In a significant move the The IRDAI (Insurance Regulatory and Development Authority of India) has brought big releif to Senior Citizens by restricting Insurance companies to increase their premium by 10% in a year.

Furthermore, for the benefit of senior citizens, the regulatory framework requires all insurers to establish a separate channel to address their health insurance related claims and grievances. The details of such channel are required to be published on the respective insurer's website.

It is observed that there has been steep increase in premium rates under some of the health insurance products offered to senior citizens (aged 60 years and above). The premium rate is primarily based on the estimated claims outgo and the expenses including acquisition costs incurred by the insurance company for acquiring and servicing the insurance policies. 

Unlike in case of Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme where the hospitalisation expenses are negotiated centrally for package rates and are thus standardised across various hospitals, there is no such standardisation in case of health insurance products. This is leading to higher hospitalisation costs resulting in higher claims outgo under health insurance products offered by insurers. In this context, the most vulnerable age group is the senior citizens having limited sources of income and this group is impacted the most when there is a steep increase in health insurance premium. 

In order to address the same, the IRDAI directs all general and health insurers, offering individual health insurance products to Senior Citizens with immediate effect:

1. The insurers shall not revise the ​Premium for senior citizens by more than 10% per annum.

2. Insurers shall undertake prior consultation with the IRDAI for any withdrawl of plans for Senior Citizens. 

3. The Insurers shall give wide publicity of the various measures (including the above) taken for the benefit of senior citizens while offering health insurance products.

4. The insurer shall take necessary steps for common empanelment of hospitals and negotiate package rates on the lines of PMJAY scheme.

As part of the ongoing monitoring of insurance products offered in the Indian insurance market, IRDAI will continue to keep a close watch on indemnity based individual health insurance products offered to Senior Citizens.