled
cl1lmsMtded
Numeric
Numeric
20
20
Yes
"'
Yes
'"
Input
Input
lnut
Databse
Diltabse
Databse
Dat.abse
§
Cl■ J
qe) Enable
Enilola Numeric
Numeric Databse
Dat.lbse 8
110 THE GAZETTE OF I DlA · EXTRAORDrNARY [PART Ill- EC. 4]
J lH
J J
il it
1
...
I' 11 I
'
ll'#'UT_HEAL1H_5
INPUT_HEALTH__5 Monthly
[WT III—
liletoTPA
Details of Due payable to TPA
Purposeaand
Put'J)OS,11 ndfrequency
freQUlfflCY
To
Ta measure
musur. the th• effectiveness
eft«tiiftne111 of functions afTPAI
of TPAs in
An terms
terffl'l: of flc ■ 1 and TPA
daim float
afdalm TPA Fees
FeM
This
Thl1 is
k the
di• recreated
r«rHt•d form
l:Jrm of the
th• proposed
propoted format for collecting
coll«ti,il due lnfcnm■ tion
du. information
The
Th• frequency
tr.quency of
at the form
form is monthty.
monthly. Tha
Th~ data is submitted
submittRd by insurers
lnsuttrs inIn respect
rmpect of every
ev«y TPA
TPA enrolled with them.
th•m.
Filtersaand
Fllt•rs ndP arameters
Parameters
4]
Year
'-------------------~I-
lnlunrflllrne
Insurer Name
~ - - - - - - - - - - - - - - - - - ~IT'P4-
,. . ...L..,____ 4• ,, • I .. s Float
!IO-'!I • TPA Fees, ______
1~~P~\ Total
lo!al
• - • ,~ i
I ~b b c
C
. ~
Closing
(losing balance
bal.anu ooff previous
pre-..io,a month
!Tlonth will
w ill be
b l! opening balance of current
cuirent month
2 Payment request received during the month
3 , Due
Ou, paid during
durin1 the month
"
t--------,-"-• 4 Due outstanding
ou_,._1,_,_difl1 at
_ al the
lhe end
en d of
af the month
the mond'I ---~ - - - --+-- - - ·------- - - - - - · -
.__ _ _5s_ __ __Due___
Due __ ___
..,_ ttia .~--;;,
ndln,: at the
outstanding end of the rMr1th
thti month ~ l
5.i
S.i More than
thc1n 0-
D- 77 days
davs I
5.11 More than 7-15 days
_.li________M_o_,e__l_h,_,~7: · ~- -- - -- - - -,- - - - - - < - · - - · - - - - - -•,- -
_ _ _ _5
----'!":"~.s'; ----, ,- -M
S.iii
5.iv 15m~:=~c.:,!~~-------
~M~::;~ : ~:~,=
More than 15- 30 days
More than 2 months :"
1
-_--,_
, ----~1-------------,·--====-=---.:-__
l----c:"~:~---'-- -':~':':"':":~: " :-=:-":=·"-: 7:'--------.-:-,-- ~
5.v 1 More than 4 months
*!K?T
5.vi More than 6 months
..)ffAL7H_fi.l
INftJf
INPUT^HEAL TH_6.1 ? 7 Monthly
| M o n t h ly I
\
be submitted by the Insurers having health business (Group)

Details of Claims Handled directly- To He
Purposeandfrequency
Pu,pme and fre,quency
Thepurpasa
The purposeofofth
theeformis
form Is to
to collectthe
collect theinformationofofth
Information theecl.alms
claimshandled
handleddi~ly
directlybylnsurt!rs
by insurershhaa
v... inghNtth
1rc healthbusinessfo
business forrthit
theg roupbuslnus
araup business
Thisis
This is a modificationo
a modlfic:~ion atfproposed
proposedfo rmatfo
to,mat forrcapturingth
capturina thec laimsd
clalms ata
data
Thefre
Thit quencyo
frequency offthefo
the rmis
tom, monthly
Is monthly
FiltersandParameters
Fllten and Panmeters
Year
v...
'--------------------'' -
'-------------------------'-- |Group
!G roup "
Clo/ms movtmtnt Details

Claims movement Dtrolls F ormln
!='.arm put_
lnput Health_6aand
_Heahh_6 ndF orm!n
form lnpu?_Health_6.11 n
put_Health_6 eedss to
n~ed to b
bf'em erg
me edb
rged yg
by ivingd
giving ropd
drop ownfo
down forrBusiness
Busine.§s
ReimbursementI B enefitB ased Total

