The Insurance Regulatory and Development Authority of India (IRDAI) has issued a clarification on insurance cover for newborns/ infants through a circular. This circular is issued under Health Insurance Policies.
It may be recalled that the Chapter –II of Master circular on Standardisation in Health Insurance Business dealth with ‘exclusions not allowed under health insurance policies’. The Master Circular stated that internal congenital diseases, genetic diseases or disorders are not allowed to be incorporated as exclusions in the terms and conditions of the policy contract.
Furthermore, on 12th October 2022, IRDAI issued a clarification on this chapter of the Master Circular. The clarification reiterated that all insurance products that cover newborns shall comply with the above referred provisions without any deviation. The coverage shall be extended from day one without imposing any waiting periods/sub-limits or any other restrictive conditions.
The present circular has now clarified that the prohibition of restrictive conditions shall be applicable to all products including the “Arogya Sanjeevani Policy”. Hence the guidelines on “Standard Individual Health Insurance Product” have been modified to delete ‘internal congenital anomalies from the list of diseases provided under “specific waiting period” in the guidelines.