As part of promoting ease of doing business for insurance companies, Insurance Regulatory and Development Authority of India (IRDAI) has been constantly striving to reduce the compliance burden of all the regulated entities. Towards this endeavour, the health insurance returns being filed by the insurance companies have been significantly reduced. Now, the General and Health Insurers will have to file 8 returns and Life Insurers will be filing 3 returns in place of 17 returns being filed currently. This step will further help insurers in focusing on their business rather than a plethora of compliances and in turn help in increasing the insurance penetration in country.
These revised reporting norms will be applicable with immediate effect.
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Insurance Regulatory and Development Authority of India
Circular Ref No: IRDAI/HLT/CIR/MISC/190/9/2022 | Dated: 13th September, 2022
To
All Insurers (except ECGC, AIC)
Sir/Madam,
Re: Revision of Health Insurance Regulatory Returns – reg.
1. In supersession of Chapter V of Section – I of Master Circular on standardization of health insurance products issued vide Ref no. IRDAI/HLT/REG/CIR/193/07/2020 dated 22.07.2020 and Circular Ref. No. IRDAI/HLT/CIR/MISC/102/5/2022 on Revision of Health Insurance Regulatory Returns, the health insurance returns attached as Annexure – 1 are issued. The periodicity of returns to be filed with the Authority is as mentioned in the respective returns. The timeline for submission of the returns is specified as under:
i. All yearly returns shall be furnished within 90 days from the close of the reporting financial year.
ii. All quarterly returns shall be furnished within five days from the close of the reporting quarter.
2. These norms are applicable with immediate effect and are applicable to all returns to be filed for FY 2022-23 and onwards.
3. This has the approval of the competent Authority.
Annexure – I
List of Health Insurance Regulatory Returns
|
Sl No |
Form No. | Description | Frequency | Applicability |
| 1 | HIR – 1 | Details of product / add-on performance (Health / Personal Accident /
Domestic Travel / Overseas Travel) |
Yearly | General and Health Insurers |
| 2 | HIR – 2 | Details of performance of Combi products | Yearly | Life, General and Health Insurers |
| 3 | HIR – 3 | Details of State-wise Channel-wise business | Yearly | General and Health Insurers
|
| 4 | HIR – 4 | State-wise details of New Business and In-force Business | Yearly | |
| 5 | HIR – 5 | Details of state wise (excluding PA and Travel) claims paid by mode of settlement of claims | Yearly | |
| 6 | HIR – 6 | State wise details on number of network providers | Yearly | |
| 7 | HIR – 7 | Details of claims handled (in-house settlement and through TPAs, as may be applicable) | Yearly | |
| 8 | HIR – 8 | Details of Gross Premium, Number of persons covered and incurred claims for the quarter | Quarterly | |
| 9 | HIR – 9 | State-wise details of claims, new business, renewal business and in-force business of health insurance products | Yearly | Life Insurers
|
| 10 | HIR – 10 | State-wise details of claims, new business, renewal business and in-force business of health insurance riders | Yearly |
