10 mind-blowing changes in Health Insurance starting Oct 1, 2020

Congrats! – Health Insurance just got a lot better

IRDA has recently come up with some major changes in health insurance guidelines which are extremely customer friendly. These changes will reduce a lot of confusion that customers used to face while buying health insurance and will also help in smooth claim experience.

Changes in health insurance in 2020

These changes are really good and it’s suggested that you should be aware of all the changes if you have a health insurance policy. It will take some time to understand these changes, but please read this article fully.

In case you like to listen, rather than read – here is a 35 min video discussion I did with Mahavir Chopra of Beshak.org who is an expert on this subject and a good friend too. While there are many big and small changes in the guidelines, the video talks about the top 10 changes which matters to you.

Change #1 – Standard definition of 18 exclusion

There are various exclusions in a health insurance policy and wordings for them differ from policy to policy. This confuses the policyholders while their decision-making process. Now IRDA has standardized the definitions and wordings for all kind of exclusions

One of the examples of this is the wordings for a pre-existing illness, 30 day waiting period, maternity, obesity, and many more. In various policies, the definition is different for these terms and it leaves a grey area many times.

Now with the new rule, every policy will have the same wordings and definition of the exclusions along with a CODE for each exclusion.

Change #2 – No ambiguous wordings or definitions

Apart from this, IRDA has also said that there should not be any ambiguity in the wordings which can create confusion in the future. For example – “Obesity is not covered, and any other illness which is derived out of obesity is also not covered”.

If you look at the example above, how will an insurer and the policy come to an agreement is something was because of obesity or not? There may be a disagreement in the future and companies can deny the claim citing some unreasonable thing.

Now, this practice ends…

Change #3 – Many Exclusions are disallowed

Now many exclusions which were part of policies earlier are disallowed, which means that companies will have to cover them. Some of the examples are as follows.

  • Treatment of mental illness
  • Behavioral and Neurodevelopmental Disorders
  • Genetic diseases or disorders
  • Puberty and Menopause Related Disorders
  • Injury or illness associated with hazardous activities

So the coverage of the health insurance policy widens now and you will be able to get coverage for many more things. This is wonderful news because mental illness or psychological related hospitalization will now get covered which was a big requirement.

Check out our youtube video on these 10 changes if you want to listen to the whole conversation

Check out this video

Change #4 – The definition of “Pre-existing” diseases is standardized

This is one area that was quite confusing for customers.

Till now, it was not very clear what exactly is a pre-existing illness? So the onus was completely on the customer to remember his symptoms and go back in past to dig out all that had happened. If he had forgotten anything and it came up later in the future which was not disclosed in the policy, there was a good chance of rejection of claims.

Now, the IRDA has made it clear that a pre-existing illness is an illness for which,

  • A doctor has advised you a treatment
  • Or Doctor has diagnosed a disease

Only in these two cases, it will be treated as a pre-existing illness, else not. Hence, it has now become a much-focused definition now which will remove all the confusion.

So now just because you have some mild symptoms or an indication of an illness, does not automatically become a pre-existing illness going forward.

Another example is let’s say you are obese and have had bad eating habits and you are not sure if you are diabetic or not… In this case, a lot of people wonder if the insurer can reject the claims in the future because of hospitalization due to diabetes.. but with new rules, unless it was diagnosed by the doctor officially, it will not be treated just a pre-existing illness.

Change #5 – No claim rejection after 8 yrs. of premium payment

This is a big relief to policyholders.

Now health insurance companies will have to settle all the claims once a policy has been active for continuous 8 yrs. In case you increase your sum assured in the same policy, another 8 yrs. of moratorium period will be applicable on the increased limit. Apart from this, the permanent exclusions will always be excluded.

Only in case of a Proven fraud, the rejection can happen after 8 yrs. However, in case of a genuine claim, the policyholder doesn’t need to worry. Check out the reply by Mahavir Chopra on twitter timeline to one of the people who asked a question on what is a fraud and what is not.

Changes in health insurance policies

Change #6 – People with serious illnesses to get cover with permanent exclusions

A lot of people who had some serious illnesses like cancer, epilepsy, Chronic Kidney disease, Alzheimer’s Disease were denied any kind of health insurance. They were not even provided cover for other things with these things put as permanent exclusions.

However, this has changed now.

IRDA has said that now people with these kinds of illnesses also have a right for getting health insurance for at least other illnesses. So health insurance companies will now have to give them health insurance for at least the other diseases with their pre-existing illnesses as permanent exclusions.

This is important because if someone had Chronic Kidney disease, they can still be hospitalized due to a completely different illness like a brain illness, mental illness, accident, or cancer .. You can’t just completely reject them and deprive them of health insurance.

This clause is not applicable to lifestyle diseases like diabetes, hypertension, etc. because insurers can’t put permanent exclusions on these things as they have almost become part of our life these days, and people like their whole life with these things. More on this in the next points.

Change #7 – Modern treatments to be covered in health insurance

Another welcoming change is that some advanced and modern treatments will now be compulsorily covered in health insurance policies. Here is a full list of modern treatments which IRDA has specified

  • Uterine Artery Embolization and HIFU
  • Balloon Sinuplast
  • Deep Brain stimulation
  • Oral chemotherapy
  • Immunotherapy- Monoclonal Antibody to be given as an injection
  • Intra vitreal injections
  • Robotic surgeries
  • Stereotactic radio surgeries
  • Bronchial Thermoplasty
  • Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
  • IONM – (Intra Operative Neuro Monitoring)
  • Stem cell therapy

A lot of times, these advanced treatments are advised by doctors but these were never covered by health insurance policies. However, with this, you get access to more advanced treatments going forward.

Change #8 – Waiting period for specified illnesses can’t be more than 4 yrs.

So earlier there was clarity on how much can be the waiting period for various illnesses like cataract, knee surgery, and many other kinds of illnesses. Most of the time it was in the range of 2-4 yrs. and some older policies may have higher than 4 yrs of waiting period.

But IRDA has now made it clear that in no case, it can be more than 4 yrs. of waiting period.

Change #9 – Waiting period for lifestyle diseases only up to 90 days

So the waiting period for lifestyle illnesses like diabetes, hypertension, and Cardiac conditions can be only up to 90 days and not beyond that. Till now the insurer used to keep waiting period for these lifestyle diseases up to 2-4 yrs. Nowadays these illnesses are very common and have become part of life in a way.

This is good from the customer’s point of view.

However, note that the waiting period of 90 days is only in case you don’t have these at the time of taking the policy. In case you already have them, then it’s classified as “pre-existing illness” in your case.

Also note that if you have recently taken a health insurance policy, then at the time of next renewal this 90 days waiting period will apply in your case and will get covered for you.

Change #10 – Pre and Post hospitalization expenses to be covered for domiciliary hospitalization

Another change is that now in case of domiciliary hospitalization (when you do the treatment at home because of unavailability of hospital beds) the pre and post-hospitalization expenses will also be covered which was not the case earlier.

