What is CIS? New Health Insurance Rule in 2025 – A Complete Guide

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.

What Does CIS of a Health Insurance Plan Mean?

A CIS (Customer Information Sheet) is a document that summarizes the essential details of a health insurance policy, allowing policyholders to understand the key features of their coverage. It includes information such as the sum insured, premiums, coverage details, exclusions, and more.

As per the latest announcement by the IRDAI (Insurance Regulatory and Development Authority of India), starting January 1, 2025, the format of the CIS will be revised. This update aims to make health insurance policies easier for policyholders to understand by simplifying complex terminology. The new format will help customers make more informed decisions when purchasing or renewing health insurance policies, ensuring they fully understand their coverage and benefits.

How is the New CIS of Health Insurance Plan Effective from January 2025 Different?

The new Customer Information Sheet (CIS) for health insurance plans, effective from January 2025, brings several changes designed to make it simpler for policyholders to understand their health insurance policies. Here’s how it differs from the previous versions:

1. Simplified Language

The primary change in the new CIS is the use of simpler, easier-to-understand language. The previous CIS was often filled with complex insurance terminology, which could confuse policyholders. The updated version aims to eliminate jargon and use plain language so that all policyholders, regardless of their knowledge of insurance terms, can easily comprehend the details.

2. Clear Breakdown of Benefits

The new CIS will include a clearer breakdown of the benefits offered by the policy. It will be more transparent, showing not only the benefits but also the limitations and exclusions in a way that is easier to read and understand. This will help customers know exactly what is covered and what isn’t.

3. Standardized Format

The new CIS will follow a standardized format across all health insurance providers. This means that no matter which insurer you choose, the key information will be presented in a consistent way, making it easier to compare policies from different providers.

4. Inclusion of Critical Information

The new CIS will now also include additional important information such as:

• Pre-existing disease coverage
• Waiting periods (for certain treatments or conditions)
• Claims process details (how to file a claim, required documents, etc.)
• This ensures that customers are better prepared and aware of all aspects of their policy.

5. Focus on Customer Understanding

The overall goal of the new CIS is to improve customer understanding. By focusing on providing essential information clearly and concisely, the revised CIS aims to make health insurance more accessible to everyone.

6. Enhanced Transparency

With the new format, customers will have more transparent access to terms like exclusions, sub-limits, co-payment clauses, and no-claim bonuses, allowing them to make more informed decisions when purchasing or renewing health insurance.

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.