The pandemic has truly changed our life’s worth. Today we are extremely careful about things we would seldom care about before. Take, for example, health insurance. Everyone’s running for cover. Hospital bills are running into lakhs of rupees. Social media like Twitter, Facebook, and others are flooded with complaints on claim rejection, non-payment, and reimbursement settlement delays. In fact, many were left with a deep hole in their pockets, settling a major chunk of their bills in cash as hospitals chose to charge patients even for doctors’ safety gear. These were not covered under health insurance.
Policyholders were often left wondering about the fate of their claims. While some policies covered one set of illnesses, others covered a diverse group of diseases, with different premiums and clauses. It was a nightmare. However, a quick intervention from the regulator has paved the way for a better standardized health insurance order.
The Insurance Regulatory Development Authority of India (IRDAI) has mandated that all general and health insurers offer standard individual health insurance products. This was implemented from October 1. 2020. For customers, it means insurance cover for more illnesses and procedures. Now pre-existing diseases include any health condition that has been diagnosed 48 months before the issuance of the health policy and a medical condition that develops within three months of policy issuance. Also, stress, mental illness, telemedicine, high tech surgeries are now covered under health insurance.
While buying insurance products has become less complicated, it has spiked up the cost of the premium, making the policy costly.
IRDAI prepared an exposure draft on “Guidelines on Standardisation of General Clauses in Health Insurance Policy Contracts” in January 2020.
The idea is to allow buyers to pick and choose without going through the tedious process of comparing products and clauses. In other words, health insurance policies have been made more inclusive and less complicated.
Commenting on the development, Surendra Bagri, Promoter of Axiom Insurance Brokers, says, “Standardisation of health insurance rules by IRDAI is a very welcome and landmark move. It will be easier to compare products, widen coverage and remove ambiguities.”
Bagri’s firm, an insurance broking house, advises individuals on buying the right insurance policies. It facilitates them on renewing policies and, if necessary, switch to the best available product.
New Diseases Covered
As per the new guidelines, insurance companies can no longer exclude diseases like HIV, mental illness, stress, and psychological disorders. Illness contracted through hazardous activities, treatments for age-related conditions, internal congenital disorders, and genetic disease will be covered as well.
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