To read everything in detail, check our IRDA circular here

Increase in Premiums due to these changes

When something improves by a big margin, it’s almost guaranteed that its price will also rise in the same fashion. The same is the case here. Because of all these new changes, the health insurance policies have got more superior and much better & provides more value now.

So you can surely expect that the premiums will rise in the future for these policies

If you already have the health insurance policy, you can expect the premiums to rise on your next renewal. However, you should take it positively and not feel bad about it.

These changes have happened for your benefit and it’s you who will benefit from it in the future. Health Insurance companies are also bound to incorporate these changes as an order from IRDA.

What is your view about these changes? Do you feel it will help customers?

Do share your views in the comments section!

Corona Rakshak Policy – Get paid when you catch Covid-19

Health Insurance companies have recently launched one more corona specific health insurance policy called as Corona Rakshak Policy” as per the IRDAI guidelines.

This is a benefit based health insurance plan which pays you a lump sum amount when you are diagnosed of covid-19 and are hospitalized for continuous 72 hrs.

Corona Rakshak Policy review

Features of Corona Rakshak Policy

  1. This policy can be purchased only on an individual basis.
  2. Sum Insured options in this policy range between Rs 50,000 to Rs 2,50,000.
  3. There is no pre-medical screening necessary for this policy.
  4. This policy has a waiting period of 15 days.
  5. Adults aged between 18 yrs. to 65 yrs. can take this policy.
  6. Tax benefit on premium paid u/s 80D of Income Tax Act,1960.
  7. The policy cannot be renewed nor it has a free look period.
  8. Its a single premium policy and the tenure have 3 options of 3.5 months (105 days), 6.5 months ( 195 days), and 9.5 months (285 days).

Benefits under this Policy

If the insured person is diagnosed with COVID +ve and is hospitalized of minimum 72 hours then the corona rakshak policy will pay the full 100% sum assured to the policyholder. Note that it’s not going to settle your bills, but make a single payment no matter what are your expenses.

To get the claim, you have to give the diagnosis report of Covid-19 from an authorized govt center and the proof of hospitalization for at least 72 hrs.

Where can I purchase this Policy from?

While IRDAI has directed all companies to launch this plan, in reality its quite complicated to find out where to buy this plan. It was reported on social media from many investors that they are not able to get the online links to buy. But few also shared that they were able to buy it from the offline agents.

So right now it’s a bit complicated to buy this plan.

Ideally following insurance companies should come up with their online links for this policy, as soon as possible.

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  • Acko General Insurance Ltd.
  • Aditya Birla Health Insurance Co. Ltd.
  • Bajaj Allianz General Insurance Co Ltd
  • Bharti AXA General Insurance Co. Ltd.
  • Cholamandalam MS General Insurance Co. Ltd.
  • Edelweiss General Insurance Co. Ltd.
  • Future Generali India Insurance Co. Ltd.
  • Go Digit General Insurance Ltd
  • HDFC ERGO General Insurance Co.Ltd.
  • HDFC ERGO Health Insurance Limited
  • ICICI Lombard General Insurance Company Ltd
  • IFFCO TOKIO General Insurance Co. Ltd.
  • Kotak Mahindra General Insurance Co. Ltd.
  • Liberty General Insurance Ltd.
  • Magma HDI General Insurance Co. Ltd.
  • Manipal Cigna Health Insurance Company Limited
  • Max Bupa Health Insurance Co. Ltd
  • Navi General Insurance Ltd.
  • National Insurance Co. Ltd.
  • Raheja QBE General Insurance Co. Ltd.
  • Universal Sompo General Insurance Co. Ltd.
  • Reliance General Insurance Co.Ltd
  • Religare Health Insurance Co. Ltd
  • Royal Sundaram General Insurance Co. Ltd.
  • SBI General Insurance Co. Ltd.
  • Star Health & Allied Insurance Co.Ltd.
  • Tata AIG General Insurance Co. Ltd.
  • The New India Assurance Co. Ltd
  • Oriental Insurance Co. Ltd.
  • United India Insurance Co. Ltd.


Premium For Corona Rakshak Policy

Here is the indicative premium chart we managed to find online.. but note that these are still indicate premiums and you will get the real numbers while you purchase the policy.

a) IFFCO TOKIO General Insurance Co. Ltd –

Corona Rakshak Policy premium detaiIs of IFFCO TOKIO General Insurance

b) Star Health & Allied Insurance Co.Ltd. –

The below image shows the premium details of the “Corona Rakshak Policy” with all 3 tenures of the policy.

Star Health & Allied Insurance Co.Ltd., premium details of corona rakshak policy

Exclusion under this policy

  • If there are any diagnostic expenses made which are not related to COVID, then those expenses will not be covered in this policy.
  • If a person is tested COVID +ve before the start of the policy, then this person cannot file a claim to the company.
  • If a person is getting testing done related to COVID in diagnostic centers that are not authorized by the government then the expenses incurred will not be covered under this policy.
  • If the insured person travels to any country placed under travel restriction by the government of India the insured person will not get the benefit under this policy if the insured person tests +ve for COVID-19.

Should you take up this policy?

If you are too scared about the expenses which might occur if you get covid+, then you can surely go ahead and take up this policy as the premiums are not very big amount and anyone can manage it.

However do note that this policy will only pay if the hospitalization is there for 72+ hrs. You know that most of the people who are getting corona do not require hospitalization, which means that the chances you getting corona along with hospitalization is quite low.

Also this is going to only give you Rs 2.5 lacs, however the expenses can be quite high if you get hospitalized for a 15-20 days in a good hospital. So treat this policy as just a small support system and not the replacement of the health insurance policy in itself.


This was all that I wanted to share in this article. Let me if you have any queries in the comments section.

Corona Kavach Policy – Get insured and save high medical bills

The ongoing COVID-19 pandemic has caused a lot of fear and anxiety in our lives because there are no vaccines or any cure available for this illness. If anyone gets COVID +ve there are chances that there may be huge medical bills running into lakhs of Rupees.

In case you don’t have big health insurance, you can go for a special policy called “Corona Kavach Policy” which got introduced recently in the market.

IRDAI has come up with a standard COVID focused basic health insurance policy known as “Corona Kavach Policy”, which I will be reviewing in this article.

Corona Kavach Policy review in detail

Features of Corona Kavach Policy

  • This policy is available on an individual as well as a family floater basis.
  • The minimum and maximum sum assured offered by the policy are Rs. 50,000 to Rs. 5,00,000.
  • A person aged between 18 yr to 65 yrs can purchase this policy.
  • This policy can be purchased for self, spouse, parents, parents-in-law, and dependent children up to 25 yrs of age.
  • 2 types of cover -Base Cover on Indemnity Basis which covers COVID Hospitalization cover and Optional Cover on Benefit Basis which covers Hospital Daily Cash.
  • This policy has a waiting period of 15 days from the purchase of the policy.
  • The tenure of the policy is 3 ½ months, 6 ½ months, 9 ½ months including waiting period.
  • Premium Payment Mode is Single.
  • Tax Exemption on the premium paid u/s 80D.

