Health Insurance Policy Enhancement

Health Insurance Policy Enhancements

Health Insurers are busy intimating policyholders revised policy guidelines and enhanced premium during renewal. IRDA in series of notifications had issued guidelines to health insurers on standardising general term & clauses. Insurers now have to follow suit and are busy revamping products.

Revised policies which come into effect from 1st October 2020, will have few benefits to policyholders—

  • More Illnesses covered: Apart from COVID, insurers will now have to settle claims related to mental illnesses, genetic diseases, neuro disorders, oral chemotherapy among others.
  • Telemedicine is now part of health cover.
  • Claims will have to be settled within 30 days, those which need investigations within 45 days. Failure to adhere to the stipulated period will attract interest @2% over Bank Rate.
  • In case of multiple health policies, the insured now has the right to choose the particular policy to claim from. In case the claim amount exceeds a single policy, the insured retains the right to choose the other policy for balance claim.
  • Renewal of policy cannot be refused particularly on grounds of previous claims. However the insurer is not duty bound to intimate renewal.
  • After eight continuous years of policy period no claim can be refused by insurer except in cases of fraud or exclusions as mentioned in the policy.

The guidelines apply to all Health Insurer and premium is likely to be revised.