The insurance regulator IRDAI has formed a panel under the chairmanship of Suresh Mathur, executive director,IRDAI, to suggest measures to bring in standardisation and to enhance transparency and uniformity in the health insurance, particularly in the matter of ‘exclusions’ as part of product design.


The working group has been asked to submit a report with recommendations within eight weeks.


The committee will deliberate issues like, exclusions that are prevalent in the health insurance policies. rationalise the exclusions by minimising the number, so as to enhance the scope of health insurance coverage granted. rationalise the exclusions that disallow coverage with respect to new modalities of treatments and technologically advanced medical treatments.


The panel will also identify the type of exclusions which will  not be allowed. study wordings/language of the exclusions and standardize the wordings of exclusions in a simple and easily understandable language, study the scope for allowing individual specific and/or ailment/disease specific permanent exclusions at the time of underwriting so that the policyholders are not denied health insurance claims unrelated to the exclusions and  any other matter relevant to the subject of exclusions.


Some of the other members of the panel are- RM Singh, G M, New India Assurance , Dr S Prakash, COO Star Health, Dr S Prakash, COO Star Health, Jit Singh Chhatwal, whole-time Director, Medi Assist TPA, D V S Ramesh, general manager, health, IRDAI.


IRDAI said it had from time to time issued guidelines on standardization such as; standardization of terminology to be used in health insurance policies and standard nomenclature and procedure for Critical Illnesses.


With the increase in the number of companies providing health insurance there is an increase in the number of products offered.


It is desired that the industry adopts a uniform approach while incorporating the ‘exclusions’ as part of product design as well as for the wording of the ‘exclusions’, said IRDAI.