What all is covered under this policy?

a) Hospitalization Cover –

If a person has tested COVID +ve in a government authorized diagnostic center then the medical expenses and expenses incurred on treatment of any comorbidity along with the treatment for COVID up to the Sum Insured will be covered under this policy provided the insured is hospitalized for more than 24 hrs in the hospital.

Let us see what all comes under hospitalization cover –

  1. Room Rent, Nursing Expenses, ICU, and ICCU charges will be covered.
  2. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor/surgeon or to the hospital will be covered under the policy
  3. Expenses on anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask, etc.. will be covered under this policy.
  4. Ambulance charges up to Rs 2000 will be covered under this policy per insurer only if the ambulance has been availed in relation to COVID Hospitalization. This also includes the cost of the transportation of the Insured Person from one hospital to another hospital as prescribed by a medical practitioner.

b) Home Care Treatment Expenses –

If a person is tested COVID +ve in a government authorized diagnostic center and is getting treatment at home which normal course would require care and treatment at a hospital but is actually taken at home maximum up to 14 days per incident, then home care treatment expenses will be covered provided under the following circumstances –

  • If the medical practitioner has advised the insured person to undergo treatment at home with a continuous active line of treatment with is being monitored by a medical practitioner for each day through the duration of the home care treatment.
  • The insured or the family member should maintain a daily monitoring chart which includes records of treatment administered and duly signed by the treating doctor.
  • Cashless or reimbursement facility shall be offered under homecare expenses subject to claim settlement policy disclosed.

The expenses made related to the treatment of COVID will be covered under this policy. They are as follows –

  1. Diagnostic tests underwent at home or at the diagnostics centers.
  2. Medicines prescribed in writing
  3. Consultation charges of medical practitioners
  4. Nursing charges related to medical staff
  5. Medical procedures limited to parenteral administration of medicines
  6. Cost of a Pulse oximeter, Oxygen cylinder, and Nebulizer

c) Pre and Post Hospitalization Medical Expenses –

Pre-Hospitalization medical expenses of 15 days prior to admission into the hospital and Post-Hospitalization expenses of 30 days after getting discharged from the hospital will be covered under this policy.

d) Hospital Daily Cash –

Hospital Daily Cash benefit comes under an additional cover if the insured has opted for Optional Cover on Benefit Basis. Under this benefit, the insured will get 0.5% of the sum insured per day up to a maximum of 15 days.

From where can I purchase this policy?

This health insurance policy can be purchased from 30 General and Health Insurance Companies. The list of these companies is as follows –

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  • Acko General Insurance Ltd.
  • Aditya Birla Health Insurance Co. Ltd.
  • Bajaj Allianz General Insurance Co Ltd
  • Bharti AXA General Insurance Co. Ltd.
  • Cholamandalam MS General Insurance Co. Ltd.
  • Edelweiss General Insurance Co. Ltd.
  • Future Generali India Insurance Co. Ltd.
  • Go Digit General Insurance Ltd
  • HDFC ERGO General Insurance Co.Ltd.
  • HDFC ERGO Health Insurance Limited
  • ICICI Lombard General Insurance Company Ltd
  • IFFCO TOKIO General Insurance Co. Ltd.
  • Kotak Mahindra General Insurance Co. Ltd.
  • Liberty General Insurance Ltd.
  • Magma HDI General Insurance Co. Ltd.
  • ManipalCigna Health Insurance Company Limited
  • Max Bupa Health Insurance Co. Ltd
  • Navi General Insurance Ltd.
  • National Insurance Co. Ltd.
  • Raheja QBE General Insurance Co. Ltd.
  • Universal Sompo General Insurance Co. Ltd.
  • Reliance General Insurance Co.Ltd
  • Religare Health Insurance Co. Ltd
  • Royal Sundaram General Insurance Co. Ltd.
  • SBI General Insurance Co. Ltd.
  • Star Health & Allied Insurance Co.Ltd.
  • Tata AIG General Insurance Co. Ltd.
  • The New India Assurance Co. Ltd
  • Oriental Insurance Co. Ltd.
  • United India Insurance Co. Ltd.


Premium for Corona Kavach Policy

Livemint Research has done a detailed study of Premium for various companies. Check out the premium table below.

premium details of corona kavach policy

Exclusion under this policy –

  • If there are any diagnostic expenses made which are not related to COVID, then that expenses will not be covered in this policy.
  • If a person is tested COVID +ve before the start of the policy, then this person cannot file a claim to the company.
  • Expenses incurred in daycare treatment and OPD treatment will be excluded from this policy.
  • If a COVID +ve person is getting treatment outside India, then the expenses incurred in the treatment will not be covered under this policy.
  • If any expenses incurred on un-proven treatment, procedures, or supplies related to COVID which lacks medical documentation to support its effectiveness will not be covered in this policy.
  • If a person is getting testing done related to COVID in diagnostic centers that are not authorized by the government then the expenses incurred will not be covered under this policy.
  • Expenses made on dietary supplements and substances which are purchased without prescription will not be covered under this policy.

A short video review of Corona Kavach Policy –

All features mentioned in this policy are referred from IRDAI notification.

Conclusion –

So this was all that I wanted to share in this article if you have any queries you can put it in the comments section.

Arogya Sanjeevani Policy – A uniform health insurance plan (REVIEW)

IRDA has recently announced the launch of health insurance policy called “Arogya Sanjeevani Policy” (official link) which will have standard features which are required by a common man for his health insurance requirement.

IRDA thought of a standard policy which will be exactly same across insurers with similar features. In this review, I plan to give you details of this policy.

Arogya sanjeevani health insurance policy review

What is Arogya Sanjeevani Policy?

It’s a standard health insurance policy for a common man with standard features. It will be offered by all health insurance companies in India starting from 1st April, 2020 onwards. The name of the policy will be ‘Arogya Sanjeevani Policy – Insurance company name’. The premium, however, may be set by the insurers on their own.

The existing health insurance policies in market are quite complex at times with fancy features and differ from each other so much that a normal investor finds it very tough to choose a suitable policy. Hence IRDA came with this policy.

Who can buy the policy and for whom?

Any person whose age is between 18 and 65 yrs can take this policy. Either the person can buy an individual policy or buy the family floater option if one wants to cover other family members.

“Family” here means

  • Spouse
  • Parents
  • Parents-In-Law
  • Dependent children between 3 months to 25 years (natural or adopted)

Note that any children who are above 18 yrs and financially independent will not be eligible for family floater.

