Starting next year, policyholders can expect these changes in their insurance policies

When purchasing an insurance policy, customers face some confusion in understanding other features and terms and conditions. As a result, policyholders cannot read the entire document as it is too esoteric for the guy next door or the girl next door.

This was acknowledged by the insurance regulator IRDAI, which issued a diktat to insurers to list all the basic features of the insurance policy in simple words and in a predefined format given in the customer information sheet (CIS).

The revised CIS format will come into force from 1 January next year.

The regulator has ordered that insurers aim to send a concise and up-to-date CIS containing all the relevant policy-related information.

In fact, several complaints were received regarding information asymmetry between insurer and policyholders.

The latest set of rules stems from the need to promote transparency and improve policyholder awareness.

The customer information sheet will contain information in a predefined format including the name of the insurance product, policy number, type of insurance product, sum insured, policy cover, exclusions, waiting period, financial limits of cover, claim procedure, servicing policy, complaints, things to remember and obligations.

The insurers are also supposed to acknowledge policyholders confirming that they have noted and received the CIS details.

Health Insurance

The CIS in health insurance is designed to provide policyholders with all the important information about their health insurance policy in plain language including the following:

A. Name and type of policy

B. Cover details

C. Waiting Periods

D. Limits and sub-limits

E. All exclusions

A. Concepts like free appearance cancellation, migration, portability and moratorium period

G. Guidance on the procedure for submitting a claim

H. Contact details/web links for complaint/complaint filing

“This step is expected to result in more informed policyholders, reduce disputes and delays, and provide a seamless health insurance experience for policyholders,” reads the IRDAI statement.

In addition, policyholders are also obliged to transparently and fairly disclose material relevant information related to their health, as non-disclosure may affect the settlement of a claim.

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Updated: 05 November 2023, 11:46 AM IST

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