. Particulars
Particulars
Col-umn Code
Column
N
Noo.o
.
alfclaims
cla1nH,
Cashless
Castiiess
A mounto
Amount offc
b
b
laims
claims N
Noo.ooffc
"''~I,,..,,
laims
claims A mountO
Amount
d
offclaims
claims
d '-S'
N
No o.o
.
alfc
e
Bene/11
laims
claims
fl.ned
Amounto
Amount offc
fI
laims
claims No.o
No offc
g
g
laims
claims
Total
Amounto
Amount offc
h
h .
laims
rla1ms
Claimsp
Claims endingaattth
pending theeb eginningo
bqmnl offthem
the onth --
month
'
2 N ew
iNt:w Claim
Claim~sre gistered
reaiste,ed d urin
duringg the
thf' m onth
month I i I I
1- ¾ - - l C
- + - t ,C
laimsS
~lms
Oalms
ettledD
Settled
laims,.pud~ted
uringth
During
repudiated____
eM
the onth
Month ·- ~
i
I
I
•
I
- --
I
I
S Claimspendln11
,Claims pendingaattth
theee ndofthem
e~iattht! onth
month I I I I
Aging of pending
ptndlno claims
<lo/ms ■
·•*
Cashless
Cashless Reimbursement
Reimbursement •BenefitB
Benf'flt ased -
Based Total
Total
,: P articulars
Particulars NNo o.o offc laims - A
claims mounto
Amount offc laims •
claims N
Noo.o offc laims1 1 A
claims mounto
Amount offclaims • N
claims o.o
No fclaims
of~a1ms Amounto
Amount offclaims • N
cla,ms o.o
No offc laims
claims Amounto
Amount offclaims
da,ms
Column Cod~
Column Code . aa • b
b • c
c |
' d
d . e
e f
f • gII . h
h
1 C
1 laimsp
Claims endingfo
pending forrle ssth
less thanan11 m onth
month _ ----· ~ - --+-----
_____1_ }OaimsClaimsp endin
ptnd in1 gfoforr1 -3m
1·3 onths
months _ _ _ _ _1 :_ i 1
33 C la im s pe n d in
Claims oendlna tor 3-6 mon g fo r 3 -6 m o n ths
.~~th_•--- - - - - - + - - - - - + 1 - - - - -- -- - - -- - · - - - -'- - - - - - - + - - - - - - - - - - - - - - - + - - - - ---- - + - - - - - --<
4• _ _,;:G:aim :;;s pen'"ad in gfo r6ti--1 2m onths -- - - - -+-- - - - - + - I - -• : i.....— - -- - - - - , - - - -----t-- - - - - - - i - -- - - - - + - - - - ----+--•--·- - - -
I--_---.--Jc::.aa
C
5S iOalms
::l::,m
la im ; =..
sp en d
oendina
;n&
::;::.
d
in ,i.,:;
gfo :;..:::
lo<
forr1 -22"mon
..:l;.
1·2 y ea=rslh=•-
years I . - • - --..-.
--+
1I - --------- .
claimsp endingfo forrm oreth an22 years .I
-.
I lclalm1 pendin1 more than wears ..........................
*• Rec k o
n e
d 'fro rr. d
Aeckonaltfron:. date of a te o f firs
firstt in tim
intimatt0natio n
AOl"II a/
Aging of settled claims**
uttltd claims ..
Cashless Reimbursement BenefitBased
* 1_________ Particulars ________ Amount of claims No.ofclaims Amountofclaims Noofclaims ^mountofclaims No.ofclaims Amountofclaims
Colum n Code
1_ Claimssettledwithinlessthan1 month
Claimssettledwith in
1n 1-3m
1-3 onth
months s
IClaimssettledwith t~
in3-6month s
ths- - - - - - -+ - - - - -1-- - - - - - - - - ~ - -
Claimss ss.ettled
ettledw rthin66-12
within -12m onths
months
iClaim
Clii msss ettledw
settlt'd ithin11-2-2y
within ears
yean
6 Ic, la1im .s
,se
1ttle
m dw~ithdin~mo ore~tha~n2ayerasrs___
** Reckonedfro
•• Reckoned frommth
theedate
dateooffre ceiptofoftast
reulpt lastre quirement
r•quir•ment
r•pudlat•d claim
Aging of repudiated dalnlJ•••
s***
,, . P 1 Cashless
Cashless . Reimbursement
Re1mbursemf'nl B enefitP
Benefit aid
Paid ,
Part,cul.ars
articulars
1
. » iI No.o
No offc laims . A
cl.aims mounto
Amount offclaim
cla s
ms 1 No.ofclaims i1 A
No of cla,ms mounto
Amount offclaims ·
cla,m,; No.o
No offd aim$
cl.11ims A mounto
Amount offclaims
cl.aim\ • No.ofclaims
No of chums Amountofclaims
- Amo nl of clam
Column Cod~
Column Code aa b
b
1 ,1 r I r u h h ' ,.
1 jC laim sre pu dia
te dw ithin le ss th an 1 m on th
__ 22_ [Claimsrepudiatedwithin1-3months
!Claimsrepudiatedwithin3-6months
_)4 _-=.c..c= "+--- - - - · - - _,_I- - -
iClaimsrepudiatedwithin6-12months -,------+-
Claimsre
___:_ S- -- 'claims pudiatedw
repudiated ithin11-2-2y
within yunears
6 'cclaims
laimsrepudiated
repudiatedw ithinm
within moreoreth an22 yean
than ears
THE GAZETTE
*** Reckonedfro
••• Reckoned mth
from edatll!
the dateo offre ceipto
rwceipt offla stre
last quirement
requi~ent
OF INDIA
INPUT_HEALTH_6.1
INPUT_HfALTH_6.2 I Monthly
M o n th ly I
I u ■ v ; ,
Details
D e t a i l s of
o f Claims Handled tfirougfi
through TPA- To be submitted by the
TPA-To the Insurers
insurers havinB
having health
health business
business
Purposeandfre
Purpose ■ nd quency
treq&.1ency
: EXTRAORDINARY
Thep
The urposeo
siurpc:is• c:iffth
theefo rmIs
farm 11 to
tc:i collectth
CDllett theeinformationo
lnfarmatlcir, olfth
tMed aimsh
daims andledth
t.andl•d roughT
throu&h PA
TPA.
Thisisamodificationofofp
This it I modiflutlon roposedfo
propcis«i rmatfo
format forrcapturingth
upturin1 th•ed aims(tau
cl.aims data
Thefr
Tha equencyofofth
fn!qU41!ncy thl!eformfsism
form onthly.
monthty.
Filtersaand
FIiters ndP arameters
Parameters ____ ___ JMonth
Y ear
Vear I' - - -_________________________________
------------------'llan tll
In surerName
lnsur•r Name I' - - - - - - - - - - - - - - - - - - - - - ' 1 P A N a 1iT
PA
1 1Nae
me
D ivision
Oivklc:in Individual O ®Group
Oa/ms movement
Claims mowment Details
• (.;isnll!'\\
Cashless , Reimbursement
RPmtJurll!'mrnt • Benefit Based
tlenrt ttla1ca Total
lOIJ
• P.;ir!cuJrS • No of
oltl.;im, _ Amauntofcl.;arr• Amount of claims Amount of claims
Particulars No. claims Amount of claims No.
",j,-, of claims
,-Ir,.,.,, Amountalclim~ •• ' • A,~~~,' ,T • •• ' • Amountolclam1
, - .. r ,,, , t (. , , • , ►
IClaimspendingatthebeginningofthemonth
INewClaimsregisteredduringthemonth___
ClaimsSettledDuringtheMonth___
Claimsrepudiated ________ ;__
IClaimspendingattheendofthemonth___
[P
art
Aging o/ prndlng claims *•
of pending
III— S e c . 4]
Ln'11eu
Cashless _________ Reimbursement___________
Rf'1mour,emc-nr __________ Benefit
Hcr,et11 Based
tla~ca ' •
, • P.;ir ,cu .;ir\
Particulars
: No of
No. of claims
cl;i ml • Amou,.,I of
Amount of claims
clams • ~No. of claims
m~ 11 Amount
Amoun~ c ~ m,
of claims • No.
~ off claims
ti;;~ Amount
Amount ofof claims
clam~ : •• • Amount
ArrounT of
ol claims
r•.a rr~
Column
Column Code
Code , ► , d e" ff • •
~=--=
1 1Claimspendingforlessthah1month - -+
2 [aaimspendingfor1-3months - -----~,-------- !--------+----- · -
3 [claimspendingfor3-6months • ➔
4 jClaimspendingfor^6-12months !
5 [Claimspendingfor1-2years____ - --+-- -- - --------'---- - -1=+----
6 [claimspendingformorethan2years
*• Reckonedfr
Red:oned omd
hotn ateo
d.;ate otffir
stin
finl timation
in11m.aihon
Aging o/
of settled
settlrd claims**
claims ..
1 a C a
- 2 a &
• Cashless
(J<l"lr~1 • J- --, _ ! • _ • Benef-t
r I Based
ti , • _ , I
Particulars
PJrtc~ Jr! ..,, • ' '· ,• ~... Amount of claims
Amountofcla•m\ -. Amount
Arr 1 oflei
claims
rn~ No.
No of
c 1 claims
c1a,m\ Arrountofca,.,.-
Amount of claims
C.01urnn Code •
Column , t ' , 1 • r , • , ..,
IC laimsssettled
ettledw ithinle ssthan1l m onth
HI—
Oanm wrthin less than month
22 [d aimsssettled
i~ims ettledw ithin11-3-3m
within onths
month~ T
3 IC ulaim~ssettledw
§e'ltle<:l ithin33--6-6m
Wlthin onths
months I
.C Claimss~tt'ed
~Claims ettledw ithin66-12
llrithin -12m onths
months I I
5 1C laimssettledwftW
cIuns~wi"hin1-2yea w1-2yearrss I
claimssettledwithinmorethan2^ I
•** Reckonedfr omthe
thedatedateofofrre.r:e.,t
eceiptaloflast
lastr~ret
4]
• Aeclconed from
00
,qudlated clalms
Aging of repudiated daims*** •
Do (Cashless
.,~l'llc11 _________ Reimbursement
Ae•rn~t. l'Tl('nl ___________ ________ Benefit
8c,ne1,• Paii
~1 : • ,
, Amount of1 claims
Arre: n10 ,~m~ • No~,m~ _ AAmount
No. of claims________ r r eof~claims
~ No. of claims
NoofclJm1 j Amount of claims
Amo~r-lo'tJ11'T1\ • • •
Column Code
Colurnt1Cod~ a1 • c dd • • , ~
i Claimsrepudiatedwithinlessthan1month .,
'O 2. ;1C laimsrrepudiatN'.I
: Claims epudiatedw ithin1-3
wi'thin 1-3m onths
months __ _JI I T
ClaimsrrelUdtatfl:I
3 lClaim~ epudiatedw ithin33-6-6m
wrthin ortths
months _ Ii ! - I
.
I
4 Oaimsrrepudi.lted
leliams epudiatedw ithin6-12 m
'!Within onths
months j i 1 I
ClaimsrrepudutNt
klatrnS epudiatedw
daims,-ppudi~ed
repudiatedw
ithin11-2-2y
within
ithinmoreth
ears
~~
an22 years
I I
-~ ~-
i l ,_.,_ i
·r
6 ldalms within th.an yea-s I I I I
' from
~ monl!
... ...._.. fromththaedateo

