20 members must for group health insurance: Irdai

Insurance sector regulator IRDAI on Tuesday proposed a 'Group' should have a minimum size of 20 members to be eligible for issuance of a Group Health Insurance Policy.

Releasing an exposure draft on Irdai (Health Insurance) Regulations, 2016, the authority also proposed that the "premiums filed shall ordinarily not be changed" for a period of three years after a product has been cleared in accordance to the product filing guidelines specified by it.

Thereafter, the insurer may vary the premium rates depending on the experience. On Group Health Insurance, the draft said no policy would be issued by any insurer where a Group is "formed with the main purpose of availing itself" of insurance. "There shall be a clearly evident relationship between the members of the group and the group policy holder for services other than insurance. "The Group shall have a minimum size of 20 members to be eligible for issuance of a Group Insurance Policy," it added. 

To examine the extant regulatory framework vis-a-vis the Business practices, the Insurance Regulatory and Development Authority of India had constituted an Expert Committee on in December 2014, which has submitted its report in April, 2015.

On examining the recommendations, experience gained in reviewing the regulatory framework, Irdai has said it has proposed to revisit the existing Health Insurance Regulations, 2013 by suitably aligning the TPA Regulations as well as revisit some of the provisions. On renewal of policies, the draft said the insurer would provide for a mechanism to condone a delay in renewal up to 30 days from the due date of renewal without deeming such condonation as a break in policy.