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Regulator hikes maximum sum insured in Arogya Sanjeevani scheme to ₹10 lakh

To widen the coverage of health insurance across the country, the Insurance Regulatory and Development Authority of India (Irdai), in its latest circular, has expanded the sum insured bands under the standard Arogya Sanjeevani policy to between 50,000 and 10 lakh.

To clear the confusion and encourage more people to buy health insurance, Irdai had in January 2020 mandated all general and health insurers to offer a standard individual health insurance product with a maximum sum insured of up to 5 lakh and a minimum of 1 lakh.

Amid increasing covid-19 cases and spiralling healthcare costs, the regulator in July allowed companies to offer sum insured less than 1 lakh under this product with no upper limit. However, a majority of the Arogya Sanjeevani products that are available in the market offer a maximum sum insured of 5 lakh.

The latest modifications to the product’s sum insured slabs will make it compulsory for insurers to offer a sum insured of up to 10 lakh, starting from 50,000 and in multiples of 50,000.

“When Arogya Sanjeevani was launched, the low sum insured was one of the major concerns for customers. Considering medical inflation, health insurance with a minimum sum insured of 10 lakh per person is necessary. The Irdai’s latest move will help increase the attractiveness of high sum insured plans even further,” said Amit Chhabra, head-health insurance, Policybazaar.com.

“Arogya Sanjeevani is a great product for the common masses, and this will increase adoption even more. This move can be considered as a game changer as it will help increase the health insurance penetration in India,” Chhabra added.

Insurers can offer the revised sum insured with effect from 1 May or earlier.

The companies can file premium rates for the revised sum insured as per the guidelines on filing of minor modifications.

According to the regulator, the unique identification number (UIN) allotted to a product will be retained after the modifications.

Keep in mind that Arogya Sanjeevani policies come with a 5% co-pay and 2% sub-limit on room rent. A 5% co-payment clause indicates that the insured will pay 5% of the claim amount and the insurer will pay the rest.

The policy covers room, boarding and nursing expenses, but only up to 2% of the sum insured, subject to a maximum of 5,000 a day.

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