JANUARY 21, 2020 BY HEALTHINSURANCEADVISOR
Just two decades ago, our lives bear a close resemblance to the pinball game. Meaning, we were the ball, diseases & sky-rocketing healthcare costs were the holding blocks. Both the factors continuously pushed us and there was no way out until IRDAI stepped in. The Insurance Regulatory & Development Authority of India came as a knight in shining armor and showed us a way out (via health insurance). Its main logic- you will pay a certain premium to the insurance provider & the company will look after your medical expenses. It was a great idea but it was full of flaws. Soon, people started to lose faith in it.
IRDAI realized it and has introduced 10 new health insurance changes in India. All existing health insurance plans have to adapt to them by October 2020 & the new plans launched since October 2019 have to implement them right away. At least from the outside, these changes look positive. So, without wasting any time, let’s highlight these updates.
10 new updates that IRDAI has to offer
- Welcome installments – It is not easy to pay health insurance premiums in one go. It can hamper the monthly budget of a few people. Thankfully, IRDAI has allowed paying premiums in future on an installment basis (monthly, quarterly & half-yearly). But there is one thing to note here. The monthly/quarterly (premiums) free look period will be less as compared to annual premiums.
- Include pre-existing changes – Earlier, if you had a pre-existing disease, the provider won’t include it in the insurance for 4 years. Now, if you get a disease with 3 months of buying insurance, the provider will note it and include it in the policy.
- Eligibility – As per the earlier rules, the minimum age to be a part of the policy was 18 years & the maximum age was 65 years. Now, you can enjoy lifelong renewability with the policy.
- Critical illness is included – If you suffer from psychological/neurodegenerative disorders, mental illness or genetic problems, its treatment will be included in the health insurance. The days of it being a part of the exclusions list are over.
- New exclusions list- Exclusions play an important part in health insurance & IRDAI has updated its new list. Now, if you suffer from 16 diseases such as chronic kidney problems, epilepsy, etc. no health insurance company will be liable to provide you its service.
- Grace period- IRDAI has directed insurance providers to give its customers a few days to pay the premium if they fail to meet the deadline of the policy period. The grace period varies- 30 days for yearly payment mode & 15 days for other payment modes.
- Freelook- As per the new rules, you will get a timeline of 15 days (from the date of policy purchase) to check all the policy’s terms & conditions & cancel it if they are not satisfactory.
- Clear claim process- Many have claimed that insurance providers cite fake reasons to deny the claims. That won’t be possible now. IRDAI has come out with exclusions basis & 18 codes that every provider has to follow to deny the claim. The age of the explicit claim process is finally here.
- Minimum & maximum insured sum- Every health policy has a min-max limit of the insured sum. With the new additions, this limit has been changed to Rs 1 lakh (as minimum limit) & Rs 5 lakh (as maximum limit).
- Waiting period- IRDAI has updated the waiting period for several diseases. There are two timelines- diseases that come under 24 months waiting period (Pilonidal sinus, cysts, etc.) & diseases that come under 48 months waiting period (joint-replacement treatment, if not due to an accident or age).
It is difficult to imagine a life without health insurance. Yes, it had flaws but with the new updates, IRDAI has laid a path of a bright future. Hopefully, people will be able to see it and enjoy its perks. If you still haven’t purchased health insurance or are planning to buy one, make sure to contact us at 7015143936 by WhatsApp.