Document Detail

Title: Circular
Reference No.: IRDAI/HLT/REG/CIR/29/02/2021
Date: 08/02/2021
Modified guidelines on product filing in health insurance business

To

CEOs of all General andStandalone Health Insurance Companies

Sub: Modified guidelineson product filing in health insurance business

Referenceis invited to the provisions of Chapter III of Consolidated Guidelines onProduct filing in Health Insurance Business (Ref No:IRDAI/HLT/REG/CIR/194/07/2020 dated 22nd July, 2020 (the guidelines)specifying the File and Use Procedure in respect of various categories of individualProducts or Add-ons or Riders of Health Insurance Business. In partialmodification of these guidelines the following norms are specified.

 

1.   Use and File procedure forcertain categories of health insurance business:

 

Thefollowing categories of the individual products or add-ons or riders of healthinsurance business offered by General and Health Insurance Companies (hereafterreferred as insurers) are permitted to be launched through Use and FileProcedure by duly complying with the norms specified in these guidelines.

a.   PersonalAccident insurance products

b.   Overseas Travel insuranceproducts

c.   DomesticTravel insurance products

d.   Benefit Based healthinsurance products

 

Note: For the purpose of theseguidelines, benefit based health insurance products are defined as the productsunder which a specified benefit, as chosen by the policyholder, is paid as a fixedbenefit, on happening of the contingency covered.

 

i.    The abovereferred categories of individual products are allowed to be launched under useand file subject to the following conditions:

i.1   Inrespect of the personal accident, domestic and overseas travel products “useand file” is allowed only if the coverage offered both under base covers andadd-on covers or riders is contingent upon an accident and/or travel asrelevant.

i.2   Wherecombination of covers from different lines of health insurance business, isproposed with products other than those mentioned above or with combination ofproducts mentioned above but not in accordance with (i.1) above, insurers shouldcontinue to file such products under “file and use” procedure, as specified inthe guidelines

i.3   Any modificationof the above referred products filed under “use and file” continue to be under “fileand use” procedure as specified in the guidelines.

 

ii.   Insurers should continuefiling the products referred at Clause (1) above, using the Form –IRDAI –FNU-HIP (Annexure -1) specified in the guidelines under Use and File Procedureas well. UIN should be obtained before launching the product.

iii.  Where any Insurer is foundto be non-compliant with the guidelines specified herein while launching theproducts under use and file procedure, the Authority notwithstanding the actionthat may be taken under the provisions of Insurance Act 1938, may take one ormore of the following actions.

a.   Directthe insurer to withdraw the product.

b.   Withdraw the Use and Filefacility for such insurer for a period as may be determined.

 

iv.  These norms are applicablein respect of products filed from 1st April, 2021 onwards.

 

Sd/-

(DVS Ramesh)

General Manager (Health)

 

 

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