December 4, 2024

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Check Out The Mandatory Kyc Documents For Health Insurance

KYC could soon become mandatory for health and motor insurance policies;  check details here - BusinessToday

Why Does the IRDAI Need KYC Documents for Health Insurance? 

To safeguard the insurance sector against money laundering operations, the insurance regulator has made KYC papers necessary. It can be used to determine whether a person is genuine and reliable when it comes to providing insurance services. #

List of Health Insurance Client KYC Approved Forms 

The Master Guidelines on Anti-Money Laundering/Counter Financing of Terrorism (AML/CFT), published by the IRDAI, lists the acceptable types of KYC. #

Consider the following methods for conducting a customer’s KYC for health insurance

  • Aadhaar Card-based KYC using an online authentication process
  • Digital KYC as per Prevention of Money Laundering (PML) Rules
  • Aadhaar Card-based KYC using an offline authentication process
  • Officially Valid Documents (OVDs)
  • Consent-based Video Based Identification Process (VBIP) of the customer
  • PAN Card/ Form 60
  • Using KYC Identifier allotted by the CKYCR (Central KYC Registry)

Needed KYC Documents to Purchase/Renew Health Insurance 

The list of KYC documents needed to purchase or renew a health insurance policy is as follows: 

  • Passport with Aadhaar Card 
  • Driving License Voter ID Card 
  • NREGA Employment Card with a state official’s signature 
  • demographic information is included in a letter from the National Population Registry. 
  • After studying the IRDAI KYC Norms for Health Insurance Firms 
  • Any other document made public by the federal government is acceptable. 

All Indian health insurance providers are required to abide by certain KYC guidelines that have been published by the IRDAI. #

Look at these KYC standards below: 

  • Attempts must be made by insurers to determine a customer’s genuine identity. 
  • Use efficient methods to collect the information needed to identify new and existing consumers. 
  • Make sure no senior citizen health insurance policies are obtained with false or anonymous names. 
  • Check the client’s identification, address, and a most recent photo. 
  • Identify the customer and its beneficial owner and take the necessary procedures to satisfy yourself that they are who they say they are if the client is a juridical person. 
  • Using a variety of papers, determine and confirm the juridical person’s legal status. 
  • Verify the identification and authorisation of anyone purporting to operate on behalf of the client. 
  • Customers who want to offer a current address that is different from what is listed on their Aadhar Card should self-declare this. 
  • Check Authenticated Documents of Clients who are Ineligible for Aadhaar Authentication due to Age, Injury, or Illness 
  • Get client data from all available sources, including agents. 
  • Make sure the cost of the customer’s health insurance is not high for their income. 
  • If the insurer is not comfortable with the real identity of the customer or the transaction they made, they should file a Suspicious Transaction Report (STR) with the Financial Intelligence Unit-India (FIU-IND). 

Factors to Consider While Performing Customer KYC for Health Insurance 

  • Do appropriate Client Due Diligence (CDD) for each new customer with the assistance of authentic KYC documents. 
  • Perform periodic CDD with KYC for current customers based on the suitability of previously received data. 
  • Collect the KYC of low-risk customers within two years and other clients within a year if the KYC of current customers is not yet available. 
  • For the purpose of maintaining the functioning of the accounts, get PANs or Form 60s from current clients with an aggregate premium of no more than Rs 50,000. 
  • When additional/following remittances are made, conduct a risk analysis and continuous due diligence of the client. Perform the necessary due diligence before paying claim amounts to policyholders, beneficiaries, or legal heirs. 
  • Ensure that senior management reviews the suggestions of Politically Exposed People (PEPs). 

A health insurance premium calculator is a tool you may use online to determine the amount of coverage required based on your needs.

# Visit the official website of IRDAI for further details. 

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.