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Insurers submit a standardized technical note containing complete pricing and product information signed by the appointed actuary when filing health insurance products. General insurers apply this template to the health portion of packaged products and personal accident or pilot health insurance products. This requirement takes effect immediately.
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भारतीय बीमा विनियामक और विकास प्राधिकरण INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA
Cir No. IRDAI/ACT/CIR/MISC/069/04/2021
Date: 01.04.2021
To
CEOs/CMDs of all General Insurers and Stand-Alone Health Insurers.
Sub: Standard Technical Note (Template)- Health Insurance
This circular is issued in exercise of the power vested under section 14(2)(e) of the IRDA Act, 1999.
Reference is drawn to the Circular No. IRDAI/ HLT/ REG/ CIR/ 194/ 07/ 2020 dated 22^nd July, 2020 on "Consolidated Guidelines on Product filing in Health Insurance Business". In terms of the above Circular, insurers are required to submit a Technical Note detailing pricing aspects of health insurance product filing.
In order to expedite the product clearance process, it has been decided to standardize the Technical Note so that insurers can provide all necessary details in a prescribed standard format. This will help to ensure uniformity amongst insurers in the matter of filing pricing and product related information for health insurance products.
Insurers shall submit Technical Note providing complete information and duly signed by the Appointed Actuary as per the prescribed format. The format is enclosed as Annexure – 1 with this Circular.
In case, a General Insurance packaged product has Health as one of its sections or covers, this Technical Note template shall be used for health portion of the packaged product.
This Technical Note format shall also be used while filing PA (Personal Accident) and Pilot health insurance products.
This Circular shall come into force with immediate effect.
(P K Arora)
Member (Actuary)
सर्वे नं/ Sy.No: -115/1 फाइनंशियल डिस्ट्रिक्ट, गच्चीबाउली /Financial District, Gachibowliनानकरामगुडा/Nanakramguda, हैदराबाद /Hyderabad – 500032 दूरभाष:/Phone No: 040-20204000
Technical Note – (Brand Name of the Product/Add-on)
Annexure – 1 (Cir No. IRDAI/ACT/CIR/MISC/069/04/2021 dated 01.04.2021)
#(Template)
(Please strike off Product or Add-on as applicable)
| Name of the Insurer | : _____________________________________ |
| Product/ Add-On | : _____________________________________ |
| Line of Business | : _____________________________________ |
| Name of the Appointed Actuary/ Panel Actuary | : _____________________________________ |
| Name of the Mentor (if applicable) | : _____________________________________ |
This technical note supersedes the Technical Note (version number* _____) dated DD/MM/YYYY.
This technical note is based on latest File and Use document / Use and File document submitted to the Authority as on DD/MM/YYYY.
*Initial version number shall be 1. It shall get incremented by 1, every time an updated technical note is submitted to the Authority.
Version No:
Date:
Technical Note – (Brand Name of the Product/Add-on)
| Sl.No. | Description | Details | ||
|---|---|---|---|---|
| 1.1 | Brand name of the Product/ Add-on | |||
| 1.2 | New or Modification of existing Product/ Add-on If modification of existing product/Add-on, please mention UIN. | New/Modification | ||
| 1.3 | Filing under File & Use or Use & File | |||
| 1.4 | Target Market | |||
| 1.5 | Is the product Reinsurance driven? | Yes/ No | ||
| 1.6 | If the filing is for base product, provide details of approved Add-ons that will be sold alongside, if any: | |||
| Name of Add-on with UIN No, Date of approval | Brief Description of Benefits under the Add-on | Whether Benefit based/Indemnity based | ||
| Confirmation that there is no overlap of benefit between base product and add-ons. | ||||
| 1.7 | If the filing is for Add-on, provide name of Base product along with UIN, date of approval. Confirmation that there is no overlap of benefit between base product and add-ons. | |||
2.1 This section should provide benefit structure for each variant/option of the Product / Add-On. In case of modification of existing Product / Add-on, provide the comparison of the benefit structure in the following format between the proposed modification and existing Product / Add-On along with the reasons for changes.
Table 1
| Sl.No. | Benefits covered | Indemnity / Fixed Benefit | Benefit Amount / Sum Insured limit / sub-limit | Deductibles & Co-pay | ||
|---|---|---|---|---|---|---|
| Variant 1 | Variant 2 | Variant 1 | Variant 2 | |||
| 2.2 | Type of Product / Add-on | Individual/ Group Product |
| Individual basis/Family Floater basis/ both | ||
| 2.3 | Policy Term | |
| 2.4 | Mode of premium payment | |
| 2.5 | Age Group | Minimum age at entry: Maximum age at entry: |
| 2.6 | Details of number of floater combinations along with relationships covered in family floater | |
| 2.7 | No Claim Bonus Please provide a grid about No Claim Bonus (if applicable) | |
| 2.8 | Other Conditions: | |
Version No:
Date:
Technical Note – (Brand Name of the Product/Add-on)
| Sl.No | Item | Description |
|---|---|---|
| i) | Source of Data | Internal / External |
| ii) | Indicate the source of internal data, if used in pricing | Provide the name of the Product or Add-on, whose experience has been used in pricing. |
| iii) | If External data is used, indicate the source of external data | Reinsurer data/ IIB Data/ Industry data/other countries data/ any other data source |
| - if IIB Data is used | Provide the publication reference with date. | |
| - if Industry data/ other countries data / any other data source is used | Provide the reference from where the data has been collected. |
