What is CIS? New Health Insurance Rule in 2024 – A Complete Guide

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CIS or customer information sheet is a document that summarizes and gives you a glance into the key details of a health insurance policy. As per an announcement of the IRDAI or the Insurance Regulatory and Development Authority of India, from 1 January 2024, insurance companies are required to revise the CIS to highlight policy details in simple words to make it easy for policyholders to understand and comprehend the health insurance jargon well.

Thus, the revised CIS will highlight the policy details of health insurance policy including sub-limits, waiting period, exclusions, NCB, free-look period, portability, etc., in simple terms for clarity of the policyholder. The CIS will also offer guidance on the claim submission procedure, including contact details for complaints, turn-around time (TAT) for settling claims, and more in the policyholder’s chosen language.

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What Does CIS of a Health Insurance Plan Mean?

A CIS is a customer information sheet that briefly summarizes the key details of a health insurance policy. The insurance company provides the CIS to the customer at the time of buying or renewing an insurance policy. As per the announcement of the IRDAI, starting January 1, 2024, the CIS provided by the insurers will be in a revised format so that policyholders can better understand the complex jargon of health insurance policies.

How is the New CIS of Health Insurance Plan Effective from January 2024 Different?

The new and enhanced format of the CIS or the Customer Information Sheet provided by the IRDAI is easy to comprehend. The revised format will have the below-mentioned details:

  • Insurance policy name
  • Insurance policy number
  • Type of insurance product – indemnity/benefit/both
  • Sum insured mentioning the particular amount
  • Policy coverage – the inclusions of your health insurance policy
  • Exclusions – the details of features not covered by your health insurance
  • Waiting period
  • Policy limits – deductible, co-pay, sub-limit, etc., as applicable
  • Procedure of claim – Include details like claim settlement turn-around time (TAT) for cashless pre-authorization, and final bill authorization for cashless policies. Further, the CIS will have details of below-mentioned online links:
    • Details of network hospitals
    • Helpline number
    • Blacklisted hospitals from whom no claims will be accepted
  • Policy Servicing
    • The customer care number of the insurer
    • Details of company officials
  • Contact details of the insurer, links to filing complaints/grievances, etc.
  • Important things to note
    • Policy renewal
    • Free-look period
    • Migration and portability
    • Sum insured changes
    • Period of moratorium
  • Obligations on policyholder – The policyholder must disclose all health details, such as pre-existing diseases (PED) and waiting periods. Not disclosing the same might affect claim settlement.

Further, the CIS also features the clause number of the policy for every applicable field mentioned above for better transparency.

IRDAI has also asked the insurers to have the signatures of the insurance policyholders in the CIS, stating that they have noted the CIS details well.

How is the Revised CIS Beneficial for the Health Insurance Policyholders?

The fact that policy documents of health insurance policies are lengthy and are filled with jargon or complex words makes them difficult to comprehend. This way, many policyholders miss out on important information about the policy. However, the updated CIS acts as a quick guide for the policyholders to understand crucial terms with ease. With the introduction of the new CIS or customer information sheet, the issue of decoding complex meanings of their coverage will become easy for the policyholders.

You may note that a normal policy document of a health insurance policy has more than 10,000 words written on it about the policy. Reading the entire policy document takes a regular reader around one hour and 15 minutes. Not only that, but the reading comprehension of the policy document is so low that even an English-speaking adult may find it difficult to understand.

The revised CIS will likely make it mandatory for insurers to offer the policy details in clear and concise language that is easy to understand for novice policyholders.

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Conclusion

The latest and revised Customer Information Sheet (CIS) is a simple and easy-to-understand policy document that is sure to make the policy-buying experience of health insurance policyholders smooth and hassle-free. This document is going to be very easy to understand and will lack complex words and terminologies such as sub-limits, clauses, restrictions, and so on.

This new step by IRDAI in revamping the CIS is likely to help policyholders make better decisions for insurance buying. The new format has been effective from 1 January 2024.

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Jan 09, 2024
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PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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