dat11 off,.utpt
receipto offlut
lastrequ~nt
requirement
«fTTcT qR
.._ ..INlll•--W----
~
Tho-ol1"'r-lllO<Oks ... -ollfie-lw•-•
.........
n,.-.11111o-1,-i.
....,
-
w
..._.,d...,._
Thep
TIit urposeo
purpose offth
theefo rmis
form toccollect
isto ollectth
theeinformationo
information fthed
olthe almsh
ctalrns andle
hand dd
Seel irectlyb
directfy yin
by surersh
inS&Jrers avingh
havt1,1 ealthb
heaN:t, usinessfo
business forrth
theeindividual
individualb usiness
business
Thisis
TIils Is a
am odificationo
fflCJldflcltlorl offproposedfo
pn,po•d rmatfo
format farrcapturingth
capt\Jr1"1 theec
cla
■ im
lmssd ata
data
Thefre
Th• quencyo
frequency offth
theefo rmis
farm is monthly
,_thly
Filters and Parameters __________________________________ ____________________

Year |
'---------------------'- [Month
Insurer Name 1 ~1
<Jol,ru _ , , , O.IOIIJ
Claims movement Details
Cashless
Cashless Reim bursement
mbur~ement Re B enefit8.ned
henef11 Based Total
T~tal
THE
No.o
offc laims ,|A mountooffcclaims
laims . No.ooffcclaims
laims j A mountooffcclaims
laims • N -l
__#_ it P articCtJlar~
Part ulars N
\o laims • A
o.ooffcrlarms mounto
Amounl offclaims .
cla,nl!i No claim-; Amou~t No Amourt o.ooffcclaims
No laims Amounto
A'Tlounl offclaims
fla1ms
::r:
(odC' Column Code aa . b
b cc 1 d
d ee 1 ff g
g h
h m
1 iC laimsp endingaattth ttM!eb eginningo offth
theem onth __
ll"L'.'nd1n, month
'.•! - 1■ ■■■ L.
GAZETTE
Claims bl!ginnfrl£ C)
~’_2 |NewC laims~eig;s1ered
registere=:d
dd :;u r,;'-"in
g" th e• c:.mon
:::tth
h _ __ _ --4_ _ _ _ _4--_ _ _ _ _ _ _- ' - - - - - - - - - - - - ' - - - - - ----,~------11 - - - - ---,e--- - - - --le--- _
~
!New Claims uc; n2 't"'h=- m:::0n c: - ■ ................ • i
__33_ [C
1
laimsSSettled
Claims ettledD uringth
Durin& theeM Monthonth- - - - - ----.--------e------- - -.. _l________,______+-- - - - - - - • - - - ---+-----
_4' ;Qaimsre
!Claims pudiated
r~pudiated 1 I m
~
_5S_ jk:Claims
laimsp oendin1. at thfo end th
en din g atth e e n d o
of f theem onth
month I I
Aging
A!llllfl of
af pending
~nd/n!J claims
dolms 0•
OF INDIA
0
'Tl
Cashless
Cas,1ess Reimbursement BenefitB
Benett ased
B.;ised Totailll
z0
He1mtlursement Tot
n P articulars
Part1cu1ars No.o
No offc laim
tla mss A mounto
Amount offclaim
c1a rrss No.o
No olfclaim
cl;:i m~s !A mounto
Amount offclaims
claims No.o
No offc laims
clams A mounto
Amount offclaims
claims N
Noo
.oo'fclaims
claims Amounto
Al'l'lount offclaims
cra1ms
' Column
Cal1Jmn Code
Codt aa b
b ---------C -------- 1------- Td
C ee ff g h
h
l jC laimspen dingfo forle ssth
t a n11 mo onth ' >
Cli1ms
22 î(la
Claim
tmssp
ndfna
endingfo
pendi~
tns
forr1-3m
1-3
an
onths
months I
\ I I l .. -·-r--
II
: EXTRAORDINARY
33 j C laim
!ClaffTu s p en d in
pendilll g fo
forr 3-6
3-6 m o n
monthsths____ I I I I --------- -
__4 Claim
------;--7c~- sp
i ~s peen dingfo
ndini forr6 -12months
6-12 months _J I I
-- -- ' " 1
I ................ i
Claimsp
5s IClaim:s endingfo
pendini forr1 -2years
1-2 ! I I I i I
ÎI
'fll!!iUS
-·
66 | claimsp
I claims endingfo
pendin111: forrm oreth
mol"I! an22 y
than ears
years — — ( I I I I
*• Reckoned
Reckonedfro frommd ateo
date offfirs
firsttin timation
intimation
Aging o •~tt~d claims ..
off settled 00
Cashless
Cashless R
keeimbursement
mbursemert B enefitB
Benefit ased
Based Total
Tota!
-
Particulars N o.o fclaims
. A mounto
offclaim
mss No.o
offcla ims i A mountooffclaims No.o
offcla ims Amounto offclaims N o.ofclaims ! A mountooffclaims
-1~---=r
P.;,t1CLL,HS "--lo ofcla,ms Amount cla No claims Amount cla,m, No claims Amount cla,ms l\o ofcla,ms Amount cla,ms
' a b c 1I d ee ff g 1 h
F Column Code b C d 8 h
~11 {C laimsssettled
ettledw ithinle ssth an11 m onth -- 1 .
~
:ctaims
2 I:Claims
_33 !ClCla
Claimssw-ttled
ettledw
imsssettlN:I
aims ettledw
within
within
~ss
ithin11-3-3m
ithin33-6-6m
withirl
than
onths
months
onths
months
month
I
:■
I t=- •,’■■■ . .I
I
•
44 jQ aimsssettled
ettledw ithin66-12
-12m onths !
•i--·-
•1 I I ----
'Claims
1Claimsssett~
__5s !Claims ettledw
within months
ithin11-2yeilrs
within -2years ! i ----t- I I
--
Ir — —
jc ia im sse ttled with in m o reth an22 y ears --.
6 '• . 1i I I!
I I
6 ·cla irm settled within lllOn!than yen
** R
•• eckonedfro
Reckoned mth
from theedate
dateooffreceipt
receipto offla stre
tast quirement
requirement
oJ repudiated
AlJlng of
Aging TPpud/al~d claims••·
claims00*
Cashless
C.1shless Reimbursement
Re1moursement BenefitP
Benefit aid
Paid Total
Total
r- ;r- P articulaanrs
P;1rh<u · N o.o
fl.a offc laims
cla,ms A mounto
Amount offcjaims
claims No.o
No offc laims
claim,; Amounto
Amount offclaims ~ N
cl,1,ms l\oo
.oolfc laims
claims A mounto
Amount cffclaims : No
cla,ms No.oo•fc<ia,rns
