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  3. IRDAI Proposes Standardised Health Insurance Product for All Indians — Arogya Sanjeevani 2.0
InsuranceIRDAI Exposure Draft IRDAI/HLT/REG/2026/014; stakeholder consultation paper

IRDAI Proposes Standardised Health Insurance Product for All Indians — Arogya Sanjeevani 2.0

18 February 2026|6 min read|By Oquilia Newsroom

IRDAI released the exposure draft for Arogya Sanjeevani 2.0 on 12 February 2026, proposing a comprehensive overhaul of India's standardised health insurance product that was first introduced in 2020. The original Arogya Sanjeevani, while groundbreaking as a concept, was widely criticised for its low maximum sum insured of Rs 5 lakh, restrictive room rent sub-limits, and limited coverage scope. The 2.0 version addresses nearly every pain point.

Key Changes in the Draft

The most significant change is the increase in maximum sum insured from Rs 5 lakh to Rs 25 lakh, with standardised slab options at Rs 5 lakh, Rs 10 lakh, Rs 15 lakh, Rs 20 lakh, and Rs 25 lakh. This brings the product in line with what urban Indian families actually need for a major hospitalisation episode. IRDAI's own analysis found that the average claim size for a cardiac procedure in a metro hospital crossed Rs 8.2 lakh in FY25, making the original Rs 5 lakh cap inadequate.

Second, the draft eliminates room rent sub-limits entirely for sum insured options of Rs 10 lakh and above. For the Rs 5 lakh variant, a 2 per cent daily room rent cap is proposed, which is more generous than the 1 per cent cap in many current budget products.

Third, Arogya Sanjeevani 2.0 mandates wellness and preventive care benefits. Every insurer offering the product must include an annual health check-up worth at least Rs 5,000, a telemedicine consultation allowance, and a wellness rewards mechanism that ties renewal discounts to measurable health metrics like BMI, blood pressure, and HbA1c levels.

Standardised Pricing Band

IRDAI is proposing a pricing corridor approach. Each insurer can set their own premium within a band: a floor price and a ceiling price determined by IRDAI. For the Rs 10 lakh family floater variant (two adults aged 30-35, one child), the proposed corridor is Rs 12,000 to Rs 18,000 per annum. This prevents the race-to-the-bottom pricing that plagued the original product while ensuring competitive options for consumers.

The pricing corridor approach is modelled on the Singaporean MediShield Life framework, where standardised products compete on service quality and claim experience rather than just price. IRDAI's actuarial team has set the corridor bands using FY24-25 claims experience across all health insurers.

What This Means for Existing Policyholders

If you already hold the original Arogya Sanjeevani policy, the draft proposes a mandatory migration pathway. Insurers must offer existing policyholders the option to upgrade to 2.0 at renewal without fresh underwriting, meaning pre-existing conditions covered under the original policy will continue to be covered under 2.0 without a new waiting period. This is a significant consumer-friendly provision that IRDAI has emphasised in its stakeholder consultation.

For those with other health insurance products, Arogya Sanjeevani 2.0 could serve as an effective base layer in a stacked insurance strategy. You could hold a Rs 10 lakh Arogya Sanjeevani 2.0 as your base policy and layer a Rs 50 lakh or Rs 1 crore super top-up on top of it, getting broad coverage at a competitive total premium.

Industry Response

The General Insurance Council has expressed cautious support, noting that the elimination of room rent limits for higher sum insured options will increase claims costs by an estimated 12-15 per cent, which will be reflected in premiums. However, the trade body acknowledged that higher sums insured and better terms are necessary to keep pace with medical inflation, which IRDAI estimates at 14 per cent per annum in India.

Timeline

The comment period on the exposure draft closes on 31 March 2026. IRDAI expects to issue the final regulation by June 2026, with insurers required to launch Arogya Sanjeevani 2.0 products by 1 October 2026. Use a health insurance premium calculator to model what your current coverage costs versus what the proposed standardised product might offer at different sum insured levels.

Source

IRDAI Exposure Draft IRDAI/HLT/REG/2026/014; stakeholder consultation paper

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This article is an editorial summary based on publicly available information for educational purposes only. It does not constitute financial advice. Always consult a licensed financial advisor before making investment decisions.

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