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IRDAI has issued draft regulation on insurance policies in which it has proposed to do away with the maximum entry age to buy a health insurance policy. Currently, individuals can buy a fresh insurance policy till 65-years of age.
In addition, the insurance regulator has asked health insurers to introduce targeted policies for specific segments like senior citizens and millennials.
IRDAI said, “There shall not be any restriction on entry based on age in health insurance covers. Notwithstanding the above, insurers may design products for specific target markets such as senior citizens, students, children and such products shall be subject to regulatory provisions.”
Another important proposal was revision in waiting period of pre-existing conditions. IRDAI has proposed the reduction of pre-existing condition from 48 months to 36 months. The insurance regulator said that all pre-existing should be covered after 36 months irrespective of whether the policyholder has disclosed or undisclosed it. In simple worlds, health insurers cannot reject claim citing pre-existing condition after 36 months.
Here are some key proposals related to health policies:
- Life insurers can launch long term health policies of up to 5 years. However, life insurers cannot launch indemnity-based health policies i.e. policies that compensate for hospital expenses
- Life insurers can only offer benefit-based policies i.e. offering fixed cost on occurrence of a covered disease
- General insurers and standalone health insurers can offer any health policies with a maximum tenure of 3 years. Also, if they opt to offer a 3-year policy, they cannot revise premium amount
- Insurers can offer facility of instalment for payment of premium
- Only general and health insurers can offer travel policies
- Health insurers cannot do medical examination at the time of renewal provided there is no change in sum insured
- In benefit-based policies, policyholders can make multiple claims with different insurers
- Insurers and TPAs will have to address claims and grievances of senior citizen through a dedicated channel