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Irdai issues norms for standardized health insurance product
Economic Times, February 19, 2019

MUMBAI: The insurance regulator today issued draft norms for standard health insurance products with basic sum assured of Rs 50,000 crore to Rs 10 lakh defining the benefit structure for individual insurance buyers.

While the minimum entry age is kept at 18 years for principal insured, the maximum age at entry is 65 along with lifelong renewability. There shall be no maximum exit age.

The standard product will be offered on indemnity basis, as a standalone product and it cannot be combined with critical illness covers or benefit based covers.

In a draft circular Irdai said that products differ significantly with each other in terms of benefits offered. “It is considered essential that the potential customers seeking health insurance shall have an access to the basic health insurance covers so as to enable them to choose the coverage based on the need,” the regulator said.

The standard health product will cover hospitalization expenses including room, nursing expenses, Intensive Care Unit, Intensive Cardiac Care Unit expenses, dental treatment, necessitated due to an injury, plastic surgery, necessitated due to disease or injury and domiciliary hospitalization. However, 5% of co-pay is part of the product feature.

The basic standard policy will also cover expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines subject to fixed and standard sub-limits based on sum insured.

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