Is Arogya Sanjeevani Insurance Policy Right For You? | Photo credit: Thinkstock
The Insurance Regulatory and Development Authority (IRDAI) has asked all insurers to offer the Arogya Sanjeevani policy on a mandatory basis from May 1. The sum insured for this health insurance scheme will vary from Rs 50,000 to Rs 10 lakh.
The Arogya Sanjeevani policy covers basic expenses related to hospitalization, pre- and post-admission treatment and Ayush treatment. Non-life insurers and independent health insurers will offer this policy. The government changed the policy twice.
The insurance regulator again capped the maximum sum insured at Rs 10 lakh after removing the same in July 2020.
The policy has been designed to provide uniform coverage across all areas. It was formulated after the insurance regulator observed too much variation in individual health insurance products that it said confused the public when choosing health insurance coverages.
All insurance companies will charge a flat rate for this standard health plan. The standard policy will have cumulative benefits and insurers will not be allowed to impose deductibles. However, customers will be subject to a fixed co-payment of 5% of the claim amount for all ages, which will be explicitly disclosed in the claim.
The regulator has asked all insurers to offer this coverage on an indemnity or protection basis only. This means that they can only pay the actual expenses incurred, either cashless or by reimbursement. There cannot be additional coverage such as critical illness coverage or benefit-based coverage. The insurers will have the final decision on the price of the premium. However, rates must be uniform across India and insurers cannot have geography or area specific pricing.
The policy should be taken out by a young insurance buyer for the first time, as it allows them to easily rate the policies. People looking for standard health insurance can opt for this policy where the maximum coverage can go up to Rs 10 lakh according to the revised rules from May 1st.
According to most financial experts, this insurance policy is a good entry-level product.