Guide to Wellness Benefits in Health Insurance

In the insurance sector, regulations play an important role in bolstering the growth of the industry and shaping its future. Not too long ago, the insurance watchdog, Insurance Regulatory and Development Authority of India (IRDAI) proposed to introduce a new set of guidelines - the Health Insurance Regulations, 2016.One of the most crucial amendments put forth in the draft guidelines, that we must be aware of is IRDAI’s take on Wellness Benefits. Let us examine this proposal in detail.

In today’s times, Indians are facing multiple health challenges due to their stressful urban routines and poor lifestyle choices. Health is an extremely crucial aspect of our well-being. Yet, in today’s times, it is overlooked and ignored. What if you were told that you’d be rewarded for maintaining a healthy lifestyle? Health insurance plans that come with wellness benefits attached incentivize the policyholder for prioritizing his or her health. In a typical wellness program, the policyholder gets credited with reward points for inculcating healthy habits. Indicators of a healthy lifestyle would be clearly mentioned in the policy document.The insured individual’s progress is regularly monitored by the insurance company through digital devices or mobile apps. The reward points can be redeemed to avail of a discount on the policy premium or a concession on medical bills or consultation fees, etc.

They say “Prevention is better than cure.” Keeping this in mind, IRDAI has called for wellness features to be incorporated as preventive measures in health insurance plans in order to promote health and fitness. The regulator has issued a new set of guidelines, thus replacing the 2013 version of rules.The guidelines suggest that health insurance providers can now start providing benefits in the form of services offered by Network Hospitals or other empanelled service providers(or discounts on the same) such as:

• Outpatient consultation or treatments
• Pharmaceuticals
• Health checkups or diagnostics

The benefits may also include

• Redeemable vouchers to obtain protein supplements and other consumable health boosters or supplements
• Redeemable vouchers for membership in gyms, yoga centersNot only this, but the reward points may also be utilized to avail of:
• Discounts on the premium amount
• An increase in the sum insured

The guidelines clearly state that no discount would be provided ton any third-party service or merchandise. For example, the insurance company cannot offer any discount or concession on the price of a health club’s membership fee just because they are tied up with that club. In Conclusion The new guidelines are proposed to motivate us to prioritize our health. They aim to improve the policyholder’s health as well as bring down the claims ratio reported by insurance providers.

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.