Insurance companies (insurers) will be required to list all policy details in a revised Customer Information Sheet (CIS) for health insurance coverage, providing policyholders key information in simple terms while highlighting their obligations for easy understanding of terms and conditions will be issued from January 1, 2024.
The Insurance Regulatory and Development Authority of India (IRDAI) directed insurers on October 30, 2023, to ensure that all the relevant information about a particular policy is listed in a simple form on one page for ease of understanding for a policyholder.
As per the insurance regulator, simple language will enable the policyholder to comprehend and follow the policy documents in a thorough manner. IRDAI had to make this move as it observed that several complaints had been emanating as a result of the asymmetry of information between the insurer and the policyholder.
Information related to coverage details, waiting period, limits, exclusions, concepts such as free look cancellation, migration and portability, change in sum insured, moratorium period, guidance on the procedure for claims submission, and contact details for filing complaints will be available to consumers, as per the IRDAI, while mandating the revised CIS to the insurers.
Furthermore, the obligations of policyholders to ensure transparent and fair disclosures of relevant information related to their health conditions, considering non-disclosure may influence the claim settlement, will also be suitably highlighted in the CIS.
The insurers are mandated to obtain the signatures of the policyholders, which would act as a confirmation that they have noted the details of CIS and received it. The insurance regulator directed all the insurers, intermediaries, and agents to forward the CIS to every policyholder and obtain the acknowledgement in a physical or digital mode.
Also, it directed insurers to make sure that the customer CIS is made accessible in a local language in case a policyholder desires it. Earlier, the insurance regulator had constituted a 12-member committee to discuss the simplification of insurance policy wordings.
Rajiv is an independent editorial consultant for the last decade. Prior to this, he worked as a full-time journalist associated with various prominent print media houses. In his spare time, he loves to paint on canvas.