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​In June 2020, IRDAI or The Insurance Regulatory and Development Authority of India proposed a set of guidelines to make changes in the health policy. these guidelines were issued because of the current scenario we are living in. Due to the COVID-19 pandemic, IRDAI issued three new guidelines to health insurance plan providing company in India. The main aim of these changes in guidelines is to make health plans more consumer friendly. Given below are the three guidelines issued by IRDAI:

Standardization Of Policy Terms

One of the first guidelines issued by IRDAI was to standardize the health insurance terms and conditions. IRDAI wants insurers to make policy terms and clauses in a way that makes it easier for customers to understand and compare health plans from various health plan providing companies. According to IRDAI, these standardized clauses will be incorporated in health plans from October 1, 2020. If you already own a health plan, then you don’t have to worry as this guideline will be incorporated into your plan at the time of renewal, i.e., from April 1, 2021. The main aim of this guideline is to make the customer more informed regarding the health policy. These standard terms and clauses consist of several essential things like: 

  • Things that an insured need to disclose at the time of policy issuance
  • Terms and conditions that an insured need to follow at the time of making a claim and settlement of the claim 
  • Information on the policy cancellation, porting, migration, etc
  • Terms of renewing a policy 

  • These standardizations will simplify what the insurance product is offering and make it easier for customers as they can understand the terms and conditions of the plan in a better way. 

    Gives Coverage For The Telemedicine

    We are living in an unfortunate time, where the world is facing the COVID-19 pandemic. This disease spreads from person to person contact. That is why people are maintaining physical distancing from people. In such a case, a person who needs medicine is not going to the shop but is ordering medicine online. Medical Council of India issued guidelines in March 2020 that depicts that Registered Medical Practitioners can provide healthcare using telemedicine. In the guideline issued by IRDAI have advised the health insurance policy providing companies to allow claim settlement for telemedicine consultation. It should be mentioned in the terms and conditions of the policy. 

    More Customer Friendly Claim Deductions

    This last guideline issued by IRDAI is regarding the norms on proportionate deductions in claims. In this guideline, IRDAI has advised policy providers to clearly define associated medical expenses in the policy contract. In that contract, things like costs of pharmacy and consumables, diagnostics, implants, and medical devices, should also be considered in this category. 

    The guidelines mentioned above will be applied to the new health insurance​ plan from October 1, 2020. So, if you are planning to buy health insurance online after October 1, 2020, you can get benefit from these guidelines. However, if you have already bought a health plan​, you can get these modifications in your plan at the time of renewal, i.e., from April 1, 2021.