🔊 New Health Insurance Guidelines by IRDAI in 2024 🔊
The Insurance Regulatory and Development Authority of India (IRDAI) has introduced new health insurance regulations effective April 1, 2024. Here are the key changes:
1. Health Insurance for All Ages
Insurers must offer health plans without an entry age limit, benefiting all age groups, especially senior citizens.
2. Reduced PED Waiting Period
The waiting period for pre-existing diseases is now capped at 3 years, down from 4 years. Insurers cannot reject PED claims after this period.
3. Shorter Specific Disease Waiting Period
The waiting period for specific diseases or procedures, such as joint replacements, is also reduced to 3 years.
4. Policies for Severe Medical Conditions
Insurers can no longer deny coverage to individuals with severe pre-existing conditions like heart disease, cancer, renal failure, or AIDS.
5. No Sub-Limits on AYUSH Treatments
AYUSH treatments (Ayurveda, Yoga, Naturopathy, Siddha, Unani, and Homeopathy) can be claimed up to the sum insured without sub-limits.
6. Customized Plans for Specialized Groups
Insurers are encouraged to create tailored health plans for senior citizens, children, maternity, students, and other specialized groups.
7. Dedicated Support for Senior Citizens
Insurers must establish specialized channels for handling claims and complaints from senior citizens.
8. Reduced Moratorium Period
The moratorium period for non-disclosure of pre-existing diseases is reduced from 8 years to 5 years, after which claims cannot be denied unless fraud is involved.
9. Benefit-based Policies Only
Insurers are now required to offer only benefit-based policies, ensuring fixed payouts for covered diseases, eliminating indemnity-based policies.
10. Multiple Claims Allowed
Policyholders with benefit-based policies can file claims with multiple insurers, offering greater flexibility and options.
Summary
IRDAI’s new guidelines aim to make health insurance more inclusive, reliable, and accessible. These changes are expected to boost consumer confidence and increase insurance penetration in India.
For more details, read the full article on Business Standard.
