Insurance sector plays a very vital role in stimulating the economy. It promotes financial stability, facilitates trade and commerce, manages and strengthens the risk-taking ability. Insurance policies can be broadly categorised as life insurance policies and non-life / general insurance policies. The Insurance Regulatory and Development Authority of India (IRDAI) is an autonomous body established under the Insurance Regulatory and Development Authority Act, 1999 (IRDA Act). IRDAI is responsible for monitoring the entire insurance sector in India and acts as the custodian for all insurance consumers' rights.

In light of the incessant spread of Covid-19 and prolonged lockdown in India, IRDAI has taken several steps by way of issuing circulars and press releases to provide guidance, clarification and relaxation to insurers and policyholders with the view to provide necessary support and protection in the present unprecedented circumstances. We have in this article consolidated the key regulatory updates that impacts the insurance sector.

A. GENERAL DIRECTIONS TO INSURERS

1. IRDAI has vide its circular dated March 30, 2020, advised insurers to:

  • ensure maintenance of essential insurance services during the lockdown with absolutely necessary staff;
  • put in place a business continuity plan;
  • set-up a crisis management committee to ensure minimum business disruption;
  • devise policies to cover risks that arise out of Covid-19 spread;
  • establish a simplified and expedite mechanism for dealing with claims arising on account of Covid-19 spread; and
  • provide an option to defer the date of travel without imposing any additional charges on policyholders, whose travel insurance policies are valid from March 22, 2020 till April 30, 2020.

2. IRDAI has further granted insurers with:

  • thirty (30) days of grace period to dispatch policy related documents issued between March 15, 2020 and April 20, 2020; and
  • twenty-one (21) days of additional response time to handle complaints received by insurers from March 15, 2020 till April 30, 2020, except for the complaints pertaining to Covid-19.

B. SPECIFIC DIRECTION TO GENERAL AND HEALTH INSURERS

1. IRDAI has vide its circular dated March 4, 2020, instructed all insurers providing health insurance policies and covering costs of hospitalization to:

  • review and expeditiously settle all claims with respect to costs of medical expenses incurred during treatment or during quarantine period as per the terms and conditions of the insurance policy; and
  • devise policies to cover the costs of treatment of Covid-19 in order to meet health insurance requirements of various sections.

2. IRDAI has vide its press release dated March 23, 2020, permitted insurers to condone delay up to thirty (30) days in renewal of health insurance policy without deeming such condonation as break in the policy.

3. The Ministry of Finance has vide its notification dated April 1, 2020, issued Insurance (Amendment) Rules, 2020, to amend Rule 59 of the Insurance Rules, 1939 and provide for provisions in relation to payment of renewal premium for Motor Third Party Insurance Policies and Health Insurance Policies, that may fall due for renewal during the lockdown period.

4. Pursuant to the amendment in the Insurance Rules, 1939, the Ministry of Finance has issued another notification on April 1, 2020 and has permitted policyholders to make payment of renewal premium for Motor Third Party Insurance Policy and Health Insurance Policy by April 21, 2020, which was subsequently extended by the Ministry of Finance till May 15, 2020, vide its notification dated April 15, 2020, to ensure continuity of the insurance cover and validity of claim arising out of such insurance policy during the grace period.

5. IRDAI in its circulars dated April 2, 2020, for motor third party insurance policies and health insurance policies, and on April 16, 2020 for motor third party insurance policies and health insurance policies has provided that:

  • the insurers shall:
    • communicate details in relation to the payment of renewal premium and the conditions thereof to policyholders;
    • inform the agents and intermediaries of the last date for payment of premium, to ensure continuity of the insurance cover;
    • ensure that the period of cover of the policy on the payment of premium shall commence from the date on which the renewal fell due within the lockdown period, without any break in the policy; and
    • ensure adequate arrangements to facilitate ease of payment of premium by policyholders;
  • the policyholders shall make the payment of renewal premium by April 21, 2020 for the entire period of 12 months from the due date.

6. IRDAI has further issued FAQs vide two separate circulars on April 3, 2020 to resolve queries related to renewal of motor third party insurance policies and health insurance policies.

7. IRDAI has vide its circular dated April 18, 2020 directed all general and health insurers on to adopt adequate response mechanism to expedite the settlement of health insurance claims pertaining to Covid-19 and to communicate its decisions to the network provider (hospital) with respect to:

  • cashless treatment within 2 hours from the time of receipt of the authorization request and last necessary requirement from the hospital to insurer or TPA, whichever is earlier; and
  • final discharge within 2 hours from the time of receipt of final bill and last necessary requirement from the hospital to insurer or TPA, whichever is earlier.

8. IRDAI has vide its circular dated April 21, 2020, issued norms for collection of health insurance premium in instalments during Covid19 crises as per the Guidelines on Filing of Minor Modifications in approved individual Insurance policies offered by General and Stand Alone Health Insurance on Certification Basis.

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Originally published 9 May, 2020

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.