Insurance firms told not to alter health products to raise premium

General and health insurance companies, while modifying health products, cannot alter existing benefits or add new ones to existing products to increase premium, said the industry’s regulator.

Insurance companies can carry out minor modifications in their products, said Insurance Regulatory and Development Authority of India (IRDAI). Also, the addition of new benefits or up-gradation of existing benefits can be offered as add-on covers or optional covers with a standalone premium rate to ensure an informed choice to the policyholders, the regulator said.

As per the regulations, insurance companies cannot modify their products within one year of getting clearance from the authority. They also have to provide reasons or justifications for bringing in modifications to the product. Also, any revision or modification of any approved health insurance product filed under the File & Use procedure shall also require the prior clearance of the authority.

The regulator said that the appointed actuary of the insurance company shall review the financial viability of every health insurance product at the end of every financial year and the report of the review has to be submitted to the board of the company to ensure the sustainability of the product and to protect the interests of policyholders of the underlying product.

Companies have to submit a status report to the insurance regulator along with the board’s suggestions and the corrective actions to be taken by September 30 of every financial year.