Insurers to offer standard health policy ‘Arogya Sanjeevani’: IRDAI

Arogya Sanjeevani Policy needs to cover the basic needs of customers with a minimum insured sum of Rs 1 lakh and a maximum of Rs 5 lakh

Insurers to offer standard health policy ‘Arogya Sanjeevani’: IRDAI

Insurance regulator IRDAI has issued guidelines to health and general insurance companies asking them to offer standard health insurance policies to customers in India. This offering should be launched under the umbrella of Arogya Sanjeevani Policy.

The regulator has stated that the said policy should cover all the basic needs of customers by offering insurance cover of minimum Rs 1 lakh and maximum Rs 5 lakh. 

Insurance providers should name their offering Arogya Sanjeevani Policy followed by their company name. IRDAI has specifically said this policy should not be launched under any other name.

Related: 5 Best Health insurance plans in India

Why a standard policy?

This move aims to simplify insurance buying for the masses without having to worry about picking from a number of options in the market. 
“The health insurance market has a number of individual health insurance products. Each product has unique features and the insuring public   may find it a challenge to choose an appropriate product. The Authority has hence decided to mandate all general and health insurers to offer the standard individual health insurance product,” said the regulator in a statement.

What will it cover?

The Arogya Sanjeevani Policy will cover basic mandatory charges. It will cover hospitalisation expenses, all day care treatments, dental treatment, plastic surgery needed due to a disease or injury, cataract treatment subject to sub limits and ambulance expenses capped at Rs 2,000 per hospitalisation.

In addition, IRDAI, in its Draft Guidelines on Standardisation of Individual Health Product had mentioned that it should cover alternate treatments under AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy). Under this, the standard insurance policy to cover hospitalisation charges, pre-hospitalisation expenditure up to 30 days and post hospitalisation care of up to 60 days.

No riders, add-ons or optional covers can be added to the policy. Insurance companies have been asked to not provide any deductibles or variants to this product. It cannot also be combined with any other critical illnesses cover or benefits based covers. This standard policy, however, can be offered for family floaters.

Related: Unique features offered by different health insurers 

Who will be offered this product?

Any individual with the minimum age of 18 years and maximum age of 65 years can purchase this insurance, subject to conditions such as health history, pre-existing diseases, etc. The policy will come with lifelong renewability. 

The policy will also reward customers by increasing sum insured by 5% for ever claim-free year, capped at 50%. This is also subject to condition that the policy is renewed every year without a break and premiums are paid on time.

Related: Lesser known features of health plans that you should take advantage of 

Who will decide the cost?

The pricing of the policy will be determined by the insurance provider depending on the cover it has to offer, keeping in mind the IRDAI guidelines. The pricing should be pan India. This means the provider has to fix the cost of this policy and it should be applied across the country. Different pricing depending on geographical locations will not be allowed. 

The regulator further said that the standard product shall comply with portability provisions.

Every general and standalone health insurer, who has been issued a certificate of registration to transact general/health insurance business, has to mandatorily offer this product from April 1, 2020 onward. 

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