The health insurance regulations have been revised by the IRDAI to benefit policyholders and insureds. These provisions will be included in all new health insurance policies and will be added to current policies upon renewal.
First, there is a three-year maximum waiting period instead of the previous four-year requirement for pre-existing disorders or illnesses. That is, your insurer will only cover hospitalization claims if you have paid at least three premiums (formerly four), for example, if you have diabetes.
Similarly, after 60 months of continuous coverage, insurers will no longer be able to deny claims on the grounds that the insured did not disclose pre-existing conditions, unless there is clear evidence of fraud. That is to say, unless the insurer can demonstrate fraud, your claim will not be denied if you have paid five annual premiums due to misrepresentation or suppression of your health status.
The following are mentioned by Dr. Bhabatosh Mishra (Director of Claims, Underwriting, and Product) at Niva Bupa Health Insurance:
- Policyholders will benefit from the reduction of the waiting period (from four years to three years) and the moratorium term (from 96 months to 60 months).
- Even in this day and age, insurers still provide shorter waiting periods; nevertheless, policyholders are still responsible for researching and identifying these specific plans. Policyholders will find the process easier if a three-year waiting period is mandated.
- A shorter moratorium period will make claims uncontested, such as where they relate to the failure to disclose pre-existing illnesses and problems.
- – Insurers are now permitted to create policies that cater to the needs of several target markets, including women, seniors, and students.
- These specialized goods will better meet the requirements of various age groups and demographics.
To buy a new health insurance policy or port your existing health insurance policy to a better plan, contact The Insurance Advisor.
