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Latest Health Insurance News

Health insurance on the rise as insurers worry about COVID-19 comeback

As per a new report, many insurance providers are raising their health insurance premiums in anticipation of rising COVID-19 cases in the future. According to the report, there has been a 10-15% increase in premium rates for new insurance plans as well as for the renewal of existing plans. The report mentions that another reason behind the rise in these rates is the increased amount of health insurance claims paid out during the last two years of the pandemic as well as an increase in the cost of healthcare services.

- April 16, 2022

IRDAI: COVID-19 specific health plans to be available till Sept 30, 2022

On March 28, 2022, the Insurance Regulatory and Development Authority shared that COVID-19 specific health plans, namely Corona Rakshak and Corona Kavach, will be available for purchase till September 30, 2022. General insurance companies and standalone health insurance providers will be extending the purchase and renewal timeline of these policies till the specified date. Introduced in June 2020, the COVID-19 specific plans were supposed to be sold till March 2021. However, the timeline was extended to September 30, 2021, due to the second wave of COVID-19.    

- April 4, 2022

Health claims jumped by over 250% in 2021, non-metros report 17% more claims than metros: Study

As per a new health insurance study released by a private health insurance company, there was a surge in overall health insurance claims in the year 2021. As per the study, around 257% higher insurance claims were reported in 2021, compared to that in 2020. The study mentions that the main reason behind this increase in claims was due to the second wave of COVID-19 pandemic, in which the Delta variant infections caused lakhs of hospitalisations. On the other hand, in 2020, the number of claims from the metro and non-metro areas remained relatively the same, with the non-metro areas reporting 17% more claims in 2021. A health insurance official commented that this signified an increased awareness about health insurance among non-metro regions. 

-  March 23, 2022 

Health insurers to do away with ‘cooling-off period’ introduced during COVID-19

Many health insurance companies are considering the removal or reduction of the ‘cooling-off period’ in health plans introduced during the pandemic. Individuals infected with COVID-19 could not apply for health insurance during this cooling-off period set by insurers. But now, some insurance companies have started to do away with the cooling-off period or have reduced it significantly. This move shall help COVID-19 survivors and other consumers seeking health insurance to opt for coverage more easily!

- Mar 19, 2022

IRDAI: Health insurers must clear underwriting philosophy for transgender persons

On March 8, 2022, the IRDAI asked health insurers to publish the underwriting philosophy and approach adopted while offering coverage to transgender people. This information shall help the applicants to have complete knowledge regarding the process used by health insurance companies. Furthermore, publishing the underwriting approach shall ensure clarity and transparency, making it easier for the community to access this information while availing health coverage. Insurance firms will now need to throw light on the evaluation of the overall health insurance proposals and the calculation of premiums in the case of transgender applicants.

- March 11, 2022

Survey: Health insurance claims by women are 31% lower in comparison to men 

As per the findings of a new survey, the average amount of health insurance claims made by women is 31% lower than the average amount of claims made by men. The survey also reported that although the ratio of insurance claims is different, the average length of hospital stay is the same for men and women. The survey also found that per day hospitalisation expenses for women are lower than those of men. Moreover, the percentage of medical issues related to maternity, genitourinary system and eye-related diseases were the highest in terms of health insurance claims made by women.

- March 8, 2022 

FSSAI to implement front-of-pack labelling rules for packaged foods as per new HSR system

The Food Safety and Standards Authority of India (FSSAI) has announced that it will implement new front-of-pack labelling rules for packaged food products. These rules will be based on a new Health Star Rating (HSR) system. FSSAI CEO Arun Singhal said that they will provide ratings for packaged food products based on the product’s nutritional information per 100mg. The FSSAI licencing application portal will have a new module to generate HSR certificates. The front-of-pack labelling system is expected to come into implementation on a voluntary basis in 2023, along with a 4-year grace period for manufacturers of packaged foods and beverages to implement this before it is made mandatory.

