Health insurance plans are being made more customer friendly. Insurance regulator IRDA had constituted a committee for this. It has given many suggestions. This is expected to increase the coverage of health insurance.
Shorter waiting period for lifestyle diseases like diabetes
For people who have hypertension, diabetes and heart disease, insurance companies will no longer be able to tell them about the waiting period.
This is the period in which a claim cannot be made for the treatment of the disease. It is kept for one to four years now. However, the committee has suggested a waiting period of 30 days.
Claims will not be rejected after eight renewals The
panel has suggested that if the policy is renewed continuously for eight years, then the claim on the ground of disclosure cannot be questioned, except in case of fraud.
This will eliminate the apprehension of the policy being rejected after paying premiums for years. This has been a major cause of concern for policyholders. However, the policy will be subject to all sub-limits, co-payment clauses and deductibles provided in the policy contract.
ickness cover after policy purchase
If any disease occurs after issuance of the policy then it will have to be covered. This will not cover those diseases (such as infertility and maternity) which are not mentioned in the policy. It states that the policy should not allow exclusion of diseases like Alzheimer’s, Parkinson’s, AIDS/HIV and obesity.
Clear definition of pre-existing diseases The
panel has suggested a simplified definition of pre-existing diseases. This will reduce the scope for controversy.
The suggested definition is: Any condition, illness, or injury that is diagnosed prior to purchase of the policy. For which medical advice or treatment has been taken from the doctor, it is a pre-existing disease.
Instead of canceling the policy on non-disclosure grounds, insurance companies can keep a waiting period for such ailments, says Nikhil Apte, Chief Product Officer, Product Factory (Health Insurance), Royal Sundaram General Insurance.
Coverage to people with serious health conditions
Cancer survivors, epilepsy patients and the disabled are often not given coverage due to their health conditions.
They do not get these covers even though there is no connection with their illness. The panel has now suggested that insurance companies should provide health cover to such individuals. These can be covered with the condition that pre-existing diseases will not be covered for the entire policy tenure.
Advance medical treatment will be covered
The regulator has proposed to constitute a Health Technology Assessment Committee.
This committee will make suggestions on incorporating modern treatment procedures and medicines. Insurance companies will not be able to exclude any process approved by the committee
. Mahaveer Chopra, Director Health, Life and Strategic Initiatives, Coverfox.com, says, “This committee will act like a self-regulatory body. This will enable policyholders to get treatment with advanced methods of medicine without worrying about money.”
