The Insurance Regulatory and Development Authority (IRDAI) has taken several decisions in the interest of policyholders. These include all types of insurance including life, health and general.
The new rules related to the new health policy have come into effect from April 1. Earlier, insurance companies were given time till September 30 to implement the new rules on the health policies issued. The insurance company will have to approve the cashless authorization within one hour of receiving the request. The final authorization will have to be approved within three hours of receiving the discharge intimation. Both these rules have been implemented.
Health policy has become expensive due to the new rule
Insurance companies say that due to the new rules, the premium has increased by 10-15 percent. Most companies have increased the premium of health policies this year. Medical inflation of 14-15 percent has also played a role in this. Anand Roy, MD and CEO of Star Health Insurance, said, ” IRDAI has issued a master circular in the interest of customers. In this, an attempt has been made to clarify the situation regarding the coverage and waiting period of the policy. IRDAI is trying to make things easier in the case of health insurance. But, due to this, customers have to pay a little more price.”
Moratorium period is now 5 years instead of 8 years
IRDAI has reduced the moratorium period for claims on health insurance policies from 8 years to 5 years. According to IRDAI’s rule, after the coverage of a health insurance policy continues for 60 months, the insurance company will not be able to question any policy and claim on the basis of non-disclosure, misrepresentation. It will have the right to question the claim only in established cases of fraud.
The company cannot reject the claim except in cases of fraud
This means that if a policyholder’s policy has completed five years, then the insurance company cannot reject the claim on the ground that the policyholder did not disclose his health condition. Non-disclosure has been a major reason for disputes related to insurance companies. If the insurance company rejects the claim on the basis of fraud, then it will have to present proof of it. Shilpa Arora, Chief Operating Officer of Insurance Samadhan, said, “If someone has cancer and does not disclose it while buying a health policy, then it will be considered fraud.” If a policyholder feels that the insurance company has rejected his claim without any reason, then he can complain about it to the Ombudsman Office.
Also Read: Cash Deposit Limit in Saving Account as per Income Tax
If you have not claimed, you will get the option of discount on premium
If the policyholder does not make any claim in a year, insurance companies usually increase the sum insured without any additional premium. Now IRDAI has asked insurance companies to give options to policyholders. This means that policyholders can increase their sum insured or get a discount in the premium at the time of policy renewal. This rule will benefit those policyholders who were facing difficulty in paying the premium due to the increase in the last few years. Since June, many companies have increased their premiums by 10-15 percent.
The customer can cancel the policy at any time
If the policyholder cancels his health insurance policy at any time in the year by giving 7 days’ notice to the insurance company, then the company will have to refund the premium for the remaining period of the year. The insurance regulator has asked insurance companies to offer products covering people of all age groups.
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