 

- Mar 7, 2022

Government-backed Yeshasvini Health Insurance Scheme to be re-introduced

Yeshasvini Health Insurance Scheme, a plan for the health of farmers in Karnataka, is back with a financial allocation of ₹300 crore. The re-introduced scheme can seem slightly different since the government has modified the scheme with a vision to make quality medical facilities accessible to farming families. This scheme offers a myriad of benefits to the people falling under the bracket of the low and middle-income group, making it a popular government-initiated scheme in Karnataka.

- Mar 4, 2022

COVID-19 causes 25% increase in global prevalence of anxiety and depression, says WHO

As per a brief released by the World Health Organisation (WHO) on March 2, 2022, the COVID-19 pandemic had led to a 25% increase in the prevalence of anxiety and depression across the globe in the first year. The scientific brief shows that the pandemic had affected young people’s mental health. It also suggests that as compared to men, women’s mental health has been impacted more severely. Dr Tedros Adhanom Ghebreyesus, the Director-General of the WHO, said that this is a major concern and is a wake-up call for countries to pay attention to their citizens’ mental health.

- Mar 2, 2022

COVID-19 related claims for health insurance see decline in third wave

COVID-19 related health insurance claims have remained on the lower side in the third wave of the pandemic. The average claim size and duration of stay in MediAssist Healthcare Services for COVID-19 related hospitalisation is ₹93,000 and six days, respectively, in January 2022 as compared to ₹1.27 lakh and 8.9 days in May 2021. With less severe infections and lower hospitalisation rates, the third wave of pandemic has not seen a significant rise in health insurance claims in the general insurance sector. On the contrary, the number of claims was much higher at the peak of the second wave. Currently, the COVID-19 related claims for the insurer are just at 8% of the claims it received in the second wave of the pandemic.

-  February 12, 2022 

Health scheme beneficiaries shall now get direct financial assistance

Beneficiaries of several schemes launched under the National Health Mission shall receive aid directly. With the National Health Mission, Gujarat gets annual assistance of ₹4,000 crore from the Centre to implement multiple health schemes like Ayushman Bharat Health Infrastructure Mission and Emergency COVID Response Package, as well as the 15th Finance Commission. The state Government has launched the electronic fund flow application-2 to ensure that financial aid is directly remitted to the beneficiary’s bank account within a week (currently, it takes 4-5 weeks).

-  February 11, 2022

Health providers suggest favourable policy in Budget 2022 to encourage insurance purchase

With the upcoming Budget 2022, many health insurance providers are suggesting the government introduce a favourable policy. Due to the medical emergency caused by COVID-19, insurers are hoping that Indians opt for health insurance to secure their medical needs. The speech by FM Nirmala Sitharaman can help stress the importance of insurance during Budget 2022 and encourage Indians, said the executive director of a hospital. 

- January 30, 2022

Tamil Nadu: More than 11 lakh health insurance cards frozen under CMCHIS

Many government employees and pensioners found their health cards frozen under the CM Comprehensive Health Insurance Scheme (CMCHIS) while seeking medical care. As many beneficiaries were registered under more than one scheme, the government was incurring additional costs for the same policyholder. Through verification, the TN e-governance agency removed over 11 lakh members from CMCHIS due to duplication, invalid ration card numbers or registration under more than one government insurance scheme.

- January 29, 2022

Health insurers insist on reduction in GST for health plans

Numerous health insurers are insisting on a reduction in the Goods and Services Tax (GST) on health plans to offer coverage to more people. Since the pandemic started, the health insurance sector has seen increased growth. To make insurance more affordable and get people to opt for it, a cut in the GST can be helpful, said a health insurance company. Another insurance expert shared that health insurance should be viewed as an essential commodity and thus, should be protected during such a time.

- January 24, 2022  

IRDAI: Health insurers cannot reject COVID-19 claims for antibody cocktail therapy

The IRDAI has asked health insurance companies to avoid denying COVID-19 claims associated with antibody cocktail therapy. Due to the rise in COVID-19 cases and the omicron variant, patients are being treated with the antibody cocktail therapy as certain medicines aren’t available. Thus, the IRDAI has instructed the insurers to assess the claims that were denied before and pay the policyholders according to the policy terms. Previously, many such health claims were denied or certain deductions were made on the basis that such therapies were experimental.

