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The Insurance Regulatory and Development Authority of India (Irdai) has proposed to rationalize and standardize the administration of group health insurance products to protect the interests of the insuring public and the insured members of group schemes. The regulator has proposed to issue guidelines on ‘Group Insurance Products under Health Insurance Business and other operational matters’. 

“The exposure draft articulates provisions to benefit all stakeholders (insurer, companies and employees) and brings further transparency to the current practices. A call for more scientific underwriting and transparent data management practices will ensure sustainable interest in insuring employees and their families with intention. This move will push the industry to leverage AI modelling for better underwriting the risk, build stronger hospital networks, and digitise the employee experience to be able to standout," said, Raghuveer Malik, head- corporate insurance, Policybazaar.com.

Insurance experts say the draft outlines the responsibility of master policy holders which is a welcome move, increasing transparency and redressal mechanisms for end-users. The need of the hour is striking right balance between sustainable & transparent underwriting while encouraging innovative solutions for the benefit of end users - making claims easier, and policy management smoother.

The regulator said group insurance facilitates enhancing access to insurance to both formal and informal sectors of society. If operated prudently, it offers the advantage of beneficial coverage at a moderate cost.

“Standardization of group health insurance products will enable the insurance industry to adopt the consumer-first approach in an even more streamlined manner. It gives an opportunity to make the process more transparent at a larger scale through corporates, and therefore build more trust with the end consumer. Today, the choice of an insurance product is often determined by its cost. Determining a fair and correct price for a group health product is crucial for both buyers as well as insurance companies. A standardised product will solve for different kinds of needs and help cater to a wider range of consumers," said Malik.

Irdai has invited comments, and suggestions on the exposure draft from stakeholders by 13 May.

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