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Pocket-Friendly Mediclaim: Insurance Regulator Releases Draft Guidelines For Standard Health Product Across Industry
Representative image. (Unsplash/Raw Pixel)
According to the draft guidelines released by India’s apex insurance regulator Insurance Regulatory and Development Authority (IRDAI) on 19 February 2019, a uniform health product will be made available to everyone in the country by the insurance companies. The minimum basic sum insured under the standard product shall be Rs 50,000 with a maximum limit of Rs 10 lakh.
The product will be called Standard Mediclaim Policy succeeded by name of the insurance company. It will only provide basic mandatory cover and no additional or add-on options. The proposed product shall be offered on indemnity basis onlyand standard exclusions may be specified by the IRDAI from time to time.
“Minimum entry age shall be 18 years for principal insured and maximum age at entry shall be 65, complying to Regulation 12(i) of HIR 2016, along with lifelong renewability. There shall be no maximum exit age. Policy is subject to lifelong renewability,” a government release added.
Expenses incurred on treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines shall be covered under the Standard Product subject to fixed and standard sub-limits based on Sum Insured.
Specific medical expenses incurred within 30 days prior to the date of hospitalisation and not less than 60 days from the date of discharge from the hospital shall be admissible. The scheme also incorporates wellness incentives to promote healthy living.
The regulator has also asked all General Insurers / Health Insurers offering this product to devise pricing mechanism to incentivise early entry into health insurance by the young prospective policyholders of the health insurance market.
Different From Health Insurance
A Mediclaim plan provides coverage only for hospitalisation, accident-related treatment and pre-decided diseases for a pre-specified limit.
On the other hand, health insurance plan offers comprehensive coverage against hospitalisation charges, pre-hospitalisation charges, post-hospitalisation charges, ambulance expenses. It also might include compensation in case of loss of income as a result of an accident.
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