Features Arogya Sanjeevani Policy

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Sum Assured The minimum sum assured is Rs 1 Lac and maximum sum assured is Rs 5 Lacs (in the multiple of 50,000)
Premium Payment Frequency Premiums can be paid on a monthly, quarterly, half-yearly and on a yearly basis. It will be a 1 yr policy renewable each year
Cashless Benefit Yes, there is cashless benefit under this policy
Maternity Benefit Not Available
Renewability Lifetime renewability is available in this policy.
Minimum & Maximum Age The minimum entry age for the principal insured is 18 years and the maximum entry age is 65 years.
Waiting Period 30 days of waiting period. Hence no claim will be paid in first 30 days after buying policy
Co-payment A fixed copay for 5% is applicable for all ages in this policy.
Portability Yes, the policy offers the portability option to other health insurance companies
Ambulance Charges Max Rs. 2000 per hospitalization
Pre & post Hospitalization 30 days Pre Hospitalization & 60 days Post Hospitalization expenses
Ayush Treatment Yes, it’s Available.

AYUSH means all treatments related to Ayurvedic, Yoga, and Naturopathy, Unani, Siddha, Homeopathy

Waiting Periods There are 2 types of waiting periods, 24 months and 48 months.

Most of the illness have only 24 months of waiting period, but two of them have 48 months of waiting period.

Sub Limits
  • For hospitalization expenses like room, boarding, nursing expenses up to 2% of Sum Assured or a maximum of Rs.5,000 per day.
  • ICU/ICCU expenses will also be provided up to 5% of sum assured or a maximum of Rs.10,000 per day.
  • Sub-limits of cataract surgery are equal to actual expenses i.e. 25% sum assured or Rs 4 lakhs, whichever is lower.
NCB (No Claim Bonus) NCB (No Claim Bonus) of 5% for each year up to 50% of the sum assured is covered.
Riders Not Available


Policy Cancellation and Refunds

You can cancel the policy subject to following refund options

  • If you cancel within 30 days, you will get 75% premiums back
  • If you cancel from 31 to 90 days, then you get 50% premiums back
  • If you cancel between 3 months to 6 months, then you get 25% premiums back
  • After 6 months, you get NO refund

Is there any grace period in the policy?

Yes, For a yearly premium payment, 30 days grace period is allowed and for other modes of premium payment 15 days grace period is allowed.

Will the premium depend on my city or the zone?

No, it will be same across India. Note that some policies have zone-based premiums model

What are some exclusion of the policy.

The main exclusion is the maternity treatment expenses, but even treatments related to weight loss, change of gender, plastic surgery, hazardous adventure sports, breach of law or due to war, etc are excluded from the policy.

Good points of Arogya Sanjeevani Policy

  • All main features are available in the policy which is required by any investor
  • The policy has standard features, so no chance of getting confused when comparing the premiums of different companies
  • It’s my guess, but the premiums of this policy would not be very high as copay is there in this policy and no complicated features exist. Also there is a very large market for this policy hence all insurance companies will compete with each other to keep premiums down
  • Its a no brainer policy for someone who wants to buy a “decent policy”
  • You can buy multiple Arogya Sanjeevani Policy from different insurers

Should you buy Arogya Sanjeevani Policy?

At the end, let me answer this important question.

Health Insurance is a long term product, and if you can afford the permission, you should go for a base policy which is very strong overall. I suggest one to go for a 10-15 lacs of base cover and extend the cover using super top up policies beyond that.

Overall Arogya sanjeevani policy is decent for a common man who wants a good enough health insurance policy which works. It’s like the Jan Dhan account which has all the decent features. However there are few things which are the issues

  • 5% copay
  • Sub limits of room rent
  • Maximum Sum assured limit of Rs 5 lacs
  • 30 days of waiting period

Hence, I would suggest to explore other health insurance policies which give option to take a higher sum assured and may also not have copay limits.

We also need to wait for couple of more months to see how this policy launch turns out to be and what kind of premiums will be charged by various companies. Overall, it’s a very positive development in health insurance space and this policy will give an opportunity to people from lower sections of society to buy a good enough health insurance policy.

How to add your new born baby to your health insurance policy?

Newborn baby comes with a bundle of joys. However, after his/her, your life changes a lot like adjusting your schedules, balancing your work life and most importantly managing your finances. One important thing which parents forget after the newborn arrives is to add him/her in the health insurance policy.

In this article, we are going to share what is the process of adding your newborn baby to your existing health insurance policy. Note that it does not matter if the child is biological or adopted, the process is exactly the same for all.

As medical emergencies are uncertain and unforeseen expenses may affect your finances badly. And also, getting health insurance for a newborn or a child below 5 years may not be possible, all health insurance policies have a certain entry age limit.

How to add a newborn baby in your health insurance?

There are two ways of adding a newborn to health insurance. First at the time of renewal and other is, adding during the year.

1. At the time of Renewal

There are two modes of doing it at the time of renewal, online and offline.

  • Offline mode – In offline mode, you need to inform your agent or insurance company, fill a prescribed form and attach a birth certificate of newborn baby, discharge card and other required documents along with cheque/DD of the increased premium amount.
  • Online mode – In online mode, you just need to visit the website of the insurer and go to the renewal page and you will see an option to add a newborn somewhere on the page. On selecting add newborn, the premium for your health insurance policy will be increased and you need to pay the revised quote. However, some companies may ask to attach a soft copy of the birth certificate of a newborn baby.

2. Before Renewal Date

Adding a child during the year can be done only through offline mode. You need to inform your agent or insurance company, fill a prescribed form and attach the birth certificate of newborn baby, along with NEFT/cheque/DD of the increased premium amount.

Important points

  • Waiting Period – Newborn baby is not covered until 90 days, due to the high amount of risk involved in medical emergencies.
  • Revised Premium – When you add a new member to your policy, the insurance company will recalculate the premium amount. So, you need to pay an increased premium amount.
  • Cashless card – You need to submit a photo of new born at the time of adding, to avail cashless card facility.

In the case of a newborn health insurance cover, it is very important to know, what is covered, what all are exclusions and whether vaccination is covered or not. So, Make sure you read your policy document.

Reduce your premiums by 20% – Zone Based Health Insurance

Do you know that your health insurance premium may depend on your city? Yes, there is something called “Zone-based premium” in the health insurance industry which I will share in this article today.

For instance, the premium amount for a person aged 30 years, living in Delhi, might be higher than the person of the same age living in Pune. So, apart from age, the sum insured & health conditions, even the city which you mention at the time of health insurance purchase also impacts your premium amount.

Zone-based pricing in Health Insurance

Here is how zone-based pricing works in health insurance premium calculation. Various cities in India are divided into 3 zones at a high level which defines Metro/Tier-1, Tier-2 cities and other rest of the cities (tier 3/4). Here is an indicative list of zones (may vary from insurer to insurer)

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Zone 1 Metro cities like Delhi, Mumbai including thane
Zone 2 Tier-II cities like Chennai, Pune, Bangalore, Hyderabad
Zone 3 Rest of India excluding areas falling under Zone 1 and Zone 2


List of companies which provide zoned based insurance pricing

Given below is the name of health insurance companies which use zoned based pricing model-

  • Max Bupa Health Insurance
  • L&T Health Insurance
  • Star Health Insurance
  • New India Assurance
  • SBI General Insurance

Why health insurance companies adopt zoned based pricing?

