Insurance regulator IRDAI has issued draft norms for standard health insurance products with basic sum assured of Rs 50,000 to Rs 10,00,000, defining the benefit structure for individual insurance buyers with no upper age limit.

While 18 years is the minimum entry age for principal sum insured, the maximum is 65 along with lifelong renewability. There shall be no maximum exit age.


The basic standard policy will also cover expenses incurred on treatment under Ayurveda, Unani, Sidha and Homeopathy systems of medicines. It is subject to fixed and standard sub-limits based on the sum insured.

The standard product will be offered on indemnity basis, as a standalone product. It cannot be combined with critical illness covers or benefit based covers.

Also read: ICICI Lombard to use AI for health insurance claim approvals


Products differ significantly with each other in terms of benefits offered, the IRDAI said in a draft circular. “It is considered essential that the potential customers seeking health insurance shall have an access to the basic health insurance covers so as to enable them to choose the coverage based on the need,” it added.

The standard health product will cover hospitalization expenses including room, nursing expenses, Intensive Care Unit, Intensive Cardiac Care Unit expenses, dental treatment, necessitated due to an injury, plastic surgery, necessitated due to disease or injury and domiciliary hospitalization.


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