Modifications Guidelines on Standard Individual Health Insurance Product

Document text

• ~·~ \!hi.JI<! all!, fll~<l lit4i ~ ffl ~ . u 1 » INSURANCE REGULATORY AND irJai DEVELOPMENT AUTHORITY OF INDIA ~ Circular ~ ~- ~~~/QtjQC1~/~~~'3fR/055/03/2020 ~: 04-03-2020 Ref. No: IRDAI/HL T/REG/CIR/O55/O3/2O2O Date: 04-03-2020 ~/To, ~ifi ~ JfR ~ -Jffi ~ -~h-llcf5c1f ({~"11~. ~3f$fi q;) 01$¢~) All General and Standalone Health Insurers (except ECGC, AIC) ~ = lTRcf> aqfc@q, ~ -alm ~ ~ ~ ra~11Pta~, Re: Modifications Guidelines on Standard Individual Health Insurance Product 1. ~~ JfR~-3ffi11~~ cf>qfrtq'j~ ~ 3fR1TQ ~Jla.:ft q1fa-Ol 1,F@l~c1 q,{1f~(A.;gdl)~sltGITTT~rm~aqf<Rtq5~~~~tll m~11R~~n ~'4= ~~~/ QtjQae1, ~~~'3fR100110112020 ~ 01.01.2020, cp't ~ £m1 -.silcf5r&a M uf@l ~ 1 ~ m~11R~~n ~ ~ 3fr.ffi£R * f1~faf{ga t!H~-s ulRT~"Gflcl~I Reference is invited to the Guidelines on Standard Individual Health Insurance Product (Ref: IRDAI/HLT/REG/CIR/OO1/O1/2O2O dated 01 .01 .2020) mandating all general and standalone health insurance companies offer Arogya Sanjeevani Policy. In partial modification of these guidelines, the following norms are issued. 2. ~~~ ~-~ q1fafflQ). q)l frrm) ffiRqii, 2016 ~ ffiRqii 4(iii) ~ ~ ~ ~. q,fa-Ol ~~1a\il ~~*~cfRRT~~*~(A·;gdl) ~~ q1falflqj ~8~1Rq5 ~ * uJRT q:,'-1 GfRft ~ I ¥ '3fRTTQ t1ufla.:ft q1fa-Ol q:,'-1 ru~1~c11~ ~ ~~-flit!!~ ~cftfl~ qrfa~ ~ ~~&RTQ~t) ffifrtfe~ q:,'-luJr~~. -3@: Q ~tj I C1 -i ffi1IBT <ITT q;i::f cpB cftfl q;i::r cp't 71{ q ~ tj ltH ffiT@ q;l ~ ffi'l-f 3ff1T 41 fa -Ol'c.fRcfTT q;)~ Qlf?iq141· ~~*~~~it ilftii1q5afJflcp1 JITT1TQ t1"11a~ q1fa~ q:,'-l q1fa~ ~ ~ach;,Rcf>1F6fG!c:ct ~"R'uITTtmctfl ~<ft~~,~ q1fa~ ~cpl F6fG!c:a ~ {-~ $ mwrr ~ ~ fcl,irr WQ1TT JfircIT <iftlTT u14101q:;1 if~~~ ~ "lTQ1111 cf~, ~ q1fa-Ol~ ~ ~ ~ ~ ~ -q' q,fa~ ~ q:,'-l 1TT7T cITTcTT t ~ ilfti:i 1q5 af ~ ~ ~ ~ "lTQ111 I In terms of the provisions of Regulation 4(iii) of IRDAI (Issuance of e-lnsurance Policies) Regulations, 2016 providing policy document in physical form is mandatory when policies are issued in electronic form directly to the policyholders. Since features of Arogya sanjeevani policy are common across the industry and as the terms and conditions of the polciy are already specified by the Authority, with the objective of reducing the oprearating costs and to pass on this benefit of reduced operational cost to the policyholders by way of affordable premiums, insurers are allowed to issue the policy contract of Arogya Sanjeevani Policy in electronic / digital format. The digital ;p.f 1. 115/1, ~m ~ . 111t.11q,p1, ~ -500 032, 'IW'f Survey No. 115, 1, Financial D1stnct. Nanakramguda Hyderabad-500 032 India : +91-40-2020 4000 ~ : www.irdai.gov.in I . +91-40-2020 4000 Website : www.1rdai.gov.in form of the policy contract may be forwaded through email or a link shall be provided in the certificate of insurance. However, where policyholder specifically seeks the physical form of the policy contract, the same shall be provided by the insurer. 3. ~ ~._,\lcFll q1fa-B1 !,F@1f°tja mcnffi~ iill-llcfJdl ~~ cfjq~Gi qft~ ~ ~ ~ q1fatfl'cfRQ, cf?1" "QcP ~ ~l-ll □IQ3! ~ ¢WPll 1 ~ ~l-ll □IQ3! "B q1fdtfl ~qft~ ~cfct,~~~~~~I Every insurer offering Arogya Sanjevani Policy shall provide a certificate of insurance to the policyholder indicating the availability of health insuarnce coverage. The certificate shall have a reference to access detailed terms and conditions of the policy contract. 4. ~ ~&m ~ cf;T dijl--fl~ri "!,f[l{1 ~ I This has the approval of the competent authority. \ ~ ~~~~ I D VS Ramesh) l-l~l~cii~ ~/General Manager(Health)