- January 11, 2022

Health insurance with COVID-19 cover to include Omicron-related expenses 

On January 3, 2022, the IRDAI said that health insurance with COVID-19 cover will also include the treatment expenses resulting from Omicron infection. Furthermore, the IRDAI has also asked insurance providers to ensure seamless cashless facilities and speedy medical services to policyholders due to growing omicron cases. “Hospitals are also requested to honour the service level agreements (SLA) entered with insurance companies for the purpose of providing cashless treatment to health insurance policyholders”, stated the IRDAI.

- January 3, 2022 

Health insurance sector bound to grow in 2022

The health sector saw a growth of 34.2% in YTD (year-to-date) July 2022, though most sectors were hit due to the nationwide lockdown during the pandemic. However, the growth reported in YTD July FY21 was only 9.9% in comparison. Such numbers have shown how the health insurance sector is going to continue to grow in the year 2022. The ongoing pandemic witnessed worldwide is another major reason that has changed the perception of health insurance for many individuals. Moreover, the rising cost of hospitalisation has greatly stressed on the need for buying health plans as well.

-  January 2, 2022 

Kerala: KPSTA urges government to address concerns regarding medical scheme

The Kerala Pradesh School Teachers’ Association (KPSTA) of Ernakulam district has urged the Kerala Government to address certain concerns about the medical scheme, MEDISEP. Earlier in December 2021, the Kerala Government had approved the medical insurance scheme launched for state employees and pensioners. However, KPSTA raised some concerns related to the MEDISEP scheme (Medical Insurance for State Employees and Pensioners). Lack of sufficient empanelled hospitals, OP reimbursement condition and the issue of having to visit different hospitals for various ailments, were some things the KPSTA district leadership mentioned on December 28, 2021.

-  December 28, 2021

Government gears up for COVID-19 wave by increasing oxygen production

To be prepared for the COVID-19 wave, the government has scaled up the production of oxygen to 18,836 metric tonnes (MT). Although the demand for medical oxygen has fallen from 400 MT per day during the second wave to currently 70 MT per day, the government wants to be ready for any COVID-19 related emergencies. The pandemic, which has affected everyone worldwide, has proven the uncertainty of life and the effects of being unprepared for any medical urgencies. Furthermore, the novel virus has also changed the perception of many individuals towards health insurance. Thus, insuring yourself and your dependents with the right health plan has become crucial during such uncertain times!

- December 27, 2021

Uttarakhand: High Court Stops Mandatory Health Insurance Premium Deduction From Pension

The Uttarakhand High Court, on December 17, 2021, ruled in favour of a pensioner who had filed a petition to stop the mandatory health insurance premium deduction. The HC bench stated that retired employees should not be forced to opt for health insurance. Moreover, the mandatory insurance premium deduction from pensions of state government employees violates Section 300A of the Constitution of India, observed the HC. Previously, on December 21, 2020, the Uttarakhand government had issued a notice which mandated the health insurance premium deduction from pensions with effect from January 1, 2021. The pensioner, in his petition, stated that the purchase of health insurance should be optional for state government employees and premium deduction should not be compulsory.

- December 18, 2021

Rajasthan: 1.33 cr Families Register Under Chiranjeevi Swasthya Bima Yojana

As per government reports, 1.33 crore families in Rajasthan are now covered under the Chiranjeevi Swasthya Bima Yojana and have access to health insurance. The universal health scheme was launched on April 1, 2021, and has already seen a large number of beneficiaries enrolled under the plan. “The aim of the universal health plan is to offer a cashless facility to all families in the state,” a health department official said. Furthermore, the health department is also encouraging the remaining citizens of the state to register under the Chiranjeevi Swasthya Bima Yojana to avail the benefits of the scheme.

- December 17, 2021

No proposal to reduce GST on health insurance being considered: MoS Finance 

In a written reply to a query to the Lok Sabha, the Minister of State for Finance, K Karad said that there is no proposal or recommendation at the moment to reduce the GST(Goods and Services Tax) on health insurance premiums. GST levied on health insurance is around 18% of the cost of premiums. Karad also said in his written reply that it is the job of the Insurance Regulatory and Development Authority of India to improve regulations and protect the interests of the insurance policyholders. He further added that the Central Government has introduced the PMJAY health scheme for the benefit of the poorer sections of society.

