Health insurance holders are likely to benefit with more wellness and preventive features, including outpatient (OP) consultations, pharmaceuticals, health check-ups, diagnostics and discount vouchers in gyms and yoga centres in the policy package.
The Insurance Regulatory and Development Authority (IRDAI) has prepared a draft proposal that will allow insurers to give premium discounts in health insurance for those following a fit lifestyle. “Insurers may endeavour to promote wellness amongst health insurance policyholders by offering health-specific services provided by network providers or other empanelled hospitals and service providers,” said the IRDA draft guidelines.
The guidelines specify that the rewards that can be offered as wellness benefits in the health insurance schemes and the manner in which those benefits can be utilised would be mentioned in the policy contract.
IRDAI has also proposed redeemable vouchers to obtain consumable health boosters, and membership in yoga centres or gymnasiums for participating in fitness activities. The draft also includes discounts on premiums and an increase in sums insured at the time of renewals based on the wellness plan followed by holders in the preceding policy period, reported Indian Express.
“Every insurer shall assess the pricing impact of wellness and preventive features offered if any, and the same shall be disclosed upfront in the File and Use or Use and File application, as may be the case, prescribed in the Product Filing Guidelines or applicable File and Use norms,” IRDAI said.
“The new proposals open up direct incentives to policyholders. But many of these will require monitoring to prevent unhealthy competition and misuse. Fraud monitoring and prevention steps will also become critical,” KK Srinivasan, former member, IRDAI said.
IRDAI has said that the increase in sum insured should be independent and not linked to cumulative bonus offered.
The regulator has also proposed that insurers should assess the pricing impact of wellness and preventive features offered, if any, and reveal them under product filing guidelines. According to the draft norms, insurers should not publish trade names or logos of third party merchandise in any of their advertisements but may refer to the product or service offered. However, insurers should disclose specific items of products and services offered on their website and provide a link in their advertisements and policy contracts.
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