In a move that will benefit lakhs of policyholders, insurance companies have been prohibited from eliminating illness connected with hazardous work activity, artificial life maintenance, treatment of mental illness, age-related degeneration & internal congenital diseases.
On Monday, the insurance regulator said that age-related ailments such as cataract surgery, knee-cap replacements, Alzheimer’s & Parkinson’s would also have to be covered. Also, factory workers, working with dangerous chemicals, which impact health over a long-term duration, can't be denied respiratory or skin ailments that arise as a result of workplace conditions.
The Insurance Regulatory & Development Authority (IRDAI) has also standardised exclusions—which means if an insurer does not want to cover epilepsy, chronic kidney diseases & HIV/AIDS—there are specific wordings to be used & a specific waiting period (30 days-1 year) after which coverage would start.
Standardisation of health norms to help portability
These guidelines will hugely benefit policyholders, who reveal pre-existing conditions, as Insurance Regulatory & Development Authority (IRDAI) has said, “Every health insurance product shall cover all pre-existing diseases disclosed by the persons to be insured immediately after the expiry of the 48 months waiting period or such lower period as stipulated in the product.”
Standardisation of health regulations will also help portability as the new insurer cant set undue waiting periods. IRDAI has said, “If a person transfers from one insurer to the other — & has already completed in part some of the waiting period requirement — then the new insurer may impose only the unexpired/residual waiting period not exceeding 48 months from the date of first issuance of porting out policy.”
According to Gurdeep Singh Batra, head (retail underwriting), Bajaj Allianz General Insurance, “Standardising of wordings of exclusions across all insurers will avoid any grey area & provide better understanding to customers. In line with medical treatments evolving & new methods coming up, insurers will be able to cover policyholders against them".
But TPAs & brokers warn that while the move is pro-policyholders, it remains to be seen how it will affect pricing.
Rahul Agarwal, founder, Ideal Insurance Brokers said, “This is definitely great news for millions of people who, till now, found it difficult to obtain a cover. However, a word of caution as it might lead to a drastic increase in the premiums if insurers faced rising claims".
In Novr 2018, a report was submitted by a working committee to the IRDAI that insurance companies can't eliminate diseases like Alzheimer’s, Parkinson’s, HIV/AIDS & morbid obesity. This move by the IRDAI follows the recommendations of the working group.
Source Link
Picture Source :
