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IRDAI asks insurance companies to disclose premium illustration for health insurance

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IRDAI also asked insurers to provide customised benefit illustration in the format specified on their websites so as to enable the customers to make out the difference while opting for coverage.

IRDAI asks insurance companies to disclose premium illustration for health insurance
Insurance Regulatory Authority of India (IRDAI) has asked insurance companies to disclose benefit/premium illustration, for all health insurance policies issued on an individual and floater basis, to the policyholders.
"This will bring out a clear distinction between the availability of coverage under family floater basis and on individual basis vis-à-vis the premium payable," the regulator said.
Based on product construct and as per the eligible parameters of members of the family to be covered, IRDAI added, the indicative ages shall be selected from all of the following age bands: 20 or less, 21-30, 31-40, 41-50, 51-60, 61-65 and 66 or more
"Where it is not possible to present the illustration considering coverage of all the indicative ages under a single policy as per the product design, insurers can present two separate illustrations covering as many numbers of age bands, as possible,” it added.
IRDAI also asked insurers to provide customised benefit illustration in the format specified on their websites so as to enable the customers to make out the difference while opting for coverage where -
  • Each member of the family is issued an individual policy separately, at a single point in time or
  • Multiple members are covered under a single policy with a sum insured available separately for each member under a family plan or
  • Multiple members of the family are covered under a single policy with a sum insured available for the entire family, on a floater basis; as may be the case.
  • Insurers, IRDAI said, are required to adopt these norms on or before April 1, 2021.
    According to Amit Chhabra, head-health & travel insurance, Policybazaar.com, customers can these days buy either separate Individual policies, or a floater policy with a common sum insured, or a floater policy with an individual sum insured for every member.
    "This can get a bit complex for customers at times to understand and comprehend. Hence, in order to simplify this, the regulator has asked insurers to clearly call out the sum insured available to each customer covered in a policy. Sum insured coverage is the single most important factor for a health policy, and this will go a long way in simplifying this for customers," Chhabra said.
    "Benefit illustration will clarify the coverage everybody has, at an individual level. The customer can have a better and clear understanding as to how much sum insured is available to all the covered members in the plan," he added.
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