laims Amounto
Amount offclaims
cla,ms
[P
_--j-____
Column Code
(c,lumn Cod~ aa b
b cc d
d ee ; ff ' g
g h
h
art
_ _1 1_ (c laimsre
1Cla1ms. pudiatedW
repud~ted ithinle
within I~ ssth an!1. m
than onth ______
,:nonth .\
. l1
_22_ fCJaimsClaimsre pudiatedw
repudiated ithin11-"-3'-'
within -3m on
rn=on th
h•s
cclcc~ - - - - --~ -+- - - - -f -- - - . -. -.- -:.-•. .-1! . - - - - - -- -+---- - - - - +- - -- - --I+ - - - · - - - --+-- - - - - --+-- - - -- - - - 1
III—
I ' -.
__3
-
-
· 3
__55 iC
jc ia im
1Clakns
___-4• - j{C
s
laimsre
Claims
•C la
re pu diate
reDUdlat~ d
pudiatedw
repudiated
imsre pudiatedw
w ith
withinin 3
Hi-6
ithin66-12
within
m
-12m
ithin11-2years
on
mcnths th
onths
months
-2years
s
-----1- I
I
_...... ■ ~
■.
. .., . III
.!
i
I
-- •
'%..
S
laims repudiated within •
6_ jc iaimsre pudiatedw ithinm oreth an22 y ears ; . 1 ■I ■
ec
I
6
*** R
iclaims
eckonedfro
repudiated
mth ed ateo
within
offre
mora
ceipto offla
than
stre
ye.an
quirement '
.
• 0 Reckoned from the date receipt last R!QUirement
4]
I
a 2 2
-
' .
purposeandFrequency
Purpose ■ nd Frequency £c
Tomllect
Ta collect$Ute
Statew iseInformation
~lse informationononGr055
GrossP remium,N
Prffl'llum, o.ofof:Policies
Na.. Policiesaand
ndTotal
TotalS umA
Sum ssuredaacross
Assured crossC hannels
Channels
Thisfcrm
This formisisn!·@nliliHrN
re-engineeredo onntlie
theb asiso
bni:s affexistingForml
Hbtln1 Form1aanc:1
ndForm
FormIIIIooff1ross
grossp remium.
premium. 0\
T hefre
The quencyo
frequency affth
ttleefo rmIsisQ
form uarterly
~ •* 4.f:>^
......,
Filtersaand
...
ndP1nmet1n
Parameters "
-o-
Rlten
,Year I J r
NameofInsufef
Nanll Df lns&nr l t
Direct Business
D•'C'rl 8L 1 11, \ r'7 •J
, (Internet) ['I,,
Direct Bl siness
•(I fl , 1 (Other
10lt'lt>• than lf'ft•r~r, 1
•~ 1~ Internet) Individual Agents
~::l \11duJI A1 f ~ Banks
8Ank<, OthP corporate
Othe corpor~IP agents
~gP~t, Brokers
P.rt,lit•I', Re'errals
fle'rrr 1,
No cf
No. of j
Prt>" H 1 Total
Premium r 1 ,I Sl.m
Sum No.
N) of
ol Premium
P,cmn.. m Total
Tc 1 ii Sum
'5u-n No.
No of Premium Total
Prp,i,um Tota, Sum NO.
No alof Premium Total Sum
Prem,um Taul No.
No of Premium
Prem um Total Sum No. of
No Premium
Prem,1.:m Total 'Sum
Sum No.
Ne, of Premium
PrPm,.Jm Total
To•al Sum
SJm
No. of policies
P•p...... ,,.... Tot
Premium 1 i! = ~ Jr
,,il Sum
State
Sf)t~ po•• r, 1 Amount
policies Amc ... nt | Insured
.,sured po ,IP\
policies Amount |
Amount Ir ured
Insured policies
polic,es Amount
Amo:Jnt Insured
l~,;urPd policies
l)olc 1M. Amount lrnurPd
Insured pol,c,Ps
policies An-ou,,,
Amount Insured
lnsJred policies
polic1M Amount Insured
lnsurl'.!d po,c,es
policies Amount
Amount 1ns1.rPd
Insured ~o c'r. [ Pi Ar
Amount ~ ~ r::l
ifsu'ed
(oJ.,mnCode·
Column Code a | bb
a }
c
c d
d --------------
- -, ------------------------
e - -{ - - - - f , - -· g
g
• 1"1-------,--
; h '
J
j
-• I
k
t • - ·1- ; ; _m- • - , ,n - • no .
--c,
P
• Q
P
•
rr • ss - • , - ~ - -- -
f
vV w
V,
•
X
1 AndhraPradesh
Andhra Pradesh
2 ArunachalPradesh
Arunadlal Pradesh '• '
3 Assam Anam '
4 BiharBlhar ■■■ ...; ..
5-• Chhattisgarh
■: Chhilttisg111rh
6 Goa Goa
77 Gujarat
Gujarat
88 Haryana
,H.aryana ■
g9 HimachalPradesh
Himilchill Pr.ade-sh ■- ■
10 Jammu8iKashmir
10 Jur.-nu & Kashmir
1111 Jharkhand
.11.arthilnd , ' ••
1122 Karnataka
lun.at.ab ' ........
13 Kerala
13 leralil -----r-
1144 M adhyaPradesh__
Madhril Prildesh
V: __ _ ..i 1
_
1l.55 M aharasthra
Matlilrasthra
1166 M anipur
Manlpur
1177 M eghalaya
.Molf,olaya
1188 M izoram
Mb:aram ____
! •
1199 N agaland ___
Nat;.aland 4- ---- J [--- -—i
20 O
20 rissa
Qn,sa
Punjab
21L_ Punjib
21 j'; •
'
22 R
22 ajasthan
RilJ.anhan
2233 S ikkim
Slldcim
__24_ 'T
24 amilN
T•mil adu __ _ j
N•dlJ
2255 T ripura
Tr1pura ,.J ../..j .... _— ’. 1i
26 "U ttarPradesh
Utt.ar"3d~ .• V
2277 U ttrakhand
Uttralr:hand
W estBengal
2288 WHtBf!ncal . '.._4
---t-■■.'. . . ■ '1
2299 A ndaman&&N
ktdam.an icobarIs
Nicab.ar Is.. : . ,1
Chandigarh
30 ICh;anC:liprh
30
3311 D adra&&Na.11ra
Dadra NagraHaveli
Haveli •••: '' : ■
3322 D aman&Diu
Dam.an&Dlu ■__ _
33 D
33 elhi
[)elt,j ____
~34_ Lakshadweep
- - t.ikshadweep I ...... J
Puducherry - -
3355 p;;-duct,,,ry ■
,
a Taraf
Total
i
...... - I I ^ .. .
116
116 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III— Sec. 4]
[ P a r t III-SEC. 4]
·7I-+--f---+-,.--l- 7--
i I
,
i
I
r-t- 7 --,f-+--t-1----+--H--,-+--i--t-H-t-+-r-+-11--+---+-e-l-~~-1--;--i..
I I
I I
. .,.
Cc No.o
No. offC laims
Claims Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
Input Both
Both
dd AmountofClaims
Amount of daims Enable
Enable Float
Float 15
15 Yes
Yes Input
Input Both
Both
In dividualA
lndivldual gents
Agents Disable
Disable
\P SnMt— III iilh ]

