1. IRDAI stipulated to all general and health insurers to offer standard individual health insurance policy called “Arogya Sanjeevani” Policy to the public from 01.04.2020. The terms and conditions of the policy are the same across insurers except that premium rates are left to be fixed by the insurers.
2. All the insurers dealing with health insurance are presently offering the standard policy to the public.
3. Now, IRDAI has also allowed the insurers to offer the same standard policy also as a group policy under the same name “Arogya Sanjeevani” provided that all the terms and conditions of the standard policy are retained except for the premium which is to be fixed by the insurers.
4. This standard group policy is expected to be useful to various private and public establishments for covering the medical needs of their employees.
5. It is clarified that “Arogya Sanjeevani” policy, whether in individual or group form, also covers Covid – 19.
6. The group policy is expected to provide protection to a large number of employees engaged in manufacturing, services, SMEs, MSMEs,logistics sector and migrant workers, catering to their medical needs.
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA
All General and Standalone Health Insurers (except AIC and ECGC)
Re: Filing of “Arogya Sanjeevani Policy” as group health insurance product
1. Reference is drawn to Clause 8 of Section 3 of “Master Circular on Standardization of Health Insurance Products” (Ref: IRDAI/HLT/REG/CIR/193/07/2020 dated 22.07.2020) vide which all the general and health insurance companies (insurers) were mandated to offer standard individual health insurance product, “Arogya Sanjeevani Policy”.
2. In partial modification of the above referred guidelines, Insurers are hereby allowed to offer this product also as a group product by duly complying with the norms specified hereunder.
a. Insurers are allowed to use the standard product name for the group policy after adding the word “group” provided all terms and conditions as applicable to the standard individual policy remain the same except premium rate and specification on operation of group policy.
b. Insurers are allowed to set their own minimum and maximum sum limits under this group policy, subject to the board approved underwriting policy. The mandate of offering sum insured in multiples of Rs 50000 (Rupees fifty thousand only) is not insisted for the group product.
c. The insurers shall determine the price keeping in view the cover proposed to be offered subject to complying with the norms specified in the IRDAI (Health Insurance) Regulations, 2016 and Guidelines notified thereunder.
d. The product shall be filed on Use and File basis by duly complying with the norms specified in Chapter IV of “consolidated guidelines on product filing in health insurance business” (Ref: IRDA/HLT/REG/CIR/194/07/2020 dated 22nd July, 2020)
e. This group product shall comply with all other applicable norms stipulated under “consolidated guidelines on Product filing in Health Insurance business” (IRDA/HLT/REG/CIR/194/07/2020 dated 22nd July, 2020).
3. This has the approval of the competent Authority.
D V S Ramesh,