You will agree that the overall expenses in a metro or tier-1 city are usually higher than a tier-4 city or a comparatively smaller city. Imagine if someone gets treatment for a big illness in Mumbai/Delhi compared to a smaller city like Meerut or Akola. There are various reasons why this happens

  • Higher Room rent charges
  • Higher charges for diagnostic tests
  • Higher doctors fees
  • Higher stress levels
  • More prone to lifestyle illness
  • Higher consultation charges pre/post-hospitalization

The point is that a policyholder living in a smaller city will claim less amount compared to a policyholder living in a bigger city, even if they both have the same amount of sum assured and claimed for the same thing.

Check an example below where we checked the yearly premium for a 30 yr old person for sum assured of Rs 10 lacs for 3 different cities from each zone. You can see how the premium reduces by approx 10% each time for zone 2 and zone 3 cities.

How health insurance premium changes based on city (zoning)

So you can see above that the premiums were as follows

  • Zone 1 (Delhi) – Rs 9862
  • Zone 2 (Pune) – Rs 9041 (9% less than zone 1)
  • Zone 3 (Varanasi) – Rs 8201 (17% less than zone 1)

So you can expect zone 2 pricing to be approx 10% lesser and zone 3 pricing to be approx. 20% lesser than zone 1. This is just approximations, for exact difference refer to policy documents.

Hence the zone-based premium pricing comes into picture. This is exactly the reason why companies charge a lesser premium if you are from a smaller city and vice versa.

What if, a policyholder of a small city wants to avail of treatment in the metro city?

Note that, there is no restriction on the city where one wants to avail of the treatment. In some cases, it may happen that the policyholder might want to go for a better hospital in a bigger city. In those cases there might be some extra amount policyholder has to pay from their own pocket. Like in some policies, if a policyholder of zone 3 (smaller city) avails treatment in zone 1 or zone 2 city, then there will be a clause of co-payment.

It means that the claim amount will not get settled 100% by the insurance company. For eg. If a person of zone 3 claimed Rs. 50,000 for getting medical treatment at Delhi, he will be paid Rs. 40,000 (80% of the claim amount) and balance 20% has to be borne by insured.

This clause changes from company to company and on a zone to zone basis. Please go through the policy document of the health insurance policy to know the exact rules and clauses applicable.

So in case, you do not want that co-pay applicable to you, then you can choose the city as any metro or bigger city of your choice so that you pay the premiums for zone 1 cities, but at the time of providing the address proof, you can give any address.

Important points regarding Zone-based premiums

  • In case you shift your city in the future, you can always inform the company at the time of renewal, and the premiums as per new zone will apply
  • In case you port your policy from one insurer to another, it might happen that your premium changes depending on the pricing model of the old/new company.
  • In zone-based pricing only premium changes depending on the city of residence. It will not change any benefits or other features of the policy.
  • Note that very few companies follow the zone-based premium pricing model, so please inquire about it.


As you are now aware of the zoning concept, see if there is any scope of using this to your advantage, provided the insurer of your choice provides it for your policies.

Please share what you think about zone-based premium pricing? Do you feel if its the right thing to do or not? Is it useful or not?


How much tax benefit can be claimed u/s 80D? (Rules + Limits)

Are you clear about the tax-saving which you can do when you pay health insurance premiums every year? You will be glad to hear that it’s over and above sec 80C.

Yes, it comes under a separate section called section 80D!

What is section 80D?

Health Insurance policies have become very famous in the last 10 yrs and to encourage it, the govt gives tax benefit when you pay the premium for yourself, your family or your parents

Section 80D defines all the rules and limits related to health insurance premium payment and tax saving.

what is section 80D of Income Tax Act, 1961

How much can you claim under section 80D?

One can claim a deduction of premium amount on health insurance of self + family (spouse + dependent children below 18 yrs.) and parents. If one pays a health insurance premium of his brother or sister then he/she will not be able to claim a tax deduction. To make it more clear, I have mentioned the list of people who will come under this benefit –

  1. Self
  2. Spouse
  3. Dependent Children (below 18 yrs.)
  4. Parents

How much you can claim Tax benefit u/s 80D?

  1. You can claim a maximum Rs. 25000 of the deduction for premium paid on health insurance of you, your spouse and children (under the age of 18 yrs.), if you are below 60 years
  2. The same amount of Rs. 25000 you can claim for deduction of premium that you pay for your parents (father+mother).

And if the age of you or your parents is above 60 years then the limit will increase to Rs. 50,000/- in each case. In the above limits, exemption of Rs. 5000 for yearly health check is included.

For getting a clear understanding of the calculation part you can refer the info-graphic given below.

these are the tax benefits u/s 80D

image on 80D exemption limit

Let us now understand this through some examples –

Case 1 – Ram (35 yrs.) with a spouse and 1 kid + parents (mother 55 yrs. and father 57 yrs.)

In case 1, Ram pays a yearly premium of Rs 15000 (for self+spouse+1 kid) and Rs 34000 (both parents). So now let us see how much exemption Ram can claim u/s 8oD.

As self + family exemption limit is Rs 25000 and Parents exemption limit is Rs 25000. Then Ram can claim exemption of Rs 40,000 (15000 + 25000) u/s 80D.

Case 2 – Rakesh (48 yrs.) with a spouse and 2 kids + parents ( father 75 yrs.)

In case 2, Rakesh pays a yearly premium of Rs 32000 (for a self+spouse+2 kids), Rs 63000 (for father) and Rs 8000 (preventive medical check-up). So now let us see how much exemption Rakesh can claim u/s 80D.

As self + family exemption limit is Rs 25000 and parent (senior citizen) exemption limit is Rs 50,000. So, Rakesh can claim exemption of Rs 75,000 (25000 self + 50,000 parent). As Rakesh has already exhausted his self exemption limit so he won’t be able to claim his preventive medical check because preventive medical check is already included in the self exemption limit.

2 Benefits into 1

I think getting tax deductions on health insurance is a wonderful thing. Health Insurance in itself is a very important financial product most people should buy and you are also getting some tax benefits on it. So, do buy health insurance for yourself, your family and parents to protect your wealth and save tax.

Let us know your views in the comment section about this article.

Apollo Munich Optima Restore Policy – Detailed Review + 13 Benefits

In this article, we will see various features of Apollo Munich Optima Restore Health Cover policy. We will be covering its benefits, exclusions, eligibility and premiums details.

