Master Circular on Health Insurance Business

The Insurance Regulatory and Development Authority of India (IRDAI) has issued a Master Circular on Health Insurance Business. This Master Circular shall come into force with immediate effect, except for provisions where specific effective dates are mentioned.

The key information for policyholders, prospects, and customers includes:

Insurance Product Availability: Insurance products are available with add-ons/riders, catering to all ages, existing medical conditions, preexisting diseases, and chronic conditions.

Technological Advancements Treatments: The latest technological advancements and treatments are made available to policyholders.

Customer Information Sheet (CIS): Insurance companies shall issue a CIS as a separate annexure, containing key information on the policy, such as type of insurance, sum insured, exclusions, waiting period, claims procedure, policy servicing, and grievance redressal mechanism

Free Look Period: A 30-day free look period is provided to enable policyholders to review the terms and conditions of the policy and cancel it if not satisfied.

Cancellation of Indemnity Policy: Policyholders can cancel their policy at any time during the term by giving 7 days’ notice in writing.

Nomination: Policyholders can register or change their nomination during the term of the policy.

Grace Period for Payment of Premium: A grace period of 15 days for monthly premiums and 30 days for quarterly, half-yearly, or yearly premiums is available. If the policy is renewed during the grace period, all accrued credits (sum insured, no claim bonus, specific waiting periods, etc.) shall be protected.

Insurance Coverage during Grace Period: Coverage is available during the grace period if premiums are paid in installments.

Renewal of Health Insurance Policy: A health insurance policy shall be renewable unless the product is withdrawn due to established fraud, non-disclosure, or misrepresentation by the insured. The insurer shall not deny renewal based on previous claims.

Migration in case of Indemnity Policies: Policyholders can transfer credits gained to the extent of the sum insured, no claim bonus, specific waiting periods,

Portability in case of Indemnity Policies: The existing insurer shall provide information to the acquiring insurer within 72 hours of receipt of the request. The acquiring insurer shall decide and communicate on the proposal within 5 days.

Policy/Claim cannot be Contested: Policies and claims shall not be contestable on grounds of non-disclosure and/or misrepresentation except for established fraud after the completion of the moratorium period (60 months of continuous coverage).

No Claim Bonus: Accumulated no claim bonus can be claimed by way of addition to the sum assured or discount in renewal premium.

Approval for Cashless Claims:

  • Insurers shall strive to achieve 100% cashless claim settlement in a time-bound manner. Authorization for cashless claims should be given immediately, not more than one hour of receipt of request.
  • Necessary systems and procedures shall be put in place by the Insurer immediately and not later than 31st July, 2024.
  • Insurers may arrange for dedicated Help Desks in physical mode at the hospital to deal and assist with the cashless requests.
  • Insurers shall also provide pre-authorization to the policyholder through Digital mode

Final Authorisation for Discharge from the Hospital : Final claim authorisation should be given within THREE hours of receipt of discharge authorisation request received. In no case, the policyholder shall be made to wait to be discharged from the Hospital.

Settlement of Claims: No claim shall be repudiated without the approval of the Claims Review Committee (CRC).

Claims in respect of Multiple Policies: In case the available coverage is less than the admissible claim amount, the primary insurer shall coordinate with other insurers to ensure settlement of the balance amount without causing any hassles to the policyholder.

Implementation of Ombudsman Award: Insurers are required to comply with the award of the Insurance Ombudsman within 30 days. Failure to comply may result in a penalty of Rs. 5000 per day.

The broad requirements to be complied with by insurers in the health insurance business, as outlined in the Master Circular, include:

General Principles:

  • Board-approved underwriting policy covering all ages and medical conditions.
  • Policy on quality standards and benchmarks for empanelment of hospitals and healthcare providers.
  • Ensuring Ayush treatments are at par with other treatments.
  • Striving to provide 100% cashless services to policyholders
  • Designing proposal forms in simple language and providing them in scheduled languages.
  • Disseminating information about products transparently to prospects and policyholders.
  • Mandatory forwarding of CIS in the specified format and obtaining acknowledgment from the policyholder

Claims Settlement : A well defined claims handling, claim settlement procedures, turnaround times (TATs) for settlement of claims and policy servicing

No claim should be repudiated without the approval of the Claims Review Committee (CRC) or the Policyholder Management Committee (PMC).

Display on Insurers Website:

  • List of hospitals / healthcare providers tie up for Cashless Claim and list of network hospitals
  • Procedures to be followed by the policyholder for claim settlement under cashless facility and reimbursement of claims
  • Turn Around Time for policy servicing, approvals of cashless as well as reimbursement claim settlement
  • List of products on offer and products withdrawn

Training and Technology Solutions:

  • Periodical training for intermediaries, distribution channels, and employees on products, TATs, and regulatory changes.
  • Implementation of end-to-end technology solutions for effective onboarding, policy servicing, and claim settlement

Performance Monitoring of TPAs:

  • Board-approved criteria for monitoring TPA performance, customer servicing, and service level parameters.
  • Feedback collection from customers on claims settlement.
  • Claw back of remuneration based on customer feedback.
  • Payments to TPAs only after satisfactory service discharge

Product Management Committee and Advertisement Committee:

  • Establishment of committees for product management and advertisement as per the regulations

Product Filing:

  • Insurers must follow a structured procedure for filing new products, riders, add-ons, or modifications, which requires approval from the Product Management Committee (PMC).
  • Details of individual and group products should be maintained in designated forms.