ee No.o
No. offClaims
Claims Enable
Enable Numeric
Numeric 20
20 Yes
Yes Input
Input Both
Both
ff AmountofofC
Amount laims
Claims Enable
Enable Float
Float 1155 Yes
Yes Input
Input Both
.
Both
Banks
Banks Disable
Disable
g No.o
No. offClaims
Claims Enable
Enable N umeric
Numeric 20
20 Yes
Yes Input
Input Both
Both
hh AmountofofC
Amount laims
Claims Enable
Enable Float
Float 15
15 Yes
Yes Input
Input Both
Both
O thercorporate
Other corporateaa1ents
gents Disable
Disable
;i No.o
No. offClaims
Claims Enable
Enable N umeric
Numeric 20
20 Yes
Yes Input
Input Both
Both
j; A mounto
Amount offC laims
Claims Enable
Enable Float
Float 15
15 Yes
Yes Input
Input Both
Both
B rokers
Brokers Disable
Disable
kk No.ofofC
No. laims
Claims Enable
Enable Numeric
Numeric 2200 Yes
Yes Input
lnout Both
Both
1I A mounto
Amount offClaims
Claims Enable
Enable Float
Float 1155 Yes
Yes Input
Input Both
Both
R eferrals
Referrals Disable
Disable
mm No.ofofC
No. laims
Claims Enable
Enable N umeric
Numeric 2200 Yes
Yes Input
Input Both
Both
nn AmountofofClaims
Amount Claims Enable
Enable Float
Float 1155 Yes
Yes Input
Input Both
Both
M icroinsurance
Microinsurance
A gents(MFI,SHG,
A1ents(MFI, SHG,N GO)
NGO)
Disable
Disable
0
0 No.. o
No offClaims
Claims Enable
Enable N umeric
Numeric 2200 Yes
Ve, Input
lnout Both
Both
P
D A mountofofC
Amount laims
Claims Enable
Enable Float
Float 15
15 Yes
Yes Input
Input Both
Both
(ForH
(For ealthInsurance
Health Insurance--
Individual),N
Individual), o.o
No. offliv es
lives
cco11ered
overed Enable
Enable Numeric
Numl!!ric 10
10 Yes
Yes Input
lnout Both
Both
(ForH ealthIn surance--
tilih
(For Health Insurance
G roup),No.
Group), No.ofofliv es
lives
ccovered
overed Enable
Enable Numeric
Numeric 1100 Yes
Yes Input
Input Both
Both
11 A ndhraP
Andhra radesh
Pradesh Disable
Disabll!!
22 A runachalPradesh
Arunathal Pradesh Disable
Disable
33 A ssam
Assam Disable
Disable
44 Bihar
Bihar Disable
Disable
55 Chhattisgarh
ChhattisHrh Disable
Disable
66 Goa
Goa Disable
Disable
77 Gujarat
Gujarat Disable
Disable
88 H aryana
Haryana Disable
Disable
99 H imachalPradesh
Himachal Pradesh Disable
Disable
1010 Ja mmu&&K
Jammu ashmir
Kashmir Disable
Disable
1111 Jh arkhand
Jharkhand Disable
Disable
12
12 K arnataka
karnataka Disable
Disable
1133 Kerala
Ker.iliil Disable
Disable
1144 MadhyaPradesh
Madhya Pradesh Disable
Disable
1155 Maharasthra
Maharasthra Disable
Disable
1166 Manipur
Manipur Disable
Disable
17
17 M eghalaya
Meghalaya Disable
Disable
1lB8 M izoram
Mizoram Disable
Disable
1199 N agaland
Nagaland Disable
Disable
2200 O rissa
Orissa Disable
Disable
2211 P unjab
Punjab Disable
Disable
2222 Rajasthan
Rajasthan Disable
Disable
2233 S ikkim
Sikkim Disable
Disable
2244 T amilN
Tamil adu
Nadu Disable
Disabll!!
2255 T ripura
Tripura Disable
Disable
2266 U ttarPradesh
Uttar Pradesh Disable
Disable
2277 U ttrakhand
Uttrakhand Disable
Disable
28
28 W
West estBenlilal
Bengal Disable
Disable
29
29 A ndaman&&N
Andaman icobarIsIs.
Nicobar D isable
Disable
3300 Chandigarh
Chandigarh Disable
Disable
31
31 Dadra&&N
Dadra agraHavl!!li
Nagra Haveli D isable
Disable
32
32 Daman&&Dlu
Daman Diu D isable
Disable
33
33 D elhi
Delhi D isable
Disable
3344 L akshadweep
Lakshadweei:, Disable
Disable
3355 P
Puu ducherry
du cherry Disable
Disable
#
• Total
Total Disable
Disable Float
Float 2200 Yes
Yes Derived
Derived Sum(No.ofofC
Sum(No. laims/A
Claims/ ArrBoth
Both -..J
..
INPU1=ffealth_S
INPUT_Health_9 S
00
Large Claim Detatr,
Details -- Insurer-wise
This form captures the claim details of lar1e
large claims in for all insurer,
insurers
This is a new form
The frequency of this form is yearl\,
yearly and as and whon
when

