IRDAI’s standard policy Arogya Sanjeevani is for those who haven’t bought the health insurance policy yet

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Do you  have health insurance? If  not then this is the right time to buy. Although the presence of many health insurance policies in the market leaves buyers in the state of dilemma, IRDA has an offer for you.

The Insurance Regulatory and Development Authority of India (IRDAI)  has mandated all the insurance companies to offer a standard insurance product with minimum sum insurance up to Rs 5 lakh.

The product will be named Arogya Sanjeevani followed by the insurer’s name.

Features of Arogya Sanjeevani

  • Arogya Sanjeevani is an annual policy renewal for life and will pay for hospitalization expenses like any other health insurance policy.  It mean s it will include  all the expenses such as consultants, specialist fees, operation theatre charges, oxygen, surgical equipment, costs towards diagnostics, surgeon, etc.
  • No sub-limits for the expenses incurred on hospitalization under the Ayush system of medicines. 
  • Pre-hospitalization (from 30 days before the date of admission) and post-hospitalization expenses (60 days from the date of discharge) will be included too.
  • Dental treatment and plastic surgery required due to a disease or injury, all day-care treatments and expenses incurred on road ambulance in which ambulance expenses will be Rs 2000 a day.
  • Facilitoes up to 5% of the sum insured, up to Rs 10,000 will be rpovided on expenses on intensive care unit (ICU) and intensive cardiac care unit (ICCU).
  • You will hav eto pay only 5% and rest insurere will pay as a fix co-pay of 5% has been fixed for all ages.
  • Up to 50% of the sum insured will be covered for modern treatments like stem cell therapy and balloon sinuplasty.
  • For room, boarding an dnursing expenses, only 25% of the sum  insured , subject to a maximum of Rs 5,000 a day will be covered under Arogya Sanjeevani.
  • 25% of su assured or Rs 40,000 whichever is low will be provided for catarct surgery.
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Premium and bonus 

The IRDAI has allowed insurers to keep the price of policy keeping in mind the policy covers they are offering and the norms set by IRDAI.

As the insurers are not allowed to offer any additional covers with this product, they can create a family package where the premium will be decided based on the income of the eldest member.

The total bonus on this product shall increase by 5% in respect of each claim-free year, subject to a maximum of 50% of the sum insured but only if the policy is renewed without a break. The bonus will decrease at the same rate of 5% it was accrued if it is made in any particular year. Also, no deductibles are allowed. 

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Conclusion

Although a cover of 5 lakh is not sufficient for a complete family but is still better than having no policy at all.

How the product will shape the health insurance sector is yet to be seen.

 

 

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