 Withdrawal of Products:

  • Insurers are required to inform the withdrawal of any products, add-ons, or riders within 30 days using the specified form.
  • The decision to withdraw a health insurance product/add-on/rider is made by the PMC, with clear documentation of the reasons for withdrawal.
  • Existing customers of a withdrawn product should be provided options to renew, migrate to another product, or choose suitable alternatives.
  • Distribution channels must be informed well in advance about product withdrawals.
  • Refunds for premiums or deposits received for withdrawn products should be promptly issued to policyholders 16.

Miscellaneous Provisions:

  • Model product for persons with disabilities, HIV/AIDS, and mental illness
  • With specific consent of the policyholder, Insurers may facilitate creation of ABHA number as per procedures laid down..
  • Submission of periodic returns on Premium, claims etc. as per the provisions of the master circular on submission of returns issued by the Competent Authority

Source: https://irdai.gov.in/

IRDAI Notification

Standards and Benchmarks for the Hospitals in the Provider NetworkIRDAI Notification on Hospitals for Insurers and TPAs

IRDAI has released a notification on 20th July, 2022 with an advisory to Non Life Insurers and TPAs about on boarding Hospitals under Cashless Empanelment Scheme and the changes to the Standards and Benchmarks Criteria laid down for the Hospitals earlier.

This advisory calls for Insurers choosing their own empanelment criteria for Hospitals and updating the same in their respective websites for the benefit of industry and stakeholders , as updated from time to time.

IRDAI has suggested to Board of Insurers to consider the Minimum Resources and Infrastructure conditions that prevail in wide range of Hospitals across the country while empanelling the Hospitals. The insurers are now empowered to empanel the network providers that meet the standards and benchmarks criteria as specified by their respective boards. The board approved empanelment criteria shall be published in the website of the insurers from time to time.

This advisory enables Insurers to extend the scope of coverage of cashless scheme to wide range of healthcare facilities in the country. While empaneling network providers for cashless facility, insurers are also advised to focus on the delivery of quality healthcare services.

These instructions come into force with immediate effect.

Download the IRDAI Advisory here

Source – https://www.irdai.gov.in/ADMINCMS/cms/Circulars_Layout.aspx?page=PageNo4762

To understand the requirement of IRDAI advisory on Standards and Benchmarks for the Hospitals, please download the earlier advisories as shared below :

Master circular (ref. IRDAI/HLT/REG/CIR/193/07/2020 dated 22nd July, 2020). . Download here to read more about the Master Circular

Please read Chapter IV of the Master Circular shared above to understand the norms laid down under Standards and benchmarks for hospitals in the provider network. Reading the Master Circular of 2020 helps healthcare establishments understand the specification laid down earlier for Cashless Schemes and Reimbursement Claims .

What does the Chapter IV of the Master Circular says ?

Insurers and TPAs, wherever applicable, shall ensure that Network Providers or Hospitals which meet with the definition of ‘Hospital’ provided in Chapter I of these Guidelines shall meet with the following minimum requirements:

a. All the Network Providers as at 27th July, 2018 shall, comply with the following by 26th July, 2020:

i. Register with Registry of Hospitals in the Network of lnsurers (ROHlNl) maintained by lnsurance lnformation Bureau (llB). [https://rohini.iib.gov.in].

ii. Obtain either “NABH Entry Level Certification” (or higher level of certificate) issued by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NOAS), issued by National Health Systems Resources Centre (NHSRC).

iii. In respect of all the new entrants (after 27th July 2018), only those hospitals that are compliant with the requirements specified at Clause (a) (i) above shall be enlisted as network providers. These network providers shall comply with the requirements stipulated at Clause (a) (ii) above within one year from the date of enlisting as a Network Provider and this shall be one of the conditions of Health Services Agreement.

iv. lnsurers and TPAs may also endeavour to get hospitals (other than Network Providers) involved in reimbursement claims to meet the requirements stipulated at Clause (a) (i) and (a) (ii) above.

b. AYUSH Hospitals and AYUSH Day Care Centres which meet the definition of AYUSH Hospitals and AYUSH Day Care Centres defined under Chapter I of these Guidelines shall also obtain:

(i) Either “NABH Entry Level Certification” (or higher level of certificate) issued by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or State Level Certificate (or higher level of certificate) under National Quality Assurance Standards (NQAS), issued by National Health Systems Resources Centre (NHSRC).

(ii) All the existing AYUSH Hospitals and AYUSH Day Care Centres shall comply with the requirements referred above within a period of twelve months from 26th November, 2019, if the said certificate
is not already obtained.

(Note: The above instructions at a and b are subject to the directions of the Hon’ble Delhi High Court in its order dated 29th May 2019 / 31st May 2019, in respect of W.P(C) 6237 of 2019, which needs to be complied with till further orders of the Hon’ble Court.)

c. The providers shall comply with the minimum standard clauses in the agreement amongst Insurers, Network Providers and TPAs applicable to providers listed in Annexure 22 of Master Circular Ref.
IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 and as amended from time to time.

d. Providers shall be bound by the Provider Services—Cashless facility admission procedure laid down in Schedule A of Master Circular Ref. IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 and as amended from time to time.

e. Providers shall be bound by the process of de-empanelment of providers laid down in Schedule B of Master Circular Ref. IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 as amended from time to time.

f. Providers shall follow the standard discharge summary format prescribed under Schedule C of Master Circular Ref. IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 and as amended from time to time.

g. Providers shall follow the standard format for provider bills prescribed under Schedule D of Master Circular Ref. IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 and as amended from time to time.

h. Providers shall ensure that the standard claim form and form for request for cashless hospitalization for Health Insurance Policy provided for under Annexure 30 of Master Circular Ref.IRDAI/TPA/REG/CIR/130/06/2020 dated 03.06.2020 and as amended from time to time are adhered to in respect of all claims.