Beginning January 1, 2024 insurance companies must provide policyholders with crucial information in a designated format. This should include details, such as the sum assured, coverage inclusions and exclusions, and the claims procedure. This update, announced by the Insurance Regulatory and Development Authority of India (Irdai), involves a redesign of the customer information sheet (CIS). The aim is to enhance clarity in conveying essential policy information, thus making it easier for policyholders to understand the terms and conditions associated with their purchased policies.
This new CIS is intended to offer customers all relevant information about their health insurance in simple terms. It will include details, such as the type of the insurance policy, the sum insured, policy coverage, exclusions, the waiting period, and financial coverage limits, such as sub-limits, co-payments, and deductibles, among other things.
Says Siddharth Singhal, business head, health insurance at Policybazaar.com: “Irdai’s proposal to modify the CIS is a customer-centric endeavour. This initiative aims to create a user-friendly reference guide for policyholders, thus enhancing their experience during hospitalisation. The updated CIS eliminates the need for policyholders to sift through extensive policy documents, thus ensuring a hassle-free process. Additionally, the revamped CIS will adopt a straightforward and uniform format, simplifying policy clauses, restrictions, sub-limits, claim procedures, and other requirements for policyholders to grasp.”
He adds: “The revised CIS will encompass vital information, including the sum insured, waiting periods, exclusions, and deductibles, along with details on migration and portability processes. In situations where policyholders lack the time to delve into the intricate policy document, they can conveniently review the policy summary through the CIS. This customer-oriented move by Irdai seeks to streamline the policyholder experience and make insurance information more accessible and comprehensible.”
The regulator cites roughly 13 points in the new CIS. Incidentally, there were also 13 points in the previous CIS. However, there are a few additions that are easier to understand this time around.
The insurer must specify the sum insured (along with the amount) for both individual and family floater plans under the new CIS. This crucial component was missing in the previous CIS.
“Second, the new CIS requires insurers to provide turn-around time (TAT) for claim settlement as well as Web links to hospitals and hotline numbers, among other things. Insurers must also get policyholder signatures verifying that they have documented the details of the CIS and received it. This measure is intended to result in better-informed policyholders, fewer arguments and delays, and a more streamlined health insurance experience,” says Rakesh Goyal, director, Probus Insurance Broker.