Page 28 - Insurance Times Janaury 2021

New tone - New song consultation etc. The regulator has directed insurers not to
admit any accountability towards the excellence of services
New strategies will definitely push all life, general and health
insurers to include wellness and preventive characteristics of service providers and it should be communicated to the
in the policy framework. Maintaining good health is as policyholders. However, the IRDAI has permitted to appoint
important as having health insurance and few insurers at several service providers.
present tender rewards for staying fit and fine.
Conventionally health insurance products supposed to focus Even though the applicable validity period of accrued
on therapeutic features, the new parameters will assist rewards is retained in the Wellness Guidelines, there is a
insurers to emphasis on preventative components. prohibition to carry forward such accrued reward for a
period beyond 3 months from expiry. The Wellness Guidelines
Moreover, the policyholders get the chance to compare the
now relax the straight-out curb on tendering products or
health insurance products not only on price but also on the
services of any third party service providers, which are not
wellness supports they propose.
in the insurer's Network. New guidelines do expressly
recognize the third party products and services. However,
As per the instructions insurers can provide reward points
to policyholders for fulfilling the set standards of wellness insurers are explicitly barred from broadcasting the trade
names or logos of such third party merchandize in their
and preemptive aspects. These features cannot be
insurance commercials and endorsing such products. In its
proffered without being assimilated in the product
consistent with the product filing rules. The procedure and place, insurers have the choice to mention such third party
the benchmarks expended in framing reward points and the services in generic terms. Also, the relaxation has been
given relating to payments made by insurers to such third
method of endowing them should be unveiled by the
insurance companies and they can also provide these party service providers for the provision of their products or
services.
features either as optional or as add-on coverage to
policyholders.
To comply with the new rules, insurers need to upgrade
their current products instantly because new regulatory
Insurers have to treat all policyholders of a related or
analogous category without any bias while awarding these framework relating to wellness guidelines is coming into
force with immediate effect. However, no particular cutoff
features and the measured pricing effect of the facets
should be revealed to the policyholders unequivocally. The date or protracted period for acquiescence has been stated
cost of processing the wellness features will have to be in this regard.
factored into the pricing and costs should be divulged in the
prospectus issued by the insurance companies. The fixed Final take
costs incurred to design the structure to track wellness Inclusion of new norms pertaining to wellness and
connected parameters, service givers, merchant preventive features in health cover benefit customers
associations and so on should be distributed as per the selecting a healthy wellness regime thereby definitely
consent of the IRDAI. Insurers have to lucidly describe and augment progress and consumer gratification. The move
divulge the method in which the accretion and redemption was very much needed and it will give stimulus to health
of rewards will be allowed in case of family floater plans.

The regulator also mentioned that at the time of renewal
insurers can offer markdowns on premium or enhance the
sum insured depending upon the wellness scheme
conformed by the policyholders although sum insured
cannot be linked to the accumulative bonus proposed.
Going further, the IRDAI has also specified some benefits
that insures can offer and they are redeemable vouchers to
obtain health complements, admissions in yoga centers,
sports clubs etc. In addition, insurers may also consider
covering the cost of treatment of a permissible claim by
paying for non-eligible stuffs that are specified in the terms
of the base policy namely oxygen cylinders, masks, OPD

28 The Insurance Times, January 2021