Sum insured limit cut for basic health policy

Chennai: The insurance regulator has brought down the sum insured limit for the proposed standard indemnity-based health insurance product from Rs 10 lakh to Rs 5 lakh. It has also clarified the specifications for Ayush hospitals that are being covered under health insurance policies.   

The Insurance Regulatory and Development Authority of India in February had proposed that all general and health insurers should offer a standard heath insurance product.

“With the objective to facilitate the public to choose a suitable health insurance policy which provides coverage to basic hospitalization related expenses, Irdai proposes to mandate all general and health insurers to offer a standard indemnity based health insurance product with a sum insured ranging from Rs 1,00,000 to Rs 5,00,000 on individual as well as family floater basis. The only differential would be the premium rates that are charged by various insurers,’ it said.

In February, it had proposed that the sum insured for the product should be in the range of Rs 50,000 and Rs 10 lakh.

The Irdai also clarified the specifications required by Ayush hospitals under the Guidelines on Standardization in Health Insurance. It should be a central or state government Ayush Hospital or teaching hospital attached to Ayush College recognised by the Central Government/Central Cou-ncil of Indian Medicine/ Central Council for Homeopathy.

 In case of Ayush  hospital, standalone or co-located with in-patient healthcare facility, it should have at least five in-patient beds, qualified Ayush  Medical Practitioner in charge round the clock, dedicated Ayush  therapy sections or equipped operation theatre and should maintain daily records of the patients.

Ayush Day Care Centre includes Community Health Centre, Primary Health Centre, dispensary, clinic, polyclinic or any such health centre which is registered with the local authorities. They should have facilities for carrying out treatment procedures and medical or surgical/ para-surgical interventions or both under the supervision of registered Ayush Medical Practitioner on day care basis without in-patient services.

They should also have qualified registered Ayush Medical Practitioner(s) in charge, dedicated Ayush therapy sections or equipped operation theatre and should maintain daily records of the patients.

Ayush  Hospitals and Ayush  Day Care Centres shall also obtain either pre-entry level certificate or higher level of certificate issued by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or State Level Certificate under National Quality Assurance Standards (NQAS), issued by National Health Systems Resources Centre (NHSRC).