The Insurance Regulatory and Development Authority of India (Irdai) has unveiled the final guidelines on allowing wellness and preventive features under a health insurance policy as optional or add-on cover.
According to Irdai, empanelled hospitals and network providers can offer health services such as outpatient consultations or treatments, pharmaceuticals, health check-ups/diagnostics including discounts under the policy.
The regulator said they can issue redeemable vouchers to obtain health supplements and redeemable vouchers for membership in yoga centres, gymnasiums, sports clubs and fitness centres for participating in fitness activities.
Insurers can also offer discounts on premiums or increase in sum insured at the time of renewals based on wellness regime followed by policyholders in the preceding policy period, provided increase in sum insured should be independent and not linked to the cumulative bonus offered, if any.
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Irdai said insurers should not publish the trade names or trade logos of third party merchandise in any of the insurance advertisements, but may refer the services in generic term. However, insurers should disclose specific items of services on their website with necessary details and may provide a link to this in their insurance advertisement and policy contracts.
Gurdeep Singh Batra, head—retail underwriting, Bajaj Allianz General Insurance, said, “The Irdai guidelines on including wellness and preventive features in health insurance is certainly a positive step forward for customers who can now proudly own their health insurance policies.”
“It will allow us to reward customers in various ways specified like discounted outpatient consultations or treatments, pharmaceuticals, health check-ups/diagnostics, redeemable vouchers for health supplement and also membership in fitness centres, sports clubs, etc,” he added.
According to Irdai, insurers should not accept any liability towards quality of the services made available by third parties and should specify upfront that the said third party is responsible for providing the services stipulated under the wellness features and insurer is not liable for any defects or deficiencies on the part of the service provider.
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