IRDA (HEALTH INSURANCE) (First Amendment) Regulations, 2014

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A~s '34 ◄'1 : ~ 1~1 1°4f.l'-lq 19 f.lkftij,ffl' e~~a ~ -,i1t11 ~ ·AA'-44119 : fq~cfi(UI ~ ~ ~ ~ ~ d1!41ft" cfil stftcfit(: ~ 1°4f.l'-lqi ctn'~~ ~qi 'S'1<fil ri 61'11-4 it ~ff) ~ cfit?;-11~ ifi1" ~ ffl ~ ~ s11i'll<fi{u1 cfiT 3'Uf&l qf)q-!i'i ~ €-G ~ Ate1cfi( 01 , ~~r 31l"{ ~~II f..l~gl ~ I fl <l'i1- ~ cfii:l I ~ I" [~S1 IGri IIU4/161/14/31ti I.] l • ['Wl 111-(906 4] • 'ltl(d cfi1 (l,ijq51 : 3rnJl.ITT1lT INSURANCE REGULA TORY AND DEVELOPMENT AUTHORITY NOTIFICATION Hyderabad, the 19th November, 2014 • 3 INSURANCE REGULATORY AND DEVELOPMENT AU'l"HORITY (HEALTH INSURANCE) (FIRST AMENDMENT) REGULATIONS, 2014 F. No. IRDA/Reg/7/90/2014.-ln exercise of the po\vers conferred under Section 114A of the Insurance Act 1938 and Section 14 read with section 26 of the IRDA Act 1999 and in consultation with the Insurance Advisory Committee, the Authority hereby makes the follov,ing regulations, namely:- 1. Short title and commencement. a. These Regulations may be called Insurance Regulatory and Development Authority (Health Insurance) (First Amendment) Regulations, 2014 b. They shall come into force from the date of their publication in the Official Ga,ette of the r .-••~--"'n• .,..&- 1·n,;1 =- uv •"''LU"""'- "VJ." UUI 2. General Provisions relating to Health Puli\:i~: lu the l11::.u1 d.ll1,;1,; Rt:~ulatory and Ucvclopn1ent Authority (I-lealth Insurance) Regulations, 2013, Reg 5 (g) is substituted by the following: Free Look Period ~, All new individual health insurance policies except those with tenure of less than a year shaJI have a free look period. The free look period shall be applicable at the inception of the policy and: l. The insured Yi ill be alloY.·ed a period of at least 15 days from the date of receipt of the policy 10 review the terms and conditions of the policy and to return the same if not acceptable 2. If the insured has not made any claim during the free look period, the insured shall be entitled to- a. A refund of the premium paid less any expenses incurred by the insurer on medical examination of the insured persons and the stamp duty charges or: b. ,vhere the risk has already commenced and the option of return of the policy is exercised by the policyholder. a deduction towards the proportionate risk premium for period on cover or; c. Where only a pan of the risk has commenced, such proportionate risk premium commensurate with the risk covered during such period. d. ln respect of unit linked policy. 1n addition to the above deductions, the insurer shall also be entitled to repurchase the unit at the price of the units as on the date of the return of the policy. Reg S (i)(iii) is substituted by the following Cumulative bonus • "Cumulat1,·e bonus may not be allowed on benefit based policies with the exception of Personal Accident cover" , • • • 4 THE GAZETTE Of' INDIA EXTRAORDrNARY Reg 5 (l)(i) is substituted by the following A YUSH Coverage: [PART Ill- SEC. 4] "Insurers may provide coverage to non--allopathic treatt11ents provided the treatment has been undergone in a government hospital or in any institute recognized b} govcrn,nent and/or accredited by Quality Council of India/National Accreditation Board on Health". 3. Miscellaneous Provisions: A ne,v regulation 19 is inserted as under • "Reg. 19: Power of Chairperson to issue clarification etc.: In order to remove any difficulties in the application or interpretation of these regulations, the Chairperson of the Authority may issue clarifications, directions and guidelines in the fonn of circulars." T. S. VIJAYAN. Chainnan (ADVT. TT1/4/l61 /l4/Exty.] Printed by the Manager, Government of India Pres~. Ring Road Mayapuri, New Delhi-I I 0064 and l'ubhshed by the Controller of Publicauons, Delhi-110054. I l