Year | | Quarter
Insurer Name
_ ______________ ~ Reported Claims ____ +--- _ _ Fully

~~ t tSettled
l e ~ claims
cla1~s ~- Partially settled
~-- - ~a~1~lly claims
se~tled ~la1ms Outstanding Claims
THE
No. of ,No. of No. of
:s I State No of Amount of claims No
No. of claims Amount of claims
Amount No of Amount ofclaims
Amount of claims Na of rla1ms
Amount of claims
claims claims claims
~
GAZETTE
• Column Cade
Code I a
a b c d I ee f g
g h
1 IAndhra Pradosh
Andhra Pradesh J.....
I M
. It I I
2 Arunachal Pradosh
Pradesh I
3.Assam
3 Assam
4 IBihar
Bihar
•I
- - - -- - - - - - - +- - - - + - - - - - - -- - - - - - - - - - - - --+----------+----+--- -- - - --+-- - - + - -- - -- ·•-
5 iChhattis1arh
Chhattisgarh I
OF INDIA
- -- - - - -- - - - + - - - - - - -- -+ - - - - + - - - - - - - -l--- - - -I i - - - - - - - -
Goa
6 iGoa I
- - - -- - - - -- - t -- - - , t - - - - - - -- - -1
7 Gujarat
8 Haryana l
9 , Himachal Pradesh
9: I
& Kashmir
10 Jammu & I
: EXTRAORDINARY
11 Jharkhand I l
12 , Karnataka I l
13 i Korala
Kerala I
---+--- - - - - - t - - - - - + - - - - -+----i..--- - - - - - - ;!
14 i Madhya Pradesh
Pradosh I
15:Maharasthra
15 i Maharasthra
16 Manipur
- - - - - - --- --+- - ---+------- - -- - · - - - - - - - - - - + - - - - - - - - - - + -- - - , 1 - - - - - - - -----<1------..1
·- -- ------<
17 ;j Meghalaya
Meahalaya I I
18;
l8 1Mizoram I !
19 Na1aland
Nagaland I
20 Orissa
--- 211 1Punjab
2
I
• I
22 Rajaslhan
Rajasthan I
23 Sikkim I
24 Tamil Nadu I
25 Tripura
2S iTripura
~ - - - - -- - - - - - - + - - --+- - - -· - - - - -- -- - - · - - - ----+-- - -- -- - - + - - -- ~ - - - - - - --t- ----;l_______ -1
26 i Uttar PradeshPradosh I
. 27 1Uttrakhand
_ _.::..:__,.:..:.::.=.:c.::.:.:,::_
j
_ __ _ _ _+------+------ - - -.:'·. .- -- - -- - ---~- - - - - - - - - 1 - - - + - - - - -- ---+-----+i- - -- ----l
I I
[P
28 West Bengal
Wost Ben1al
~
art
29 !Andaman
Andaman & Nicobar Is. ►
::j
~ - - - -- - - + - - - - - + - - - - - -I- t - - - -- - -- - + - - - - -- - - - + - - --+--- - - --+- -____,li_ _ _ _ _____,
30 Chandi1arh
Chandigarh
,_
,_
III—
31 Dadra & Na1ra
Nagra Haveli
32 Daman & Diu
33 Delhi
Dolhi i
i I
T
S
[/J
e c
t'I1
Lalcshadwoop
34 · Lakshadweep I I 0
.
35 Puducherry I ..:::
4]
I1 #
* !Total
Total I I I
ld h ]
Input!HEALTH_10 Quarterly
Grievance movement
[t? S n g L — III
Insurer>
<this form is filled by lnsurer>
Purpose and Objective
Thisformt represents the grievance movement through out the period for each insurer against different types of complaints
ThisFormt
quarterly
The frequency of this form is quarterly
Parameters
FIiters and Parameters
Filters
Year Complaint Type

Delay in Payment
Complaint Type off claim
Refusal o
Deduction
Policy not received
Any Other
No. of
No. o f complaints pending at the No. of new complaints
Name of Insurer No. of complaints resolved complaints No. of complaints pending at the end
beginning registered
rejected
Column Code
Grievance
Grievance M anagem ent
P>lk
Source/ Calculation Grievance M anagem ent System Grievance M anagem ent System M anagem ent Grievance M anagem ent System
/• System
System
fchfrft
No. o f
No. o f complaints pending for < 1 No. o f complaints pending fo r 1- No. of complaints pending complaints
Name o f Insurer No. o f complaints pending fo r > 1 yr
month 3 months for 3-6 months pending fo re -
12 months
Column Code
Source/Calculation
- -- - -- --+··------ - -- - --;--- - -- - -
INPUT_HEALTH_ 4.1
INPUT_HEALTH_4.1 | Y e a rly Yearly
I ' I·
Details of new business and renewal business - Statewise
Tocapture
To captureth theesta tewisen
st.iltewise ewbusiness
new businessand
andrenewal
renewalbusiness
businessaartMties
ctivitiesfo
forreachin
each surer
insurer
Thisfo
This rmisisaa new
form newformat.
format.
Thefre
The quencyo
frequency offth
theere turnis
return is yearly.
yearly.
Alters and Parameters

