Disclosure of benefit/premium illustration for Health insurance policies issued on floater basis

Last updated: 29 December 2020

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The IRDAI has issued new guidelines requiring insurers to provide clear benefit illustrations for health insurance policies that offer individual and family floater options. These illustrations will help customers understand the differences in coverage and premiums between individual policies, family floater policies where each member has a separate sum insured, and family floater policies with a pooled sum insured for the entire family. Insurers must provide these illustrations in their sales literature and on their websites by 1st April 2021.

Insurance Regulatory and Development Authority of India Ref. No: IRDAI/HLT/REG/CIR/298/12/2020 Date: 28-12-2020 To All Insurers Sub: Disclosure of benefit/premium illustration for Health insurance policies issued on floater basis. 1. Reference is drawn to clause 5 of Chapter-II of Consolidated Guidelines on Product filing in Health Insurance Business (Ref: IRDAI/HLT/REG/CIR/194/07/2020 dated 22.07.2020) stipulating mandatory disclosures in the prospectus of health insurance pro

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FAQ :

The new guidelines aim to ensure clarity for customers by requiring insurers to provide benefit illustrations that clearly distinguish between individual and family floater health insurance options, including the associated premiums and sum insured.

The illustration must show the difference in coverage and premiums for individual policies, family floater policies with individual sum insured per member, and family floater policies with a total sum insured for the family. It should cover various age bands.

Insurers must include these illustrations in the product prospectus or sales literature, attach them to the customer information sheet, and also make them available on their websites for customers to compare options.

The age bands to be considered are: 20 or less, 21-30, 31-40, 41-50, 51-60, 61-65, and 66 or more. If a single illustration isn't possible, insurers should provide two separate ones.

Insurers are required to adopt these new norms on or before 1st April 2021.

Notification No : Ref. No: IRDAI/HLT/REG/CIR/298/12/2020
Source : https://www.irdai.gov.in/ADMINCMS/cms/Circulars_Layout.aspx?page=PageNo4310

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