IRDAI issues guidelines on COVID Standard Health Policy

Jun 29, 2020 | by Avantis RegTech Legal Research Team

Industry Specific Compliance

The Insurance Regulatory and Development Authority of India (IRDAI) on June 26, 2020 issues guidelines on Covid Standard Health Policy. In view of the global pandemic Covid-19, the Authority has decided to mandate all general and health insurers to offer Individual Covid-19 Standard Health Policy with the following objectives:

• To have a Covid-19 specific product addressing basic health insurance needs of insuring public related to Covid-19.

• To have a standard product with common policy wordings across the industry.

The detailed guidelines are as follows:

 All general and health insurers shall offer the COVID Standard Health Policy by duly complying with the following guidelines.

 The COVID Standard Health Policy shall have one basic mandatory cover as specified in these Guidelines which shall be uniform across all General and Health Insurers.

 The insurer may determine the price keeping in view the covers proposed to be offered subject to complying with the norms specified in the IRDAI (Health Insurance) Regulations, 2016 and Guidelines notified there under the base cover of COVID Standard Health Policy shall be offered on Indemnity basis whereas optional cover shall be made available on Benefit Basis.

 The COVID Standard Health Policy shall offer a policy tenure of three and half months (3 ½ months), six and half months (6 ½ months), and nine and half months (9 ½ months) including waiting period

 The COVID Standard Health Policy should cover the Hospitalization expenses, home care treatment expenses, AYUSH treatment, pre and post hospitalization medical expenses.

 No deductibles are permitted in the product.

 The Policy shall include the cost of treatment for any comorbid condition including pre-existing comorbid conditions along with the treatment for Covid-19.

 The nomenclature of the product shall be Corona Kavach Policy. No other name is allowed in any of the documents.

 The Covid Standard Health Policy may be offered as Micro Insurance Product subject to Sum Insured limits specified in IRDAI (Micro Insurance) Regulations, 2015, and other circulars or guidelines issued in this regard by the Authority from time to time.

 General and Health Insurers shall ensure that this product is compulsorily offered on or before July 10, 2020. 

 Every insurer offering Corona Kavach Policy shall provide a certificate of insurance to the policyholder indicating the availability of health insurance coverage. The certificate shall have a reference to access detailed terms and conditions of the policy contract.

 Insurer shall cover the costs of treatment of COVID incurred by the Insured person on availing treatment at home maximum up to 14 days.

The policies issued under these guidelines will remain valid till March 31, 2021.

[Circular No. IRDAI/HLT/REG/CIR/163/06/2020] 


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