Indemnity Health Insurance Products through Point of Sales

[Image omitted. See the official document.]

भारतीय बीमा विनियामक और विकास प्राधिकरण INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA

No. IRDA/INT/CIR/PSP/2.37/2017

25th Oct 2017

To All CEOs of Non-Life & Health Insurers

Re. Inclusion of Indemnity based Health Insurance Product through PoS – General Insurers and Standalone Health Insurers.

Your attention is drawn to the Guidelines No.IRDA/Int/GDL/ORD/183/10/2015 dated 26.10.2015 pertaining to Point of Sales Person (POS) and the subsequent Circulars giving the details of types of products that can be solicited by the POS.

The Authority has received requests from many insurers to allow indemnity based health insurance products to be sold through Point of Sale (POS). On examination of the request made, the Authority under the powers vested with it under clause V(1)(f), of the said guidelines, has decided to allow individual indemnity based health insurance products to be solicited through PoS channel with the following conditions:-

• i) the indemnity based health insurance products may be offered to only individual policyholders excluding groups and government schemes
• ii) Rs.5 lacs per life/individual will be the maximum sum insured
• iii) Number of such products that can be filed as POS product is capped at 3 (three) per insurance company
• iv) Since Health indemnity products follow a different process than health benefit products, which were hitherto included in the POS channel, the POS may be educated about the process involved in preferring claims, particularly the cashless claims who in turn shall educate the holder of indemnity based health insurance product.

[Image omitted. See the official document.]

(P.J. Joseph) Member (Non-Life)

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