IRDA has come up with draft regulations with respect to Health Insurance
on 30th May,2012. These regulations will be effective from the date of
their publication in the Official Gazette by the Central Government. Few
important points to noted are:
1) Entry Age: All Health insurance policies should provide maximum entry age at least up to 65years.
2) Exit Age: All health insurance policies shall not have an exit age for renewal of the policies, once the proposal is accepted, provided policy is continuously renewed without break.
3) Travel Insurance: Travel Medical insurance can be taken as an add-on cover to existing health policy as and when existing policyholder travels by charging suitable premium for the add-on cover.
4) Cost of pre-insurance health check up: In case of non-life insurers, where the proposal is accepted and subsequently resulted into a policy, in all such cases, insurers shall reimburse at least 50% of the cost if any, incurred by the insured in pre-insurance medical examination.
5) Senior Citizens: All health insurers and TPAs, shall establish a separate channel to address the health insurance related claims and grievances of senior citizens.
6) Multiple Policies: Contribution clause may not apply in case two or more policies are taken by an insured during a period from one or more insurers, the policyholder shall have an option to chose insurer with whom the claim to be settled.
7) Ayush/Ayurvedic treatment: Insurers may provide coverage to non-allopathic treatments provided the treatment has been undergone in a government hospital or in any institute recognized by government.
8) Claim Settlement: Claim must be settled within 30 days.
1) Entry Age: All Health insurance policies should provide maximum entry age at least up to 65years.
2) Exit Age: All health insurance policies shall not have an exit age for renewal of the policies, once the proposal is accepted, provided policy is continuously renewed without break.
3) Travel Insurance: Travel Medical insurance can be taken as an add-on cover to existing health policy as and when existing policyholder travels by charging suitable premium for the add-on cover.
4) Cost of pre-insurance health check up: In case of non-life insurers, where the proposal is accepted and subsequently resulted into a policy, in all such cases, insurers shall reimburse at least 50% of the cost if any, incurred by the insured in pre-insurance medical examination.
5) Senior Citizens: All health insurers and TPAs, shall establish a separate channel to address the health insurance related claims and grievances of senior citizens.
6) Multiple Policies: Contribution clause may not apply in case two or more policies are taken by an insured during a period from one or more insurers, the policyholder shall have an option to chose insurer with whom the claim to be settled.
7) Ayush/Ayurvedic treatment: Insurers may provide coverage to non-allopathic treatments provided the treatment has been undergone in a government hospital or in any institute recognized by government.
8) Claim Settlement: Claim must be settled within 30 days.
