IRDAI has mandated all general and health insurance companies to offer a Standard Health Insurance Product- Arogya Sanjeevani Policy.
Standard Health Insurance Policy: If different features and various benefits of a health insurance policy are leaving you confused, the IRDAI has found a way out. Buying a health insurance policy will soon become easier. IRDAI has mandated all general and health insurance companies to offer a Standard Health Insurance Product (SHIP). The SHIP is aimed at taking care of basic health needs, carrying similar policy wordings and enabling seamless portability among the insurers.
The SHIP of each insurer will have the nomenclature of Arogya Sanjeevani Policy followed by the insurer’s name. For example, Arogya Sanjeevani Policy SBI General insurance, Arogya Sanjeevani Policy Apollo Munich etc. IRDAI has already issued guidelines and the insurers have to roll out Arogya Sanjeevani Policy from April 1, 2020, onwards.
“This policy mandates to offer a standardized product that covers basic hospitalization needs of customers with minimum sum insured of Rs 1 lakh and maximum of Rs 5 lakh with a co-pay of 5 per cent and room rent limit upto 2 per cent of sum insured or Rs 5000, whichever is lower,” says Ashish Mehrotra, MD & CEO, Max Bupa Health Insurance.
Some of the important features of Standard Health Insurance Policy will be:
- Minimum and maximum sum insured will be Rs 1 lakh and Rs 5 lakh respectively.
- Minimum and maximum entry age will be 18 and 65 years while for children under Family Floater policies, it will be 3 months to 25 years.
- Arogya Sanjeevani Policy will only be an indemnity policy. It means it will work on a reimbursement basis. Depending on the amount of hospital bill, the claim will be paid by the insurer up to the sum insured.
- 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.
- There will not be any deductible but a co-payment of 5 per cent will there across all ages. It means the policyholder will have to pay 5 per cent of the bill amount compulsorily.
- No add-ons and optional covers will be available in Arogya Sanjeevani Policy.
- Each Arogya Sanjeevani Policy of the insurer will have some basic mandatory covers which shall be uniform across the market. The premium, however, may be set by the insurers on their own.
- Some common mandatory coverage will be hospitalization expenses, pre-post hospitalization, Ayush treatment, cumulative bonus
“The insurers can additionally offer more comprehensive products beyond this product, without co-pay and with additional features like wellness, and higher sum insured per the customer’s needs,” says Mehrotra.
As the features are going to be almost similar across insurers in Standard Health Insurance Policy, the buying process will become easier. Similar to term life insurance, buying health insurance based on the premium may also become much easier than before. However, as and when such plans are launched, a close look at the inclusions and exclusions will help in better claim management.