Govt. Pushes For A Standard Health Policy For All Indians With Rs 5 Lakh Maximum Sum Insured

Starting this year, the Insurance Regulatory and Development Authority of India (IRDAI) issued new guidelines in favor of basic health needs of customers. Different insurance companies have different health insurance products, with different packages and it all comes up as confusing to customers.

Cutting down the steps of confusion choosing from innumerable health insurance products, the regulating body IRDAI on Thursday issued guidelines on standard individual health insurance, where in it mandated all general and health insurance companies to offer a Standard Health Insurance Product (SHIP).

You can Now Enjoy a Standard Health Insurance Product

Buying a health insurance policy will soon become easier. The regulator body IRDAI has issued guidelines on standard individual health insurance, mandating all general and health insurers to offer a product that can take care of basic health needs of customers with maximum sum insured of ?5 lakh and a minimum of ?1 lakh.

This Standard Health Insurance Product is subjected to take care of basic health needs, carrying similar policy wordings and enabling seamless portability among the insurers.

The product has a defined nomenclature as well. Each insurer will have to make the product as ‘Arogya Sanjeevani Policy’, followed by the name of their insurance company.

For example, Arogya Sanjeevani Policy SBI General insurance or Arogya Sanjeevani Policy  Apollo Munich. No other name is allowed in any of the documents, as per IRDAI’s guidelines.

IRDAI has already issued guidelines and the insurers have to roll out Arogya Sanjeevani Policy from April 1, 2020 onwards.

Important Features of the Policy You Should Know About

The health insurance market is having a number of individual health insurance products. Each of these products have their own unique features, causing the public difficulties to choose an appropriate product. 

Thus, the authority decided to mandate all general and health insurers to offer the standard individual health insurance product.

• It will have the basic mandatory covers. No add-ons or optional covers will be allowed with the standard product.
• The insurer may determine the price, depending upon the covers proposed to be offered.
• The minimum and maximum sum insured will be Rs 1 lakh and Rs 5 lakh, respectively.
• The minimum and maximum entry age will be 18 and 65 years. For children under Family Floater policies, it will be 3 months to 25 years.
• The standard product shall be offered on indemnity basis only and the policy tenure shall be for a period of one year.
• The mandatory covers under the standard health product include hospitalization expenses, other expenses such as cataract subject to sub-limits, dental treatment and plastic surgery.
• It will also include all day care treatments and expenses on road ambulance subject to a maximum of ?2,000 per hospitalization.
• Expenses incurred on hospitalization under AYUSH treatment, pre-hospitalization expenses and post-hospitalization expenses, will also be included.
• Speaking of cumulative bonus, as per the IRDAI guidelines, a sum insured should be increased by 5% for each claim-free policy year.
• There will not be any deductible but a co-payment of 5% will be there across all ages. It means the policyholder will have to pay 5% of the bill amount compulsorily.
• Arogya Sanjeevani Policy will be available on both individual lives and on Family Floater basis.
• Arogya Sanjeevani Policy will be an annually renewable policy with a grace period of 30 days.