Irdai Asks General Insurers, Health Insurers To Cover Mental Illness, HIV & PwDs

The insurance regulator has asked insurance companies to come up with a model policy, setting out the minimum scope and parameters for product design

Irdai has made it mandatory for non-life insurers to offer coverage for mental illness and or those afflicted with HIV, Aids, or disabilities.

Source : Getty

The Insurance Regulatory and Development Authority of India (Irdai) has made it mandatory for health and general insurers to offer policies that can provide coverage to people with mental illness and or those afflicted with HIV, Aids, or disabilities.

In a circular, the insurance regulator has asked insurance companies to come up with a model policy, setting out the minimum scope and parameters for product design.  In other words, insurers may widen the scope of this product, but in no case can the scope of the product can be narrowed down.

What is the direction from the insurance regulator?

In the circular, Irdai has directed the insurers to put in place a board-approved underwriting policy to ensure that no proposal from the above-mentioned categories of the population is denied for reasons of the above-stated disabilities and/or illness/es.

“The insurers may determine the price of the product subject to complying with the norms specified in the Irdai (Health Insurance) Regulations, 2016 (HIR, 2016) and guidelines/circulars notified there under,” the circular said.

The policy tenure of the product shall be for a period of one year and renewable in accordance with the regulatory framework already laid down.

The standard product shall comply with all the provisions of Irdai (health insurance) regulations, 2016, all other applicable regulations, and other applicable guidelines/circulars as amended from time to time.

Every general and standalone health insurer issued with a certificate of registration to transact general and/or health insurance business, shall mandatorily launch and offer their respective product immediately. In fact, the regulator reiterated that this circular shall come into force with immediate effect.

According to the Mental Healthcare Act, 2017, every insurer will have to make provisions for medical insurance for the treatment of mental illness as they do for the treatment of physical illness. In October 2022, Irdai directed insurance companies to ensure all health insurance policies cover mental illness. Insurers were asked to implement the new rule by October 31, 2022.

Mental health became a topic of concern during Covid-19 as a result of increasing levels of stress and anxiety.