Basic health may Rs 50,000-10 lakh cover

The Insurance Regulatory and Development Authority of India (Irdai) released draft guidelines on standardisation of individual health products.

According to the guidelines, the standard indemnity health product should have basic mandatory covers and shall be uniform across the market. No additional add-ons or optional covers will be allowed along with the standard product. The minimum basic sum insured under standard product may be Rs 50,000 and the maximum limit shall be Rs 10 lakh, the regulator said.

The regulator has suggested companies to price the products in such a way so as to incentivise early entry or prospective policyholders, continued renewals and favourable claim experience.

The standard product must be subject to standard exclusions, which may be specified by the regulator. It is mandatory for every general and health insurer to offer this product.

Some features the standard health product should include are hospitalisation expenses (room, boarding, nursing expenses, surgeon, etc), ICU/ICCU expenses, dental treatment and plastic surgery is required after an injury or disease, expenses for cataract subject to sub-limits and domiciliary hospitalisation.

The guidelines also suggest covering expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy subject to fixed and standard sub-limits based. Pre-hospitalisation expenses for 30 days prior to hospitalisation and post-hospitalisation expenses for a period of up to 60 days from the date of discharge, wellness incentive such as health check-ups and consultation services, outpatient consultations or treatments, etc.