Standard health policy with Rs 5 lakh maximum sum insured: IRDAI allows selling through PoS

The Insurance Regulatory and Development Authority of India has allowed selling of standard health insurance product named ‘Aarogya Sanjeevani Policy’ through insurance Point of Sales (PoS) persons. Vide circular dated January 13, 2020, the regulator made a partial modification to its circular dated October 25, 2017, that capped the number of products to be filed as PoS products by insurers to three.

“Number of such products that can be filed as PoS product is capped at three (3) per insurance company. ln addition to these three insurance products, Standard Health insurance Product- “AROGYA SANJEEVANI POLICY” is also allowed to be marketed by Point of Sales,” IRDAI said in the new circular.

All other conditions for PoS mentioned in the 2017 circular, which allowed selling of indemnity-based health insurance products to be sold through PoS, remain unchanged. These are:

1. Indemnity-based health insurance products can be offered to only individual policyholders, excluding groups and government scheme.

2. Rs.5 lakh per life/individual will be the maximum sum insured of indemnity-based health insurance product.

3. The PoS needs to be educated about the process involved in preferring claims, particularly the cashless claims, who in turn will educate the policyholders about the products.

What is Aarogya Sanjeevani Policy?

Early this month, the IRDAI directed all general and health insurance companies to offer a Standard Health Insurance Product. To be named as “Aarogya Saneevani Policy”, this product will cover basic hospitalisation needs of the policyholders with minimum sum insured of Rs 1 lakh and maximum of Rs 5 lakh with a co-payment condition of 5 per cent and room rent cap up to 2 per cent of the sum insured, or Rs 5000, whichever is lower.

If the sum insured is Rs 5 lakh, the cap on room rent under the policy will be up to Rs 5000 as two per cent of Rs 5,00,000 is Rs 10,000.

Co-payment clause of the policy means the insured will have to bear 5 per cent of the hospitalisation expenditure, while the rest will be paid by the insurer.

The standard health insurance policy will not have any add ons and optional covers.

Source: Financial Express