Apollo Munich is one of the most respected and well known health insurance company in India, which offers different health insurance plans for family, individual and senior citizens. Optima restore is its flagship health insurance plan, which has recently got some more features and we will discuss that in detail.

Let’s start.

Benefits of Apollo Munich Optima Restore policy

Below are the benefits you will get as a policy holder.

Benefit #1 – Restore Benefit

In Apollo Munich Optima Restore policy there is restoration benefit, which means that when you file for a claim in any year and the sum insured (plus the bonus, if any) is totally exhausted, then it will automatically be refilled to the extent of your basic sum insured. So in a way you get the full sum assured benefit again in the same year.

Let’s take an example – Suppose you are having health insurance of Rs. 5 Lakhs per year so, restoration benefit will work as follows –

[su_table responsive=”yes” alternate=”no”]

Cover Amount Claims made Restoration Benefit
5,00,000 Claimed Rs. 3 Lakhs after 5 months of policy in force Zero – as balance health cover is still there
Balance Left 2,00,000 Claimed Rs. 1.5 Lakhs in next 2 months after first claim (7 months over) Zero – as balance health cover is still there
Balance Left 50,000 Claimed balance Rs. 50,000 in next 1 month after second claim (8 months over) As the whole sum assured is exhausted, the restoration benefit will trigger now and the sum assured now will again be Rs. 5,00,000 – for next 4 months


So, as per the example, you can again claim up to Rs. 5,00,000 in remaining 4 months of your policy without paying any premium or any charges. If restored sum insured is not utilized in a policy year, it will expire. Note, that the restore benefit is available once in a year and it will be available to all Insured Persons for all claims under In-patient Benefit during the current Policy year.restore benefit of Apollo optima policy

**Restoration benefit is different from recharge benefit offered by different health insurance policies. Recharge benefit says that, your sum insured will be refilled to the amount of basic sum insured, every time when your sum insured amount is utilized for any claim, it does not matter what amount has been reduced from the total amount of sum insured cover.

Benefit #2 – ‘Stay Active’ – Get discount for staying healthy

In order to encourage policyholders to stay healthy, this policy provides stay active benefit which says that, if you walk certain number of steps on daily basis, you will get discount at the time of renewal. Your activity will be tracked on a mobile application provided by them (Health Jinn app). The discount can vary from 2%, 5% or 8% depending on average steps you made during the year.

They have defined the time intervals of 90 days starting from the date of policy to average out total walking steps taken during this period. The year is broken down into 4 parts as follows – 90 days, 91 – 180 days, 181 – 270 days and 271 – 300 days. You can refer following table to understand how this benefit will work –

Apollo Munich Optima Restore stay active benefit table

In year 2 of policy, calculation will be bit complicated but, the point is, if in a year you can manage to have average walking steps of 10,000 and above, you will be able to avail 8% discount on renewal premium, provided that, the mobile app must be downloaded within 30 days of the policy risk start date to avail this benefit.

In an individual policy, the average step count would be calculated per adult member and in a floater policy it would be an average of all adult members covered whereas, dependent children covered either in individual or floater plan will not be considered for calculation of average steps. So, dependent child is not eligible for this benefit.

For this you simply need to download an app called Health Jinn app on your phone, sync it with Google Fit or Apple Health and aim to walk 10,000+ steps every day to earn the complete 8% discount. Walking is one of the most beneficial things one can do for health and fitness. So, you will enjoy discount on premium amount as well as be motivated to exercise regularly.

However, we are not sure how many policy holders will have this level of discipline to track their walking steps and buy all the equipment’s, so in a way it’s a benefit only tech savvy policyholders will be able to enjoy who can also be disciplined for the whole year at the same time.

Benefit #3 – E-opinion (Second Opinion for critical illnesses)

In Apollo Munich optima restore health insurance, if insured is diagnosed with any critical illness (listed in policy) then he will be able to take second opinion from a medical practitioner appointed under penal of medical practitioners. Following illnesses are covered under critical illness –

  • Cancer of Specified Severity
  • Open Chest CABG
  • Myocardial Infarction (First Heart Attack of specific severity)
  • Kidney Failure requiring regular dialysis
  • Major Organ/Bone Marrow Transplant
  • Multiple Sclerosis with Persisting Symptoms
  • Permanent Paralysis of Limbs and Stroke resulting in permanent symptoms

However, this benefit is available only once in a policy year.

Benefit #4 – Preventive Health checkup

We all know that health is wealth but, even after knowing this, we tend to neglect regular health check-ups. In this policy, the health checks costs are included, which in a way gives the policyholder a great push to do their health checkups.

So, in this plan, the policyholder will get the cash reimbursement for taking preventive health checkups.

In Optima restore, for a sum assured of Rs. 5 Lac they provide cash reimbursement at the end of a block of every continuous 2 Policy Years and once a year on the sum assured of Rs.10 Lac or more.

You can refer following to know what amount of cash will be reimbursed –

**Preventive Health Check-up means a package of medical test(s) undertaken for general assessment of health status, it does not include any diagnostic or investigative medical tests for evaluation of illness or a disease.

Note that these checkups are great for people because if you keep doing these checkups, then you will be able to detect any illness or major issue before it becomes critical.

Benefit #5 – Daily cash Benefit

Daily cash is the cash benefit, which you get by the insurance company on a day to day (in case of hospitalization above 24 hrs.) basis, if you have been hospitalized in a shared accommodation in network hospitals of insurance company for more than 48 hours.

This cash benefit is already decided amount irrespective of your actual daily expenses. In this policy, you will get Rs.800 per day as daily cash which has a limit of up to Rs.4, 800.

For example: If “A” and “B” both get admitted to a hospital (both of them are covered under this policy). Suppose A’s daily expenses are Rs.600 per day and B’s expenses are Rs.1000 per day, in this case, though the expenses are different, both of them will get Rs.800 as a daily cash because it is decided previously in their policy.

So here A will save Rs.200 and B has to pay Rs.200 extra from his own pocket per day.

In another case, a person “C” is hospitalized and his daily expenses are Rs.800, but he has to stay there for 7 days. Here the total daily expenses of the person will be Rs.5600 (for 7 days)but as it is mentioned in his policy clearly, he will get only Rs.4800 as daily cash and the rest he has to pay by his own.

However, daily cash benefit is not given for an insured admitted in Intensive care unit. And the limit is higher for higher sum insured i.e. it is Rs. 1000 per day up to Rs. 6000 for sum insured of Rs. 20 Lakhs, 25 Lakhs and 30 Lakhs.

You can watch this video given below to know the plan details of Apollo Munich Optima Restore policy:

Benefit #6 – Multiplier Benefit

There is something called as Multiplier benefit under this policy which gives additional sum assured to policy holder when there is no claim in any given policy year. It is like a bonus included in sum insured amount in case of no claim made during a year.

One can get a bonus of 50% of the basic sum insured for every claim free year, accumulating up to 100%. In the event of a claim, the bonus shall be reduced by 50% of the basic sum insured at the time of renewal. It simply means insurance company will take back benefit of bonus on making any amount of claim.

