A Comprehensive Analysis of IRDAI-Mandated Standard Products
Executive Summary
IRDAI has mandated standardized health insurance products to ensure minimum coverage standards and facilitate comparison across insurers. This guide examines Arogya Sanjeevani, Corona Kavach, and other standard products.
Key Statistics (2024-2025)
| Metric |
Value |
| Arogya Sanjeevani policies |
50 lakh+ |
| Average premium (individual) |
Rs. 8,000-15,000 |
| Minimum sum insured |
Rs. 1 lakh |
| Maximum sum insured |
Rs. 5 lakhs |
1. Statutory Framework
IRDAI (Health Insurance) Regulations, 2016
- Regulation 3: Standard products
IRDAI Circulars
- Arogya Sanjeevani Policy (April 2020)
- Corona Kavach (July 2020)
- Corona Rakshak (July 2020)
2. Arogya Sanjeevani Policy
Key Features
| Feature |
Specification |
| Sum insured range |
Rs. 1-5 lakhs |
| Entry age |
18-65 years (individual) |
| Family coverage |
Self, spouse, dependent children, parents |
| Room rent |
No sub-limits |
| Co-payment |
Nil |
| Pre-policy medical |
Not required below Rs. 2 lakhs |
Coverage Components
| Component |
Coverage |
| In-patient hospitalization |
Full sum insured |
| Day care procedures |
Listed procedures covered |
| Pre-hospitalization |
30 days |
| Post-hospitalization |
60 days |
| Road ambulance |
Rs. 2,000 per hospitalization |
| AYUSH treatment |
Full coverage |
Waiting Periods
| Condition |
Waiting Period |
| Initial waiting |
30 days |
| Specified diseases |
24 months |
| Pre-existing diseases |
48 months |
3. Corona Kavach Policy
Key Features (Historical Reference)
| Feature |
Specification |
| Coverage |
COVID-19 hospitalization |
| Sum insured |
Rs. 50,000 - Rs. 5 lakhs |
| Policy term |
3.5/6.5/9.5 months |
| Home treatment |
Rs. 14,000 limit |
| AYUSH |
Covered |
| No claim bonus |
5% per year |
4. Comparison with Regular Products
| Aspect |
Arogya Sanjeevani |
Regular Products |
| Room rent |
No sub-limit |
Often 1-2% of SI |
| Co-payment |
Nil |
Often 10-20% |
| PED waiting |
48 months |
12-48 months |
| Sum insured |
Max Rs. 5 lakhs |
Up to Rs. 1 crore+ |
| Premium variation |
Limited |
Wide range |
5. Compliance Requirements
For Insurers
6. Key Takeaways for Practitioners
- Arogya Sanjeevani is mandatory offering for all health insurers
- No room rent sub-limits is significant benefit
- Rs. 5 lakh cap may be insufficient for major treatments
- Consider as base policy with top-up
- Standardization enables easy comparison