IRDAI is constantly trying to simplify the rules of life, health and general insurance. The new rules of the insurance regulator will come into effect from October 1 on health policies issued before April 1. This will greatly benefit health policy customers
Insurance Regulatory and Development Authority (IRDAI) has taken many decisions in the interest of policyholders. These include all types of insurance such as life, health and general. New rules related to new health policies have come into effect from April 1. Earlier, insurance companies were given time till September 30 to implement new rules on health policies issued. Insurance companies will have to approve cashless authorization within one hour of receiving the request. Final authorization will have to be approved within three hours of receiving the discharge intimation. Both these rules have been implemented.
Health policy has become expensive due to new rules
Insurance companies say that due to the new rules, the premium has increased by 10-15 percent. Most companies have increased the premium of health policies this year. Medical inflation of 14-15 percent is also a factor in this. Anand Roy, MD and CEO of Star Health Insurance, said, “IRDAI has issued a master circular in the interest of customers. In this, an attempt has been made to clarify the situation regarding the coverage and waiting period of the policy. IRDAI is trying to make things easier in the case of health insurance. But, due to this, customers have to pay a little higher price.”
Moratorium period is now 5 years instead of 8 years
IRDAI has reduced the moratorium period for claims on health insurance policy from 8 years to 5 years. According to the rules of IRDAI, after the coverage of the health insurance policy continues for 60 months, the insurance company will not be able to question any policy and claim on the basis of non-disclosure, misrepresentation. It will have the right to ask questions about the claim only in established cases of fraud.
The company cannot reject the claim except in cases of fraud
This means that if a policyholder’s policy has completed five years, then the insurance company cannot reject the claim on the ground that the policyholder did not disclose his health condition. Non-disclosure has been a major reason for disputes related to the insurance company. If the insurance company rejects the claim on the basis of fraud, then it will have to present proof of it. Shilpa Arora, Chief Operating Officer of Insurance Samadhan, said, “If someone has cancer and does not disclose it while buying a health policy, it will be considered a fraud.” If a policyholder feels that the insurance company has rejected his claim without any reason, he can complain about it to the Ombudsman Office.
If claim is not taken, there will be an option of discount on premium
If the policyholder does not make any claim in a year, then insurance companies usually increase the sum insured without any additional premium. Now IRDAI has asked insurance companies to give options to policyholders. This means that policyholders can increase their sum insured or get a discount on the premium at the time of policy renewal. This rule will benefit those policyholders who were facing difficulty in paying the premium due to the increase in the last few years. Since June, many companies have increased their premiums by 10-15 percent.
The customer can cancel the policy at any time
If the policyholder cancels his health insurance policy at any time in the year by giving a 7-day notice to the insurance company, then the company will have to return the premium for the remaining period of the year. The insurance regulator has asked insurance companies to offer products covering people of all age groups.
