Irdai proposes to standardize group insurance policies and publishes draft guidelines


The Insurance Regulatory and Development Authority of India (Irdai) has proposed to streamline and standardize the administration of group health insurance products to protect the interests of the insuring public and insured members of group schemes. The regulator has proposed to issue guidelines on “group insurance products in connection with health insurance business and other operational matters”.

“The exposure draft sets out provisions for the benefit of all stakeholders (insurer, companies and employees) and brings more transparency to current practices. A call for more scientific underwriting and transparent data management practices will ensure a lasting interest in insuring employees and their families with intent. This move will push the industry to leverage AI modeling to better underwrite risk, build stronger hospital networks, and digitize the employee experience to be able to stand out,” said Raghuveer Malik, head of insurance at company,

Insurance experts say the draft outlines liability for primary policyholders, which is a welcome move, increasing transparency and redress mechanisms for end users. The need of the hour is to strike the right balance between sustainable and transparent underwriting while encouraging innovative solutions for the benefit of end users – making claims easier and easier to manage policies.

The regulator said group insurance facilitates improved access to insurance for the formal and informal sectors of society. If operated prudently, it offers the advantage of advantageous coverage at a moderate cost.

“Standardizing group health insurance products will allow the insurance industry to adopt the consumer-centric approach in an even more streamlined way. This gives the opportunity to make the process more transparent on a larger scale through companies, and therefore to build trust with the end consumer. Today, the choice of an insurance product is often determined by its cost. Determining a fair and correct price for a group health product is crucial for both buyers and insurance companies. A standardized product will meet different types of needs and help cater to a wider range of consumers,” Malik said.

Irdai invited stakeholders to provide comments and suggestions on the exposure draft by May 13.

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