IRDAI Approves Arogya Sanjeevani Policy as Group Health Insurance for Diverse Sectors

The Insurance Regulatory and Development Authority of India (IRDAI) has permitted insurers to offer the Arogya Sanjeevani Policy as a group health insurance product. This initiative aims to provide financial security against viral outbreaks for workers in various business sectors. The policy, introduced this year, is designed to simplify health insurance for first-time buyers by avoiding complex jargon.

Whether purchased from a private or public sector insurer, the Arogya Sanjeevani policy remains consistent in its coverage. However, premium rates may vary between insurers. The policy's name will include "Arogya Sanjeevani" followed by the insurer's name. Importantly, this standard policy also includes coverage for COVID-19 treatment.

The IRDAI has specified that insurers can use the standard product name for group policies by adding the word 'group.' This is allowed as long as all terms and conditions match those of the individual policy, except for premium rates and group policy operations. This flexibility allows insurers to tailor the policy to meet specific group needs while maintaining core benefits.

The Arogya Sanjeevani policy caters to both individual and group needs, covering essential medical expenses. It includes hospitalisation charges, pre and post-hospitalisation costs, AYUSH treatment, and cataract surgery. This comprehensive coverage ensures that policyholders have access to necessary healthcare services.

The group policy is designed to protect a wide range of employees across sectors like manufacturing, services, SMEs, MSMEs, logistics, and migrant workers. It addresses their medical needs effectively. Additionally, it serves both private and public establishments by covering their employees' healthcare requirements.

Unlike individual policies, insurers have the flexibility to set their own minimum and maximum sum insured limits for group policies. This allows them to customise coverage based on the specific needs of different groups. The IRDAI has also updated individual policy norms, permitting health insurers to offer a minimum sum insured below Rs 1 lakh and a maximum above Rs 5 lakh.

This initiative by IRDAI aims to make health insurance more accessible and adaptable for diverse groups while ensuring comprehensive coverage for essential medical needs.