In order to make health insurance convenient and to benefit several policyholders, insurance companies can no longer exclude illnesses related to artificial life maintenance, hazardous activities at work, age-related degeneration, and treatment in case of mental illness as well as internal congenital diseases. Earlier, these illnesses were not covered by health insurance providers in India.
The Insurance Regulatory and Development Authority of India (IRDAI) stated that illnesses related to age like knee-cap replacement and cataract surgery will also be covered under a health insurance plan. In addition, Parkinson’s and Alzheimer’s will also be included. Considering the health requirements of factory workers, IRDAI also included them in the purview of the policy. All factory workers, who have to work with harmful chemicals that have an impact on health will be covered under health insurance. An insurance company cannot refuse skin ailments or respiratory illnesses that arise due to workplace conditions.
Today, the IRDAI has standardized exclusions. This means that if an insurance company does not wish to cover critical kidney diseases, epilepsy, or HIV/AIDS, it will have to use specific wordings. Moreover, the insurer needs to start the coverage for these diseases after a specific waiting period. The waiting period will range from 30 days to one year.
It is believed that the guidelines will benefit policyholders who are honest in sharing their pre-existing illnesses. All the health insurance products will cover pre existing diseases that are disclosed by policyholders. The coverage will begin after the end of the waiting period of 48 months or a lesser duration, if stated in the policy. The standardization of the regulations will help with the portability of the insurance cover. An insurer cannot set an undue waiting period.
When a policyholder transfers the policy from one company to another and he has completed a part of the waiting period requirement, the new company will be able to impose only the remaining waiting period, which will not exceed 48 months from the issuance of the policy. This means that policyholders can conveniently move from one insurance company to another if they are not satisfied.
Standardizing of words in exclusions across insurers will help avoid any confusion and will provide a clear understanding to the consumers. With evolving medical treatment, insurers will now provide a better cover to the policyholders.
Brokers and Third-party Administrators warn that although the move is in the favor of policyholders, it might have an effect on the premiums. This step is ideal for those who earlier had a difficulty to obtain a cover.
Considering the benefit of tax deduction under section 80D, a large number of people will invest in a health cover. However, the tax benefit should not be the primary purpose behind buying a health insurance plan. The core objective of investing in a health plan should be to remain covered against illnesses and medical emergencies.
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