Home Updates Health Insurance Mandate
📝 DRAFT POLICY Published: Dec 3, 2025 • Public Consultation

Mandatory Health Insurance for All Gig Workers

Major health security boost! Draft Platform Workers (Health & Safety) Rules 2026 proposes mandatory ₹5 lakh health insurance for all active gig workers. 100% accidental injury coverage, maternity benefits, zero waiting period for emergencies.

🏛️ Why Health Insurance for Gig Workers is Critical

Currently, 85% gig workers operate without any health insurance। Accident या illness हो जाए तो income stop, medical bills बढते जाते हैं। Proposed mandate से 2.3 crore workers को instant coverage मिलेगा।

₹5L
Minimum Coverage
100%
Accident Coverage
Zero
Waiting Period

📜 Proposed Coverage Breakdown

🏛️ Base Health Insurance (₹5 Lakh)

  • Hospitalization: ₹5L cashless treatment (network hospitals)
  • Pre-Hospitalization: 30 days before admission covered
  • Post-Hospitalization: 60 days after discharge covered
  • Room Rent: No sub-limits (single AC room allowed)
  • Day-Care Procedures: 100+ treatments (cataract, dialysis, etc.)

🚑 Accidental Injury (100% Coverage)

  • Work-Related Accidents: Unlimited coverage (road accidents during delivery/rides)
  • Permanent Disability: ₹10L lump sum compensation
  • Death Benefit: ₹15L to family/nominee
  • Ambulance Charges: ₹5,000 per emergency
  • Zero Waiting: Accident coverage immediate from day 1

🤰 Maternity Benefits (Optional Add-on)

  • Normal delivery: ₹50,000 | C-section: ₹75,000
  • Pre-natal checkups (8-10 visits) covered
  • Post-natal care (6 weeks) included
  • Waiting period: 9 months (waived for existing workers)

💼 Platform Aggregator Obligations

Who Must Provide Insurance?

✅ Mandatory for platforms with:

  • Annual turnover > ₹20 crore
  • Active workers > 500 (monthly average)
  • Operating in 2+ states

⚠️ Cost Burden: Platform must bear 100% premium cost—cannot deduct from worker earnings।

📅 Coverage Trigger: Worker active for 15+ days in a month becomes eligible automatically।

📊 Cost Estimate per Worker

Base Health (₹5L): ₹3,000-4,000/year

Accidental (₹15L): ₹1,500-2,000/year

Maternity (optional): ₹1,000/year

Total: ₹5,500-7,000/worker/year

🧩 Platform Impact (Example)

Platform: Zomato

Active Partners: 2.5 lakh

Annual Premium: ₹150-175 crore

As % of turnover: ~1.2-1.5%

📝 How to Claim Insurance (Proposed Process)

1

Emergency Hotline

हर platform app में "Health Emergency" button होगा → 24/7 helpline connect होगा → cashless hospitalization arrange होगा।

2

Hospital Admission

Network hospital में cashless treatment → Insurance card (digital + physical) show करें → approval 2-4 hours में।

3

Claim Settlement

Cashless: Hospital directly से settle करेगा (zero paperwork for worker)

Reimbursement: अगर non-network hospital, तो bills submit करें → 15 days में payment

🏛️ Draft Policy: Public Consultation February 2026

Workers can submit feedback on coverage requirements via Labour Ministry portal

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