The objective of these Guidelines are to rationalise and standardize the exclusions in health Insurance Contracts that every Insurer shall comply with. Health Insurance has undergone various changes and improvements over the years. The Insurance Regulatory and Development Authority of India (Health Insurance) Regulations as well as the TPA (Third Party Administrators) Regulations have brought in standardization of various definitions / formats in the health insurance industry to promote uniformity keeping the customer in focus. The health insurance industry is keeping pace with the advancements in technologies that are taking place in the healthcare industry.With the increase in number of health insurance companies as well as health insurance products in the market, it has been desired that the health insurance industry adopts a uniform approach while incorporating exclusions in the health insurance products. In order to have a holistic and structured approach in devising appropriate guidelines, IRDAI, constituted a Working Group vide order Ref: IRDAI/HLT/ORD/Misc/113/07/2018 dated 24th July,2018 to review the extantpractices andmake appropriate recommendations to meet the above objective.Report of the Working Group was published in IRDAI website on 02/11/2018.
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