As per IRDAI, the mentioned diseases or treatment (except those caused due to accident) during the period up to 36 months from the inception of the health insurance policy are not covered.
A major change has been made in health insurance. Under this, policyholders will no longer have to wait more than 36 months for treatment of chronic diseases. Earlier the waiting period for treatment of these diseases was 48 months. The new rule is effective from April 1, 2024.
The Insurance Regulatory and Development Authority (IRDAI) said in a recent notification that any pre-existing disease (PED) is to be examined by a physician 36 months prior to the date of commencement of the policy issued by the health insurance company or as per medical advice or If treatment is recommended, the waiting period in such cases will not exceed 36 months.
As per IRDAI, the mentioned diseases or treatment (except those caused due to accident) during the period up to 36 months from the inception of the health insurance policy are not covered. These diseases/treatments will be covered on completion of the term, provided the policy has been renewed continuously without any interruption.
Insurance company will have to give information about chronic diseases
IRDAI has clearly stated that while purchasing the policy, buyers will have to give complete information about chronic diseases to the insurance company. On this basis, the insurance company can try to reduce the waiting period and specific waiting period for pre-existing diseases in health insurance products. However, this rule will not apply to foreign travel policies.
Companies should introduce easy products
The regulator has said that insurance companies need to offer simple and easy to understand products which the policyholder can understand. There should be transparency and clarity in their wording, coverage and conditions. The interests of policyholders should be protected. All risks associated with the products should be appropriately considered in pricing.
Premium rates should be reasonable
IRDA said that the premium rates should be reasonable. Not be unfairly discriminatory and give fair value to insured premiums. Have the ability to take all risks. Any products that may be recalled if necessary.
