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IRDAI directs insurers to create standard health insurance product

February 22, 2019

IRDAI, the insurance regulator in India, has asked all non-life insurers to offer a standard health insurance product so that customers can have access to a basic health cover. This standard product shall have the basic mandatory covers, which shall be uniform across the market. No additional add-ons or optional covers are allowed to be proposed to offer, along with the standard product.

The regulator has let non-life insurers determine the price of the product. While the coverage will be the same the pricing will vary as all the insurance companies will be pricing it on experience. The IRDAI has also asked non-life insurers to devise their pricing for the standard health product in a way that it incentivises the early entry of young prospective policyholders of the health insurance market, and that would encourage young people to renew their cover and have a favourable claim experience, where applicable.

The sum insured for the product will be in the range of INR 50,000 ($702) to INR 1 million (USD 15,000). The product will cover hospitalisation expenses, which include room, doctor, intensive care unit charges, medicine and drug costs. In addition, post hospitalisation expenses for a period of up to 60 days from the discharge from hospital will be covered. This would include consultant fees, diagnostic charges, medicine and drugs wherever required. The minimum 24-hour hospitalisation rule will not apply when medical treatment does not require hospitalisation. The product would have a lifelong renewability option for those in the age group of 18 and 65. The regulator has also decided to include wellness activities in the standard product to promote and maintain a wellness regime. The product will be available across various channels, including micro insurance agents and common service centres.


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