Example : Suppose you had a policy cover of Rs. 10 Lakhs for a year, but you didn’t claim anything in that year. So, policy sum insured will be increased to Rs. 15 Lakhs (10 Lakh + 50% of 10 lacs). And next year again, if there is no claim then it will be increased to Rs. 20 Lakhs.

But, once you claim any amount against your insurance, then renewal amount of sum insured will be reduced by 5 Lakhs (50% of 10 Lakhs) and it will Rs. 15 Lakhs.

It’s a great thing, because this way you are actually getting upto 20 lacs of health insurance even if you have taken just 10 lacs at the time of buying the policy.

Benefit #8 – Cashless Service

Like most of the policies, there is cashless service in this policy too, which means that the insurance company will make payment directly to the hospital provided it’s within its network and there was prior approval taken for the hospitalization at least 48 hours before.

In case of unplanned or emergency hospitalizations, one can still do all the expense from their end and claim for reimbursement later.

Benefit #9 – Pre and Post hospitalization

Apollo Munich Optima Restore policy covers pre hospitalization expenses up to 60 days immediately before hospitalization and post hospitalization expense of 180 days immediately after hospitalization.

Whenever a person is hospitalized, before that he might have gone through various tests/consultations and even after getting discharge from hospital, he will have to pay bills of medicine and other tests.

Benefit #10 – Organ donor Expenses

When insured is having an organ transplant surgery then all the expense related to that will be paid by insurance company. But it will exclude pre and post hospitalization expense of donor. Provided the undergoing of a transplant must be confirmed by specialist. However, any other expenses incurred by an insured person while donating an organ is NOT covered.

Benefit #11 – Domiciliary Expenses

Apollo Munich Optima Health Restore policy also provides for domiciliary expenses which means medical treatment for an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances:

  • The condition of the patient is such that he/she is not in a condition to be removed to a hospital, or
  • The patient takes treatment at home on account of non-availability of room in a hospital.

Benefit #12 – Portability

If you are insured with some other company’s health insurance and want to shift to this policy on renewal, then without starting a new cycle of waiting period, you can shift to this policy. Apollo’s portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.

Benefit #13 – Day Care Procedures

This health insurance also provides for Day Care Procedures i.e. Medical treatment or surgical procedure (eg. cataract), which require admission in a Hospital/Day Care Center for stay less than 24 hours. Treatment normally taken on out-patient basis is not included in the scope of this definition.

Indicative list of Day Care Procedures that are covered in this benefit is as follows-

• Cancer Chemotherapy
• Liver biopsy
• Coronary angiography
• Haemodialysis
• Operation of cataract
• Nasal sinus aspiration

Other Rules of the Policy

  1. Maximum Age – The maximum entry age is 65 years, however, there is no maximum cover ceasing age in this policy.
  2. Minimum Age – The minimum entry age is 91 days i.e. children between 91 days and 5 years can be insured provided either parent is getting insured in this policy.
  3. The validity of the policy and Discount – The policy will be valid for a period of 1 to 2 year(s) as opted. If a 2-year policy is chosen then an additional 7.5% discount is offered on the premium
  4. Eligibility for buying the policy – An individual or his family members such as spouse, children, parents/parents-in-law are eligible for buying this cover on an individual or floater basis.

Exclusions – What is not covered in this policy?

  • Any treatment within the first 30 days of cover except any accidental injury.
  • Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
  • 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Abuse of intoxicant or a hallucinogenic substance like drugs and alcohol.
  • Pregnancy, dental treatment, external aids, and appliances.
  • Hospitalization due to war or an act of war or due to the nuclear, chemical or biological weapon and radiation of any kind.
  • Non-allopathic treatment, congenital external diseases, mental disorder, cosmetic surgery or
    weight control treatments.

Details of individual policy –

If you are buying health insurance for yourself then following table will be helpful to understand what all benefits you will be having for different amount of sum insured.

details of Apollo Munich optima health insurance policy

Details of a family floater –

If you are buying health insurance for you and your family then following table will be helpful to understand what all benefits you will be having for different amount of sum insured.

Apollo Munich family health insurance policy details

Premium details of individual and family policy:

You can refer below given table to get an idea of the premium amount of this policy. The table shows followings –

  • Premium details of a man aged 30 years for an individual policy.
  • Premium details of a family policy, comprising of an individual (aged 30 yrs.), his wife (aged 30 yrs.), son (aged 8 yrs.) and daughter (aged 10 yrs.). The family policy starts from 5 lakhs of sum assured.

Apollo Munich health insurance premium details

**This is the premium details of 1-year policy including GST and excluding the critical illness cover cost.

Infographic of Apollo optima restore health insurance policy


We feel that overall this policy has all the standard features, however there are many other policies which can also be looked at before making the decision.

If you have any doubts regarding this policy cover, you can leave your query in the comment section.

Want your Insurance Claim to be Processed? Link your Aadhaar/PAN asap!

As per IRDAI, the insurance regulator – it is now mandatory to link your Aadhaar and PAN number with your insurance policies. Though this linking process does not have a deadline right now, its advised to act fast and complete this action asap to avoid any last minute rush and issues which you might face at the time of renewal or claims.

Note, that those investors who still don’t have PAN , have an option to submit form 60.

Why to link your adhaar and PAN with LIC and other insurance policies

How to link Aadhaar & PAN in your LIC policy?

If you have any existing life or health insurance policies, you should link your Aadhaar and PAN soon.

As most of the investors have LIC policies, I am covering the online and offline process for LIC policies right now in this article and will give the links to update the Aadhaar for some other companies as well.

Online Process for updating Adhaar in LIC policies

If you want to update your Aadhaar in your LIC or any insurance policy, the first criteria is that your active mobile number should be linked to your Aadhaar number, so that you can generate OTP which is necessary for the registration process.

Here are the 3 steps you need to follow

Step #1: First of all visit this dedicated link from LIC’s website

Step #2: Fill the details like your

  • Name
  • Date of birth
  • Email ID
  • Aadhaar number
  • PAN number
  • Policy number
  • Aadhaar registered mobile number

and then click on generate OTP. Here is how it looks like.

link adhaar and PAN with your insurance policies

Step #3: You will get an OTP on your mobile, which you need to enter on the site and click on submit. You will see the massage of successful registration for Aadhaar linking with LIC.

It might take few days to link your Aadhaar number with your Policy. Once this linking process is completed after verifying your details from UIDAI, you will be informed via SMS/e-mail on your registered mobile number or mail-ID. You can also watch this video to know the process.

Online Process for updating Aadhaar in LIC policies

You can also have an option to visit your LIC branch and fill up the offline form to link your adhaar and PAN with your policy. Make sure to take an acknowledgement letter once you complete the process.

How to link your Aadhaar and PAN with non-LIC policies?

