CIRCULAR NO.2/IRDA/HLT/MISC(51)/2013-14, DATED 11-2-2015


CIRCULAR NO.2/IRDA/HLT/MISC(51)/2013-14DATED 11-2-2015

During the review meetings held by health dept. at IRDA, with all the insurance companies separately on different dates during last May to October, 2014, it has come to the dept’s notice that many of the companies are selling the captioned products without making them compliant with Regulation 17 of Health Insurance Regulations, 2013 (HIR) consequently making themselves vulnerable to regulatory actions. It was expressed by many of the insurance companies that non-filing of such products under certificate basis is unintentional and mainly due to lack of understanding and confusion as the companies felt that these products since related to NL Dept. might not come under Health dept. and might not attract the HIR provisions.

It may be noted that as per the HIR all the products containing health (health, Accident and travel) benefits irrespective of whether they are in the nature of an independent product or in the nature of a cover in a package/micro/rural/miscellaneous/govt. sponsored insurance product, were to be either filed on certificate basis or to be treated as withdrawn. Since many companies are still selling these products without making any certificate based filing, withdrawing such products from the market (in line with HIR) at this moment, may not be in the interests of the policyholders. It is also felt that the insurance companies are desirous to maintain the said products in the market.

Under the above circumstances, as a onetime exercise, the last date of filing of certificates is extended up to 31.03.2015. The companies desirous of filing these existing products may file on certificate basis on or before 31.03.2015, failing which the products will be treated as withdrawn and further selling of such products will be treated as unapproved products.

It may be noted that:

1. The filing of such products will strictly be limited to (i) Rural products, (ii) Micro insurance products and (iii) package products (iv) Govt. sponsored insurance products and (v) Miscellaneous products only, where health as defined in HIR is a part of the cover/product. Products other than the above types shall be out of the scope of this onetime exercise.
2. There will not be any further extension of date for whatever reason, and this extension shall be taken as final.
3. Products if not filed on certification basis on or before 31.03.2015, shall be treated as withdrawn and cannot be sold in the market. Selling products without approval shall be treated as violation of provisions under the HIR.
4. The insurers are advised to use the same form as they had filed for other products on certification basis earlier.
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