IRDAI vide Circular Ref. No. IRDAI/HLT/CIR/PRO/32/1/2024 dated January 31, 2024 has issued a modification to the ‘product model’ originally issued under circular on ‘Product for Persons with Disabilities (PWD), Persons afflicted with HIV/AIDS, and those with Mental Illness’ with the view to provide the health insurance policyholders with equal choice of choosing either Allopathic Treatment or AYUSH Treatment.
Earlier, the cover was for 50% of sum insured under Ayush Treatment.
The following modifications are made in the product model:
1. Clause 4.2 on “AYUSH Treatment” and “AYUSH” referred at clause 11 in Table of Benefits as well as Product Construct shall be read as under-
“Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines is covered up to 100% of Sum Insured, during each policy year as specified in the policy schedule.
2. This modification comes into force with effective from April 01, 2024.
Relevant Governing Law:
Relevant paragraph of IRDAI Circular on Product for Persons with Disabilities (PWD), Persons afflicted with HIV/AIDS, and those with Mental Illness vide circular number IRDAI/HLT/CIR/MISC/58/02/2023 dated February 27, 2023.
“Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines shall be covered up to 50% of Sum Insured, during each policy year as specified in the policy schedule.
Source category: IRDAI
Attachments
- /2024/344_Modification_in_Product_for_PWD,_Persons_afflicted_with_HIV_AIDS_and_those_suffering_from_Mental_.pd
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