The company added a condition of proportionate deduction in proportion to room under the head 'incremental charges condition' in cases of group health policies, which was in violation of health insurance guidelines, Irdai said.
"Under the said condition, the insurer kept the provision to reduce amount payable for various charges in case the insured opts for higher room rent category. However, it was noted that the said condition is not part of policy wordings filed with the Authority of Group Health Insurance Policy," it said in its order.
It further asked the company to ensure no claim is settled based on product features and conditions that is not filed and approved under file-and-use procedure complying with Health Insurance regulations.
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