Page 147 - IC38 GENERAL INSURANCE

As per Insurance Regulatory and Development Authority (Health Insurance)
Regulations, 2013

1. Life Insurance Companies may offer long term health products but the
premium for such products shall remain unchanged for at least a period
of every block of three years, thereafter the premium may be reviewed
and modified as necessary.

2. Non-Life and Standalone Health insurance companies may offer
individual health products with a minimum tenure of one year and a
maximum tenure of three years, provided that the premium shall remain
unchanged for the tenure.

2. Features of health policies

Health insurance basically deals with sickness and therefore expenses incurred
due to sickness. Sometimes, the disease contracted by a person could be
chronic or long lasting, lifelong or critical in terms of impact on day to day
living activities. Expenses could also be incurred due to accidental injuries or
due to disablement arising out of accident.

Various customers with different life styles, paying capacity and health status
would have different requirements which need to be considered while designing
suitable products to be offered to each customer segment. Customers also
desire comprehensive cover while buying health insurance which would cover all
their needs. At the same time, to achieve greater acceptability and bigger
volume, health insurance products need to be kept affordable, they should also
be easy to understand for the customer and also for the sales team to market
them.

These are some of the desirable features of health insurance products which the
insurance companies try to achieve in different forms for the customer.

3. Broad classification of health insurance products

Whatever be the product design, health insurance products can be broadly
classified into 3 categories:

a) Indemnity covers

These products constitute the bulk of the health insurance market and pay
for actual medical expenses incurred due to hospitalization.

b) Fixed benefit covers

Also called as „hospital cash‟, these products pay for a fixed sum per day for
the period of hospitalization. Some products also have a fixed graded
surgery benefit incorporated in the product.

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