Use and file procedure for all categories of products under health insurance business

IRDAI has issued circular vide Ref no. IRDAI/HLT/REG/CIR/108/06/2022 dated June 1, 2022, on Use and file procedure for all categories of products under health insurance business –reg’ (Circular), superseding the earlier circular issued on Modification guidelines on product filing in health insurance business dated February 8, 2021 and subsequently issued press release on Insurance product approvals made easy dated June 1, 2022 (Press Release).

The major highlights of the Circular are as follows:

• General and health insurers are now allowed to launch all categories of products and add-ons or riders, including Non-life package products where UIN is already obtained for non-life covers through “Use and File” by duly complying with the norms specified as follows:
• Insurers to have in place the Board approved policy covering following at minimum:
• Philosophy of the company in enhancing the insurance penetration
• Health insurance needs of the insurable population
• Provision of inclusive insurance to all the market segments and
• Need for providing simple and easily comprehendible products

The Product Management Committee (PMC) shall ensure compliance to the above stated policy at the point of launching the products or modification / revision of the products.

• On receipt of UIN, insurers shall file the product along with necessary documents as prescribed under Consolidated Guidelines on Product Filing in Health Insurance Business dated 22 July, 2020 with the Authority within 7 days of launch of the product
• Any revision in price shall be based on underwriting claims experience, revision in pricing shall be disclosed on the website along with rationale for such revision and underlying claim experience of the product that lead to the revision in the price of the product
• Where optional covers or add-ons are offered with very low premium rates giving an indication that coverage is not material under the said add-on or optional cover, insurers can consider subsuming such add-ons or optional covers into base cover of the product
• The premium rates shall appropriately reflect the benefits, terms and conditions of the underlying products/add-ons and shall not be discriminatory
• Management Expenses loading for add-ons are to be considered on marginal basis
• No two risks with identical risk characteristics shall be rated separately
• Experience under all the base and add-on cover shall be built up, maintained and monitored separately
• All categories of the products, namely, Pilot Products, Health plus Life Combi Products and Health Package Products are also allowed to be launched under Use and File procedure.
• Insurers shall continue to comply with the requirements specified in the circular dated April 1, 2021 on Standard Technical Note (Template) – Health and all other applicable regulations/circulars/guidelines while launching the product.
• Any non-compliance with the regulation or guidelines specified herein may lead one or more of the following actions by the Authority:
• Direct the insurer to withdraw the product.
• Withdraw the Use and File facility for such insurer for a period as may be determined
• All products that are already filed with the Authority and whose UIN are yet to be issued shall be deemed to be withdrawn and insurers may launch the same in accordance with revised provisions under this circular.

These norms are applicable with immediate effect

Source category: IRDAI

Attachments

• /2022/50_Press_release_Insurance_product_approvals_made_easy1.pdf
• /2022/50_USEAND~1.PDF