The Insurance Regulatory and Development Authority of India vide its notification dated 4th September 2020 has revised its Guidelines on Product Filing in Health Insurance Business.
As per the revised norms wellness and preventive feature shall be designed only with the objective of maintaining and improving good health and as part of promoting wellness and preventive regime, insurers may offer reward points to those policyholders who comply with or meet the set criteria of wellness and preventive features.
Wellness and preventive features under a policy may also be offered either as optional or add-on cover and every Insurer shall assess the pricing impact of wellness and preventive features offered, if any, and the same shall be disclosed upfront in the File and Use or Use and File application, as may be the case, as specified in the Product Filing Guidelines.
Based on criteria stipulated for wellness and fitness, insurers may endeavor to promote wellness amongst health insurance policyholders by offering health-specific services provided by Network providers or other empanelled hospitals / service providers for the following:
- Outpatient consultations or treatments
- Pharmaceuticals
- Health check-ups/diagnostics
Further Insurers shall not publish the trade names or trade logos of third party merchandize in any of the insurance advertisements, but may refer the services in generic term. However, Insurers shall disclose the specific items of services in their website with necessary details and may provide a link to this in their insurance advertisement and policy contracts and the Insurers shall clearly specify in the policy contract as to whether the accrued rewards can be carried forward or not when the policy is renewed with the Insurer and the period of validity of the accrued rewards under both the scenarios. In case of expiry of policy, the accrued rewards may be carried forward for a period not exceeding three months.
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