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9 Revised Rules for Health Insurance Policies

The sector of health insurance has witnessed growth over the past few years in India. It is good to know that people have started to understand how important it is to purchase health insurance, as the expenses for medical treatment have risen. To ensure that your family members are covered and well-prepared for unforeseen eventualities, you can go for plans such as family health insurance that meet your needs & provide the required coverage for your loved ones. Policies such as personal accident plan & critical illness cover are also available to cater to more specific requirements.

There have been several changes under health insurance, as the Insurance Regulatory and Development Authority of India (IRDAI) wishes to make health insurance plans more standardized and customer-friendly.

Let’s look into the changes made in health insurance policies:

  • Changes have been made by the regulator to cover the existing health conditions that you may have. The insurance companies have been told by the IRDAI to mention the pre-existing diseases that won’t be covered up to a certain period. The duration, however, must not be more than 4 years.
  • Health plans have a list of exclusions wherein a few health conditions are not covered. Therefore, the IRDAI has asked insurance providers to remove various critical illnesses like genetic diseases, psychological disorders, mental problems, neurodevelopment disorders, etc. from the exclusions list of health insurance policies.
  • The premiums of health insurance companies caused as a result of modifications can be increased or decreased by 15%, considering the loss-ratio numbers for the last three financial years.
  • While selling a policy, the health insurance companies must provide you with a list of TPAs. As a buyer, you can choose a TPA of your choice. However, you can change the TPA only during renewal. Also, the number of TPAs might be limited by the insurer, based on your geographical location, as well as the health insurance product.
  • The services for customers have been improvised as the insurance companies have now adopted cutting edge technology and will get momentum in 2020.
  • As per the IRDAI, you can pay health insurance premiums in installments. You can now pay the premium amount on a monthly, quarterly or even half-yearly basis. The free-look period for the monthly and quarterly premiums, however, will be lower than the amount you get while paying the annual premiums.
  • The insurers are allowed to increase the limit of maximum age required to file an insurance policy. Usually, the limit is up to 65 years of age. According to the IRDAI, the insurance provider will need to inform the regulator about the change based on certification.
  • As per the IRDAI, the change of premium rates that increase must only be after the expiry of three years from the launch date of the modified or approved individual product.
  • The health insurance companies can introduce additional channels of distribution for specific products, without waiting for approval from the regulator. Small modifications can also be made in approved individual insurance products, based on certification.

The above-mentioned guidelines laid down by the IRDAI are aiming towards a decrease in frauds and to increase the level of satisfaction among the policyholders. This way, people who wish to seek insurance will understand the various clauses of the policy and can purchase a suitable health plan. To get an estimate of the premium payable, you can also make use of the health insurance premium calculator.

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