Circular Issued By IRDAI Dated April 16, 2020 Pursuant To Guidelines Issued By The Ministry Of Home Affairs On April 15, 2020 Prescribing Medical Insurance Coverage For All Employees.
The Employees’ State Insurance (ESI) Act, 1948 prescribes medical insurance to those organised sector employees whose monthly wage is Rs.21,000/- or less. Pursuant to the Ministry of Home Affairs Directive dated April 15, 2020 medical insurance has been made mandatory for all employees meaning thereby that even those employees in the salary bracket exceeding Rs.21,000/- will be entitled for a group medical cover from their employers. As per the IRDAI Circular dated April 16, 2020, this medical cover will extend not only for the duration of the lockdown due to the Covid-19 pandemic but for all times henceforth.
The Insurance Regulatory and Development Authority of India (IRDAI) vide a circular dated April 15, 2020 has advised all General and stand along Health Insurers, except AIC and ECGC to formulate health Insurance policies providing medical insurance coverage for all employees as part of the National Directives issued by the Ministry of Home Affairs on April 15, 2020 to all industrial and commercial establishments for implementation of Standard Operating Procedure (SOP) [Annexure 2, Clause No. 5] before resuming their operations during/after the present lockdown.
All General and Health Insurance companies have been advised to offer comprehensive health insurance policies either to individuals or groups in order to enable the listed organisations/ employers establishments to comply with the said directions.
Insurers have been advised to devise comprehensive health insurance products in simple language and conditions and at affordable cost to be offered to the aforesaid organisations.
The said organisations are required to continue the Medical Insurance Policy by insurers not only for the present situation but for all times henceforth.
Our View: The Employees’ State Insurance (ESI) Act, 1948 prescribes medical insurance to those organised sector employees whose monthly wage is Rs. 21,000/- or less. Pursuant to the Ministry of Home Affairs Directive dated April 15, 2020 medical insurance has been made mandatory for all employees meaning thereby that even those employees in the salary bracket exceeding Rs. 21,000/- will be entitled for a group medical cover from their employers. This medical cover will extend not only for the duration of the lockdown due to the Covid-19 pandemic but for all times henceforth.