Filters ___________________ ____________________________
YearYear | BLJsines.s |BusinessjIndividual
l1ndividual
InsurerName
Insurer Name
In
ln dividualBusiness
di\lidual BusinessNeedstotob
Needs beeremoved; create
removed; createth ed
the ropdown
drop downaassshownaabove
shown bove
N ewB usiness RenewalBusiness
Business In-ForceB usiness
THE
Nrw Business Renewal In Force Business
GrossPrem ium
Gross Premium Gross
Gross P remiu
Premiumm G ross
Gross
Total S
Total um
Sum
#
# State
State *• No. ofofp
No. olicies A
pohc,es
mount TotalS
Total umA
Sum ssured No
Assured No. o
offp olicies -A
policies
mount T
Amount
otal S
Total umA
Sum ssured N
AssurPd o.ofofpolicies
No. policies Premium
Premium
Assured
Assured
GAZETTE
Amount
,A mount
Amo1.1nt
h
- -
ee If
-
Column
C o lu m n Code aa b
b d
d e
e fI h
h h
1 AAndh hraPra desh
a '
■'V. -
22 A runachalPradesh
Arunachal Pradesh i
33
44 B
A ssam
Assam
ihar
Bihar
- - I ., ......... i , :'
I
OF INDIA
55 C hhattisgarh
Chhattis1arh I
66 Goa
Goa I _
I I i
-
7 7 Gujarat
Gujarat I
88 Haryana
Ha""ana I
99 iHimachal
HimachalPradesh
Pradesh I
1100 1Jammu
Jammu& &K ashmir
Kashmir I
: EXTRAORDINARY
1111 Jh arkhand
Jharkhand
1122 Ka Kamataka
rnataka
1133 Kera
Keralala
1144 M adhyaPradesh
Madhya Pradesh i' .................... . .J
15 M
15 aharasthra
Maharasthra ■ !
Manipur
1166 Manipur :■ j
17 M
17 eghalaya
M•ahalaya .
18 Mizoram
18 Mizoram I: ■
- 22019_
19 N agaland
Na1aland
0 O rissa
Orissa
' '• •' 'li
......... ..;.... . .
2211 Pu Punjab
njab ! I
Rajasthan
2222 IRajasthan ! ■ ....·. - - · -
, ....
2233 S Siik kim
kkim !
■ "i ! I
2244 i T Taam ilN

mil adu
Nadu
2255 Tris:iur.1
Tripura ·- -
2266 Uttar
UttarPradesh
Pradesh ' !
27 U
27 ttrakhand
Uttrakhand ......
'
28 West
28 WestB engall
B•n1a !
■
29 Andaman
29 Andaman& &N lcobarIs
Nicobar Is.. I
[P
30 Chandqiarh
30 Chandigarh • I
art
3311 D adra&&Na1ra
Oadra NagraHaven
Haveli '
i
~
~ ·
32 D
32 aman&
Daman &D iu
Diu I
III—
33 Dtlhl
33 Delhi --- i
34 Lakshadweep
34 Lallcshadw••P i
35 P uducherry ' 1 /. ; :
Sec.
35
"# ra ta lT-
Puducherry
n -
.....
, I
I I ,·. -. ' .;...........
4]
GroupBusiness*
Group Business •
.
... I..
1_ --..---
' NewBusiness RenewalBusiness t In-ForceBusinessData ■ 8
Irik]
_______________ I___ _
_ _ NewBusiness ----,.-----~ ___ RenewalBusmess _ ln-ForceBus1nessData
No.ofoflives
lives GrossPremium TotalSum• No.of#polic
, ies No.oflives GrossPremium TotalSum No.ofpolicies GrossPremium Total
TotalPremium
Premium
0\ 1 I State
State
No.
~ a
:J No.
policies ccovered
No.ofofpolmes overed
b
Amount
c
Assured
e f »
covered Amount
h
Assured
f
Amount A mount
Amount
hh
TotalSum
Total SumA ssured1
Assured
g j g : ........iI
HI
CDlumnCDde
Q
E///0
C olum n Code
AndhraP
1 Andhra radesh
N ArunachalP
2 Arunachal
Pradesh
radesh ~ ~
---+
r
~
Pradesh
! I
griis>
w
, 4 B
Assam
3 Assam
ihar
Sihar
Chhattisgarh
5 Chhattisgarh
-t
+
+
I
·--~ I
i
[fr
/£-
LN 6 GoaGoa
- T t r
--- 7 Gujarat
8 H
Gujarat
aryana
Harya~a
+
I
f -i-
i
9 H imachalP
Himachal radesh
Pradesh
10 Jam
10 Jamm mu
Jharkhand
1111 Jharkhand
u& Kashmir
& Kashmir
----+--
- t I t
Karnataka
1122 Karnataka + t
1133 K erala
Kerala
1144 M adhyaP
Madhya radesh
Pradesh I
1155 M aharasthra
Maharasthra
-......- ... .................. .. .......
1166 M anipur
17 M
17
Manipur
eghalaya
Meghalaya II
1188 M izoram
Mizoram
j
19 N
19 agaland
Nagaland "j+· ‘ - I I
2200 O rissa
Orissa
+- I I
.t.i
2211 P unjab
-f j ~
a ih
Punjab
2222 ...R ajasthan
23 S
Rajasthan
ikkim 1 ~
life
23 Sikkim
2244 T amilN adu
2255 T
Tamil
ripura
Tripura
UttarP
2266 Uttar
Nadu
radesh
Pradesh ___ ____ __
-... ......... - .. ,...... . I r 1
~
I
2277 U ttrakhand
Uttrakhand
j ; '''
28 W
28 estBengal
West Bengal | ‘ I
29 A
29
_3300 _ C
3311 D
3322 D
ndaman&&N
Andaman
han
Cha digarh
ndigarh
adrraa&
Dad
aman&
Dam.in
&N
icobarls.Is.
Nicobar
agraHave
Nagra
&D iu
Oiu
Havelili L_ — _____ , —
- - :j
I
1I ~
]
33_ Delhi r~~ “i I
33 Delhi 1 ___ - , [ " T~.."...........1} — ~ 1
3344 L akshadweep
lakshad weep
3355 P uducherry
Puducherrv j\ , . ...... [7' v . - j i .
#
# Total
T o ta l L . . . ... . ___;:V
-v _ '... ■___
__ -
_ ...... i
Note:
Note:
* family floaters
Group include family floaters and any policy
polic y with more
mo re than
th.in one insured
iMured person
I✓
INPUT_HEALTH_6.4
tNPUT_HEALTH_6.4 Q uarterly I
IQuarterly 1-.,
o f Government
Perform ance of
Performance H ealth Insurance Scheme
G o vern m en t sponsored Health

Th is form is used to capture the details of the Performance of Goverement Health Insurance sponsered Scheme
This
Is aa new format
This is
The frequency of the form is
is quarterly

