Page 58 - Insurance Times November 2022

Circular

IRDAI Corner

Insurance cover for new-borns/infants un- FinTech) had been constituted under the aegis of the Fi-
nancial Stability and Development Council- Sub Commit-
der health insurance policies
tee (FSDC-SC). The terms of reference (ToR) of IRTG on
12th October, 2022 FinTech include discussion on issues relating to hybrid
product/ service falling under the regulatory ambit of
1. Reference is invited to the Clause (1) of Chapter –II on different financial sector regulators for admission in Regu-
‘exclusions not allowed under health insurance policies’ latory Sandbox and framing of Standard Operating Pro-
cedure (SOP) for IoRS for hybrid products/services. The
issued vide Master circular on Standardisation in Health
insurance Business dated 22.7.2022 where in it has group, in addition to the members from Financial Sector
Regulators, has representation from Department of Eco-
been mandated that internal congenital diseases, ge-
nomic Affairs (DEA), Ministry of Finance and Ministry of
netic diseases or disorders are not allowed to be incor-
Electronics and Information Technology (MeITY), GoI.
porated as exclusions in the terms and conditions of the
policy contract. The intent of the above provision is to 2. In order to facilitate testing of innovative products/ser-
cover newborns with internal congenital birth defects vices falling within the regulatory ambit of more than
from day one (1). one financial sector regulators viz. RBI, SEBI, IRDAI,
IFSCA and PFRDA, a Standard Operating Procedure
2. However, it is observed that many health insurance
(SOP) for IoRS has been prepared by the Inter-Regula-
products that are marketed by insurers are not provid-
tory Technical Group on FinTech (IRTG on FinTech). The
ing cover to newborns/infants with internal congenital
Insurance Regulatory and Development Authority of
birth defects from day one(1) thus going against the
India today placed on its website the SOP for IORS.
true spirit of the above referred clause.
3. The Common Application form for participating in the
3. In view of the above, it is reiterated that all insurance
IoRS is attached. The entities meeting the minimum eli-
products that cover newborns/unborns shall comply
gibility criteria for participating in the RS of the Princi-
with the above referred provisions without any devia-
pal Regulator (as defined in the SOP), may apply, along
tion and provide, coverage from day one(1) without
with requisite documents through email at
imposing any waiting periods/sub-limits or any other
iors@rbi.org.in (maximum size 10 MB). Additional in-
restrictive conditions.
formation and/ or documents, as and when required,
4. These instructions shall come into force with immedi- will have to be furnished by the applicant. The Princi-
ate effect. pal Regulator/ Associate Regulators shall reserve the
right on admissibility of the hybrid product / solution /
Standard Operating Procedure for Inter- innovation as per their RS framework.
operable Regulatory Sandbox (IoRS)
Product Filing Procedure
Date:12-10-2022
13th Oct, 2022
1. An Inter-Regulatory Technical Group on FinTech (IRTG on 1. This is further to the Circulars Ref: IRDAI/NL/CIR/MISC/

52 November 2022 The Insurance Times