Arogya Sanjeevani
Arogya Sanjeevani is a standardised health insurance policy mandated by IRDAI effective April 1, 2020, requiring all general and health insurers to offer a uniform basic indemnity health product to eliminate feature complexity and facilitate genuine consumer comparison.
The Indian health insurance market, while growing rapidly, was characterised by product proliferation: hundreds of policies with widely varying definitions of 'hospitalisation', different co-payment structures, divergent exclusion lists, and non-comparable waiting period rules. A consumer comparing five health policies faced five essentially different product architectures, making informed choice extremely difficult. IRDAI's health insurance standardisation initiative resulted in Arogya Sanjeevani, named after the life-restoring herb in Hindu mythology.
Key standardised features of Arogya Sanjeevani: sum insured options from Rs 1 lakh to Rs 5 lakh (later expanded to Rs 10 lakh); individual and floater basis both permitted; 5% co-payment on all claims (irrespective of age or hospital tier); standard waiting period of 30 days for all illnesses except accidents, 2 years for specified pre-existing conditions, and 4 years for pre-existing diseases at entry; and a uniform list of covered procedures including AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy) treatments.
Coverage mandated under all Arogya Sanjeevani policies: in-patient hospitalisation, cataract treatment, modern treatments (such as robotic surgery, stem cell therapy up to defined limits), and day-care procedures. Room rent is limited to 2% of sum insured per day, capped at Rs 5,000 — a specific provision addressing the long-standing problem of room rent sub-limits that left policyholders exposed to large out-of-pocket costs in premium hospitals.
Exclusions were also standardised: cosmetic surgery, external congenital anomalies, experimental treatments, and outpatient (OPD) expenses are universally excluded, removing the asymmetry where some products covered fringe items while omitting more material risks.
The product was released just before the COVID-19 pandemic, which serendipitously drove mass awareness of health insurance gaps. Arogya Sanjeevani became the entry-level product that many first-time buyers considered. Insurers initially reported low margins on the product due to regulated co-payment structures, but volume growth partially compensated. IRDAI's design philosophy — use standardisation to expand the insurable population at the base, then compete on value-added features in proprietary products above the standard tier — mirrored the approach used in other standardised financial products globally.