IRDAI orders insurers to cover PwDs, AIDS

IRDAI has ordered insurance companies to “mandatorily” launch an appropriate product offering health insurance cover for certain vulnerable sections of society — persons with disabilities (PWD), persons afflicted with HIV/AIDS and those with mental illness – “immediately”.

In its latest circular, IRDAI said every general and stand-alone health Insurer, who has been issued a Certificate of Registration to transact general and health insurance business, should “mandatorily launch and offer their respective product immediately”. “It is reiterated that this circular should come into force with immediate effect,” the regulator said.

In October 2022, IRDAI had directed insurance companies to provide cover for mental illness under health insurance policies before October 31, 2022. However, insurers have not made any progress in launching such a scheme, forcing the regulator to issue another directive.

IRDAI has also prescribed a model setting out the minimum scope and parameters for design of the product. In other words, insurers may widen the scope of this product but in no case can the scope of product be narrowed down. “The insurers are directed to put in place a Board approved underwriting policy that ensures that no proposal from the above-mentioned categories of population is denied for reasons of the above stated disabilities or illnesses,” IRDAI said.

The policy tenure of the product should be for a period of one year and renewable as per regulatory framework already laid down. The standard product should comply with all the provisions of IRDAI (Health Insurance) Regulations, 2016, all other applicable Regulations and other applicable guidelines and circulars as amended from time to time.

“The insurers may determine the price of the product subject to complying with the norms specified in the IRDAI (Health Insurance) Regulations, 2016 (HIR, 2016) and guidelines and circulars,” it said.