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​Insurance Regulatory and Development Authority of India passed three new guidelines this June to all the insurers who offer health insurance. These guidelines are to make health insurance more consumer-friendly. IRDAI is the controlling body of health insurances in India and has been passing guidelines to make health insurance better for people. These changes are:

  • ​Important product clauses must be standardised so that consumers can understand the policy in a better way and compare products provided by different insures.  
  • With this pandemic, at the time of physical distancing, ensuring insurance coverage for telemedicine. 
  • The claim deductions are to be more rational and customer friendly. 
  • Insurance companies will be required to either settle or reject a claim within 30 days from the date of receipt.
  • In case the insurer fails to decide on a claim within the stipulated period, it will be required to pay an interest of 2% applicable on the bank dues to the policyholder. 
  • The new rule also states that the insurer cannot reject a genuine claim if the person has completed 8 years of paying the premium. Insurers will also not be allowed to re-evaluate the policies for which the policyholder has been paid. 

  • ​On which insurers will these rules be applicable ​

    The newly implemented guidelines will apply to all the general health insurance companies. There will be no exclusions for any policy or any company. All insurance providers have to follow these mandates. The policies which are not in compliance with new guidelines will be modified. 
    All these new clauses are to be incorporated from 1st October on all the latest products filed by the insurer. Also, it will be implemented on the policies due for renewal on 1st April 2021. It is also necessary to take note that the premium might go up. The coverage of health insurance will become wider, many more illnesses will be covered under a basic plan. Previously there were 30 exclusion categories, now the permanent ailments have come down to 17. The new rules also guide around the inclusion of mental illness, genetic disease and psychological illness. A condition that is mentioned to the person 48 months ago will be categories as pre-existing illness. 
    If you have your insurance with more than one company, you have the option to choose your claim. After the amount from one company has been exhausted, the remaining can be filed from the other company. Also, if you are migrating your policy from one company to other, the older waiting period will be considered. 
    There are further benefits for the policyholder. An insurer is to make sure that proportionate deduction is not done, in the case of hospitals following differential billing. They are also not allowed to apply proportionate deduction for ICU charges. 
    IRDAI is a government body that has been working a lot to promote the buying behaviour of health insurance. One can now buy the best health insurance online in a hassle-free way. Health insurance will keep the person secure from any future mishap which may occur.​