Simplifying Health Insurance Information: IRDAI’s Initiative

As of January 1, a recent circular issued by the Insurance Regulatory and Development Authority of India (IRDAI) mandates health insurance companies, intermediaries, and agents to provide policyholders with a document called the customer information sheet (CIS) in a simplified and easily understandable format. This move aims to enhance transparency and ensure that policyholders have access to essential information regarding their health insurance coverage.

Key Requirements of the Customer Information Sheet (CIS)

The CIS must be provided to all policyholders, either in physical or digital format, with the option for it to be available in the policyholder’s local language. Furthermore, the document should employ a font size of at least 12 (in Arial) or larger to facilitate readability. Accuracy and completeness of information are paramount, ensuring that policyholders receive comprehensive details about their coverage.

Enhancing Transparency and Understanding

Bhaskar Nerurkar, head of the health administration team at Bajaj Allianz General Insurance, lauds this initiative, highlighting its role in presenting policy information in a simplified and tabular format. This approach allows for easy comprehension of critical details such as sublimits or room rent restrictions, which are often embedded within complex policy wordings.

Dr. S. Prakash, chairperson of the Health Committee at the General Insurance Council, emphasizes the practical utility of the CIS in expediting claim processing and minimizing delays. Given the prevalence of technical jargon and legal language in policy documents, the CIS serves as a valuable tool in addressing common customer queries and clarifying policy benefits and limitations.

Facilitating Information Access

In addition to providing the CIS, insurers are required to include a note in the main policy document directing policyholders on where to locate the CIS for future reference. This proactive measure ensures that individuals have ready access to pertinent information, empowering them to make informed decisions regarding their insurance coverage.

Prakash underscores the importance of offering both online and offline assistance to policyholders, enabling them to seek clarification or resolution for any inquiries or doubts they may have. Customers are encouraged to leverage the support services provided by health insurance companies, including contacting customer support teams for further assistance.

IRDAI’s initiative to streamline health insurance information through the CIS reflects a commitment to enhancing transparency, accessibility, and consumer empowerment within the insurance sector. By providing policyholders with clear and concise information, this measure aims to foster greater understanding and confidence in health insurance coverage.