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IRDAI Directs Insurers to Cover Surrogacy Expenses
Nov 13, 2023

Maternity Health Insurance Might Soon Cover Surrogacy Expenses As Per IRDAI Directions

In the last few years, surrogacy has become a preferable option for individuals who are not able to conceive on their own. By opting for surrogacy, a couple can fulfil their dream of having children via a surrogate mother and advanced medical technology. Surrogacy can be a life-altering process for the couple and the surrogate mother. Thus, it is essential that the concerned parties get adequate financial support during the process. This can be made possible via suitable health insurance products. As a welcome development, the IRDAI (Insurance Regulatory and Development Authority of India) has directed insurers to provide health insurance products that cover surrogacy expenses for individuals unable to conceive due to medical conditions. Let’s learn more about these directions below.

Insurance Companies to Provide Health Insurance with Surrogacy Coverage

The IRDAI has directed all insurance companies to comply with two Acts in this regard: the Surrogacy Act, 2012, and the ART (Assisted Reproductive Technology) Act, 2021. The following points provide an overview of the circular: [1]
  1. As per the IRDAI, insurers are to comply with the provisions in Section 4(iii)a(III) of the Surrogacy (Regulation) Act, 2021, which states that insurance coverage of such amount and in such a manner be provided to the surrogate mother; the coverage to be for a period of thirty-six months covering post-partum delivery complications and purchased from an IRDAI-recognised agent or insurance company.
  2. The IRDAI circular also mentions Section 22(1)(b) of the ART Act, 2021, which states that insurance coverage of such amount shall be provided for a period of twelve months for the oocyte donor by the commissioning couple or woman from an IRDAI-recognised insurance company or agent.
  3. The IRDAI circular also goes to mention Rule 12 of the ART (Regulation) Rules, 2022 which states that the general health insurance coverage for the oocyte donor purchased by the intending couple or woman should be enough to cover all expenses for all complications arising due to oocyte retrieval.
  4. The IRDAI has urged all insurers to provide suitable health insurance products that meet the provisions mentioned in the two Acts with immediate effect.
Whether a couple is having a baby themselves or is opting for a surrogate mother, having health insurance with maternity benefits can be a boon in multiple ways. Let’s understand how.

Benefits of Comprehensive Maternity Insurance 

By opting for health insurance with maternity benefits, one can enjoy the following benefits:

- Financial security for a stress-free pregnancy

When one is pregnant, the last thing they should have to deal with is stress. After all, it is not only the woman but also the foetus that can be affected by any kind of stress. However, if a medical emergency occurs leading to heavy expenses, the expectant mother will have to deal with financial stress. This can be avoided with maternity insurance coverage that deals with pregnancy complications. By taking care of such expenses, maternity insurance can allow the mother to recover and heal without financial worries. * Claims are subject to terms and conditions set forth under health insurance policy.

- Coverage for pre- and post-natal expenses

There are multiple tests and check-ups one must go through not just before the delivery but also after it.  These are important to determine the health of the mother and the baby. If you opt for health insurance with maternity benefits, you might get coverage for pre-natal and post-natal expenses (depending on the kind of plan chosen). * The list of tests and check-ups covered may differ according to the insurer and the plan chosen. Claims are subject to terms and conditions set forth under health insurance policy.

- Delivery coverage

Depending on the kind of maternity plan you choose, you might get coverage for delivery expenses as well. This can allow you to opt for high-quality medical care and the top healthcare professionals, so that the expectant mother has a smooth, hassle-free delivery. Delivery coverage may have sub-limits, depending on whether the delivery has been carried out normally or via the Caesarean way.  * Claims are subject to terms and conditions set forth under health insurance policy.

- Peace of mind

One of the most significant benefits of health insurance that is often overlooked is peace of mind. Whether the couple is buying maternity health insurance for themselves or a surrogate mother, they can rest assured that the expectant mother will be taken care of during and after their pregnancy. This allows the couple to take their minds off any financial concerns and focus on the physical and emotional well-being of the mother. They can have a deeper peace of mind, knowing that expenses for various situations have already been taken care of. * Going through pregnancy and childbirth can be life-changing experiences. They can mean the start of a new journey. Hence, it is important to ensure that one is financially prepared for such a journey, whether they are conceiving themselves or opting for surrogacy. Hence, with maternity insurance and IRDAI directions on coverage for surrogates, one can have a happy and safe beginning to parenthood. [1] https://irdai.gov.in/document-detail?documentId=3388684 * Standard T&C apply. 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.

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