IRDAI clarifies about premium increase in health insurance

IRDAI has clarified that it has permitted general and health insurers to change the base premium by up to +/-5% of originally approved premium rates in order to comply with the guidelines on standardization of exclusions.

IRDAI had last year broadened the scope of coverage to include conditions such as mental illnesses and HIV-AIDS. The regulator has also been standardizing the products and has reduced the list of non-payable items also called exclusions such as chemotherapy and robotics treatment, among others. Items under exclusions are not reimbursed by the insurer.

The permission to increase premium was done as a one-time measure for seamless transition of existing products to ensure viability and sustainability. “As on 30 September 2020, out of 388 products, premiums were increased by general and health insurers up to 5% of the then prevailing rates only in case of 55 products,” IRDAI said in a circular.

The clarification comes primarily in the wake of policyholders blaming regulatory changes for the rise in premiums in this financial year.

Moreover, the regulator said it had cleared revision in premium beyond 5% of only five health insurance products of general or health insurers during the year up to 30 November as part of periodical modification of their respective products, based on the incurred claims experience.