Each and every insurance company has implemented the solution of linking Aadhaar with policies and you will find a dedicated page on their website. Just search for “Aadhaar + PAN + Linking + <<enter Insurance company>>” in google and you will surely get the link for completing the Aadhaar linking process.

However we are putting up a small list of some insurance companies and their respective links to make it easy for you.

[su_table responsive=”yes”]

Sr. No. Insurance Companies Link to update Aadhaar and PAN
1 ICICI Prudential https://www.iciciprulife.com/services/update-your-aadhaar.html
2 SBI life insurance https://www.sbilife.co.in/en/aadhar-updation-form
3 HDFC standard life insurance https://cp.hdfclife.com/Aadhar_Info/Default.aspx?Source=Website
4 Max life insurance https://www.maxlifeinsurance.com/customer-service/aadhaar-update.html
5 Bajaj Allianz life insurance https://general.bajajallianz.com/BagicNxt/ValidateAadhaarPAN/LinkDtlsCorpPortalDirect.do
6 Reliance Nippon life insurance https://customer.reliancenipponlife.com/AadhaarUpdation/
7 Tata AIA life insurance https://apps.tataaia.com/UnclaimedAmount/AadhaarDetail.jsp
8 PNB Metlife India insurance https://www.pnbmetlife.com/wps/portal/Home/aadhaar_updation
9 Apollo Munich health insurance company limited https://ekyc.apollomunichinsurance.com/ekyc/#/login
10 Star health and allied insurance company https://retail.starhealth.in/updatecustomerdetails
11 Religare health insurance company https://www.religarehealthinsurance.com/aadhaar-linking-verification.html
12 United India insurance company https://portal.uiic.in/polclaim/tb/CustomerUpdateFirst.do


Note that this takes just 1-2 minutes of your time, but its an important thing to complete. If you still have any doubt regarding this linking process you can leave your query in the comment section.

From 1st Oct, Insurance policies will be issued online (even renewal policies)

Starting 1st Oct 2016, all the insurance policies are going to be issued in electronic form.

Yes, you heard it right

Few years back IRDA had come up with the concept of 13 digit e-Insurance Account (EIA), where an investor had the option to convert their existing physical policies into demat form, but till now it was not mandatory. However now things have changed and starting 1st Oct,2016 it has become compulsory.

Now, every insurance company has to issue all kinds of insurance policies in an online format. So if you are buying any kind of insurance policies (life, health, motor, pension policies and all kind of general insurance policies too) you need to have an e-Insurance Account (EIA) and the policies will be issued in Demat form only in that account.

This will be true even for renewal policies. So even if you are not buying any fresh new policy, at the time of your policy renewal this will apply to you

Under which cases, is this e-insurance account mandatory?

This e-account is required only if the annual premium crosses Rs 10,000 for most of the policies like term plan and health insurance or if the sum assured is above 5-10 lacs. The exact requirement is as follows for various kind of policies (source link)


How to open E-Insurance Account?

Step 1: Choose the Insurance Repository

There are 5 registered insurance repositories in the country, licensed by IRDA, out of which you need to choose one. These are …

  • CAMS Repository Services
  • SHCIL Projects Limited
  • Central Insurance Repository
  • Karvy Insurance Repository
  • NSDL Database Management

Note that you can choose any one of them, and there won’t be any difference, other than level of service. At the backend, everything will be the same. Also if you are not satisfied with your insurance repository provider service, you can switch to another one later.

Step 2: Fill up the form and submit the documents

The process now is very simple, once you have decided the repository company, all you need to do is fill-up the form and attach your KYC documents and submit it to their office in your city.

CAMSrepository also has an option where you can first fill-up the form online and then download the filled form. I think it will work for most people and save time. If you want to fill the form offline, you can download e-insurance account opening form here

Following are the documents you need to submit

  1. e-Insurance Account form (fill by hand OR filled online one)
  2. Date of Birth Proof (PAN , Passport, Voter Id etc)
  3. Photocopy of ID proof (PAN or Aadhaar Card)
  4. Photocopy of Address proof (Aadhaar, Passport, Electricity or Telephone Bill etc)
  5. Canceled cheque
  6. Passport size photograph

Note that the canceled cheque is required so that the information of the bank account is captured beforehand, Any maturity proceeds or claim amount will be paid in this same account. Ideally, this should be the same one from where the insurance premium is paid, but not mandatory.

All the major insurance companies like LIC, ICICI, HDFC, and others have already joined hands with this facility.

Check out this short video created by CAMS team

Once you submit the documents, it will just take a few days to open the account.

If you need the detailed list of the documents required, you can view this PDF document (2nd page)

The concept of Authorized Representative

A special feature called “Authorized Representative” is introduced in this e-insurance account where an investor can assign someone trustworthy or close to being AI (authorized representative) who will be able to access the details of the account in case of death of the policyholder. This is different than the nominee.

For example, I can give my close friend name and details in the AI section ask him to have a look at all my details in case I am dead and ask him to communicate things to my family as per my plan.


Features and Benefits of e-Insurance Account (EIA)

Let me know to share some benefits and key points of this e-insurance account and how it will benefit the overall insurance industry as well as the investor, even though it may look like another hassle to you right now

  • FREE account – This account will be 100% FREE account for investors, there are no charges or maintenance fees to be paid by anyone. One person will have only a single account (like PAN)
  • All policies at one place – This will be the single point of contact for investors to view, download and manage their insurance policies, be it life, health, motor or any travel insurance policy.
  • No KYC repetition while buying new policies – After doing the KYC first time, you won’t have to do it again and again when you buy new policies. All you would need to do is mention your EIA number and buy the policy.
  • Get reminders – You will get reminders for your policy maturity, payment reminders and any other important updates.
  • Single place to update your KYC – IF you want to update your mobile, address or other details, you will just have to update it in e-insurance account and not in each policy individually.

Understand that with this initiative, the insurance companies will simplify their process and a good amount will be saved as there won’t be a lot of paperwork involved (printing of documents, courier etc) and that’s why insurance companies will fund this initiative and will keep it FREE for investors.

Converting your existing physical Policy in Electronic form

I know you must be thinking about what will happen to my existing policies which I have bought till date? So, there is a simple process to convert them online.

Once you open the e-insurance account, you can apply for conversion of your existing policies into the online form (its good that you do it beforehand, because at the time of renewal it’s going to happen anyways going forward)

As per Cam’s repository FAQ point 18, you can just mention your policy number and it will be converted into an online format

18. How do I convert my existing paper policy into electronic form?

If you already have eInsurance account, log in to your eInsurance account, click on “ePolicy conversion” and enter your policy number, name of Insurance company that needs to be converted into ePolicy. In the next few days, your policy will be converted into ePolicy.

You can also download the policy conversion form and submit it for offline -> online conversion of policies

Please share what do you think about this new rule? Do you think it will help investors and the insurance industry?