In the health insurance contracts where there is a sub limit for room rent, in the event policyholder occupying a room with higher tariff, than the one that he is eligible, health insurance products, subject to product design, may stipulate recovery of proportionate deductions in respect of various associated medical expenses. In order to ensure uniformity. it is desired to put in place a uniform approach while applying proportionate deductions in health insurance claims when policyholders opt for room with a higher rent than the eligible limit under the policy. With this objective it is proposed to issue norms on making proportionate deductions and a draft circular is herewith attached.

All stakeholders are requested to forward their comments/suggestions on the proposed guidelines in the attached format.

Comments may please be forwarded to Dr Pankaj Sharma, Manager (pankaj.sharma@irdai.gov.in) before 2nd April, 2020 

SURESH MATHUR 

Executive Director (Health)

Insurance Regulatory and Development Authority of India,

Sy No: 115/1,

Financial District, Nanakramguda,

Hyderabad 500032