Year .___ _ _ _ _ _ _ __ _ __ _ _ _ _ ___, Quarter
Insurer Name
lnsuner
THE
Incurred -l
INo. of policies No.of
No.of BPL I' Gross Pnemium I Amount
Amount of I No. of claims :c
1 polic,es f
,
BPL No o f-
)__ _
ot hers --
covered in I Total number of Premium No.of claims of
.
C1aims
Claims
claims
No.of claims Claim Amount Incurred
Cla,m
Amount of ■Claim Rat,o
Ratio !Tl
families I
reported I settled settled O/s Claims O/s.
GAZETTE
1 issued
ossued , covered BPL Families beneficiaries covered
beneficlarie (In OOOs)
000s) reported O/s (%)
(% ) Cl
covered reported
n
# Product/ Schem,
Product / Scherrw
Code ,\
Colu;,; Code
- Column a b
,
I c
c d ___
_d e
e ff g
g
, h
h iI ;- - ,-.
j
• k- -
k ~
tTl
11
~
4 5
2
---- --
2
-~- -~=t
33
I -~- ---r·-
OF INDIA
0
4
-- --- - - - -- - --+ --t---- "T1
5_
5
6
+---
_j__
-
_ __j
I
I 0
z
I
7
88
-,_-=-_-
.... f-- - ---i-
-+ I
►
: EXTRAORDINARY
9 __L
-~--·- -·- ::-:,
10
---+-- -- --+------ ...,><
11
11
12 -+ ~
I
;;:o
►
0
;;:o
0
z
►
~
[ P art
III—
S ec.
4]
•
Ik ]
n I
-....
If
0\ _—.—-—_
[ P s-nis>— ITT
<3i ~— - - - - - - " r - -
~
- I ~ ] .; 7 j--'""1
] database/
% jU ,r ’ ■ TaKI uam
; e‘ -H a taTiype
iL b
raîoN | uoium n N a m e j uara _
Product/Scheme
20 Input
Cw C
c Enable 20 Yes Database
No. of policies
I C{a)
C(a) i5Jued
issued Enable Numeric 20 Yes Input Should not be Negative Database
W
No.of BPL
families covered Input
C(b) Enable Numeric 20 Yes Should not be Negative Database
Total number of
beneficiaries
covered
C(c) Enable Numeric 20 Yes Input Should not be Negative Database
Gross Premium
{In OOOs)
(In 000s)
C(d) Enable Numeric 20 Yes Input Should not be Negative Database
No.ofdaims
No.of claims
~
C(e) reported Enable Numeric 20 Yes Input Should not be Ne alive
Negative Database
imte
Amount of
m
JSilkJi. life
Claims reported (
C(f)
C(f) Enable Numeric 20 Yes Input Should not be Negative Database
~
No.ofdaims
No.of claims
C{g)
C(g) settled Enable Numeric 20 Yes Input Should not be Negative Database
Claim Amount
20 Yes
;
C{h)
C(h) settled Enable Numeric Input Should not be Negative Database
No. of daims
claims O/s
((I)
C(i) Enable
Enable Numeric 20 Yes Input Should not be Negative Database
C{j)
CO)
Amount of
Claims O/s. Enable Numeric 20 Yes Input Should not be Negative Database ~
Incurred
Claim Ratio (%)
((k)
C[k) Enable Numeric 20 Yes Input Should not be Negative Database
""
w
RfP_HEAL TH_ O/fice_2
Qoadea,ly --""--'"''-•=.i.r..•'Qa
of'f offices -.. Quarterl
Statewise Report of clistribution O
mm
for.each insurer
The purpose of this report is provide information on the distribution of office locations in each state fo^.each
The frequency of this report is quarterly

,------------,
Year Quarter
Quarter
H
-l
State :r:
X
m
!:Tl
O
C)
>
)>
N
N
Rura l Urban m
tT1
Area Area =1
m
!:Tl
~No. of O
0
'Tl
~ n
f branches No. of No. of %%of
of
#
Name o I
,approved rural
% of rural ■f t - .
urba
urban n Urban
Urban
z
aCJ
Insurer I Branches
but not branches branches Branches >
>
I
opened m
!:Tl
X
><
Column ! H
-l
a b c d e
i~
C
Code I
o
0
;:o
73
j INPUT N
INPUT_N INPUT_!'. INPUT_N
INPUT_N =l00*b/( I INPUT_N O
CJ
= 1 0 0 *b /( =l00*d/(
= 1 0 0 *d /(
Source/C , ON LIFE
Source/C
a lcu la tio n
olculation
ON_LIFE_ ON_LIFE
I -
ON_LIFE_
- - b+d)
b+d)
ON_LIFE_
ON_LIFE_ b+d)
I z2
>
)>
Office_l
O ffice_l Office_l
O ffice_l Office_l
O fflce_l
I 3~
- 1
3
- - -·- -- - - - - t - - --
4
5
\ 3
- - -
--+-- - - ---! _ ____,__
________
6
----,
- - + - - - - + - - - --+-- - - + - - - - - + - - - - + - - - --I
.
V ' .
r
I# Total -
futal ;:. i % j i - ■V--1 .
O
m
O
p
0
•
*nrcr : sm rw i
RfP_
OF
The
The purpose
purpo se of o f this
this report
re p o rt is to provide the th e office d!!tails
details of
o f each insurer
Insurer in
In each state
state and at an overall level
The frequency
T h e fre q u e n c y of
o f this report
rep o rt is quarterly
q u a rte rly v 1 ' ,
'' Filters and i>arameterr..;;.s

Parameters _ _y_ _ _ _ _ _ ___,
Year I | QQuarter
uarter |
State | |
No.
N off
o. o
branches
branches
opened
o pened
during
d the
u rin g th e
year
ye ar
-
No. off
No. o
Noo .. Of
of Out off
offices at
N Out o
Out
O u t of
of "lo . o f 'lloof
branches
branches approvals
ap p ro vals branches
b ranches branches
branches
Name off th
Nam e o thee approvals
app ro vals
n approved
ap p ro v e d off
o r losed
closed aatt th
the end
e end
ln5urer
In s u re r beginning off this
o
during the
du rin g th e previou
previouss during
d the
u rin g th afthe
e o f th e
of the
o f th e year
y ear
year
ye ar year
y ear yyear
ear yearr
yea
year
y ear
---
Coll1mn
,l b c
C d ('
- ~
<odP
!I!!!!!!!!!!!
- ---- - -
INPUT N INPUT_N
IN P U T_N INPUT N INPUT _N IN
IN P U T -_N INPUT
PUT N N IN
INPUT_N
PUT N
Source/C
S o u rce/C
ON _LI H ON _LIFE- O
O N_LIFE_ ON_LIFE
N _LIFE -_ OON
N_LIFE_ ON
LIFE - O _LIFE
N _LIFE_ ON
O _LIFE_
N _LIFE_
alculation
Office I Office_l
O ff ic e _ l Office_l
O ffic e _ l Office
O ffic e 1 Office
O ffic e _11 Office
O ffic e 11
'2
3
3
4
4 ..........
5
66
i
■
·• Total
T o ta l - - _ .......
Printed
P r in te d by the Manager,
M anager, Government of
o f India Ring
Press, R ing Road, Mayapuri,
M ayapuri, New D elh i-110064
Delhi-110064
and Published by the Controller of Delhi-110054
o f Publications, D elh i-110054.

IRDA (Health Insurance) Regulations, 2013

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