IRDAI Issues Master Circular on Standardization of Health Insurance Products

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The Insurance Regulatory Development Authority of India on 22nd July 2020 has issued a Master Circular on Standardization of Health Insurance Products by consolidating all the Guidelines issued up to 31st March, 2020.

The present Master Circular is applicable to all insurers (excluding specialized insurers) and the TPAs wherever applicable. The Network Providers or Hospitals shall Register with Registry of Hospitals in the Network of lnsurers maintained by lnsurance lnformation Bureau and shall Obtain either “NABH Entry Level Certification” or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NOAS), issued by National Health Systems Resources Centre.

Providers shall ensure that the standard claim form for request for cashless hospitalization for Health Insurance Policy provided are adhered to in respect of all claims.

The timeline for submission of the returns is specified as under:

  • All Yearly returns shall be furnished within 90 days from the close of the Financial Year.
  • All Half Yearly returns shall be furnished within 45 days from the close of every Half – Year.
  • All Quarterly returns shall be furnished within 30 days from the close of the Quarter.

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