- December 6, 2021 

NFHS Survey shows rise in health insurance coverage

The fifth edition of the National Family Health Survey showed a 12.3% increase as compared to the fourth edition in health insurance coverage to 41% of households surveyed. Experts give credit to the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-Pmjay) for the significant rise in medical coverage. AB-Pmjay is a public health insurance scheme introduced to provide up to Rs. 5 lakh hospitalisation coverage to 100 million poor families in India. Hence, the survey unveiled an interesting fact—the coverage in rural areas is higher at 42.4%, whereas, in urban areas, it is 38.1%.

-  November 25, 2021

Tamil Nadu: Over 20,000 people benefit from CM’s Comprehensive Health Insurance Scheme

More than 20,000 people in Tamil Nadu have availed benefits under the Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS), with advanced treatment in private and government hospitals. The CMCHIS scheme is being implemented in one of the government medical colleges, six government hospitals and 46 private hospitals, a release said. Under this government scheme, a total of 3,992 patients have undergone medical treatment at government hospitals, which is worth up to ₹5.41 crore. Whereas, 16,421 patients have undergone treatment under the CMCHIS at private hospitals where the state government has paid ₹52.04 crore to the hospital, the release shared.

-  November 19, 2021

Health Insurance for patients with birth defects now available

Until now, insurance companies did not provide any coverage for complications arising out of birth defects and their treatment. Now, the Indian Association of Paediatric Surgeons has partnered up with a private insurance company to provide insurance for medical cases involving birth defects. ‘The cost of treatment for neonatal patients is very high and the beds available are very few’, said Dr Shilpa Sharma, Chairmen of Delhi Association of Paediatric Surgeons. She further added that this insurance will be very helpful for families to take care of these issues.

- October 26, 2021

Tamil Nadu: More than 10,000 health insurance claims of govt staff rejected

As per a report, over 10,000 health insurance claims made by the Tamil Nadu state government employees and retired pensioners have been rejected under the New Health Insurance Scheme during the COVID-19 pandemic. Since the number of claims that have been rejected is very high, a district-level team has been formed to audit these rejected insurance claims. Commissioner of Treasuries and Accounts informed collectors that 10,929 cashless claims had been rejected. The district-level teams will investigate and audit these claims and send a detailed report to the Commissioner, as added in the report.

- October 25, 2021

Tamil Nadu: 40-day old baby gets CM health insurance card

For the first time in Tamil Nadu, the district administrator has issued a Chief Minister insurance card to a 40 day old baby before her open-heart surgery in a private hospital in Coimbatore. The health card was issued for the baby as she is being taken care of at an orphan home being run by Sharanalayam, an NGO. The girl was taken to a hospital due to breathing difficulties. After the diagnosis, the NGO approached the Collector GS Sameeran for aid and he helped secure the health insurance for the baby.

- October 25, 2021

Insurance scheme for Covid affected health workers extended for 180 days

The central government announced on Wednesday that they have extended the duration of the ‘Pradhan Mantri Garib Kalyan Package’ (PMGKP). The PMGKP is a health insurance scheme for healthcare workers fighting COVID-19. According to the ministry, the government has extended this scheme to continue providing support to the healthcare workers who are responsible for taking care of COVID-19 patients. 1351 health insurance claims have been paid up under this scheme till now.

- October 20, 2021

Medical coverage for over 40 crore Indians without any health insurance

Under a new health insurance scheme, over 40 crore Indians will be offered coverage on a voluntary basis. The government recognised over 40 crore individuals who aren’t covered under any healthcare scheme in India. With the help of this initiative, the government shall provide highly subsidised insurance to such individuals as part of a pilot project. These group insurance plans will be provided by commercial insurance companies in the country on a voluntary basis.

- October 12, 2021

Health insurance premiums to rise for retired bankers and workmen

The group health insurance premiums will be increasing by almost 40% for retired bankers and workmen due to the high incurred claim ratio. The second wave of COVID-19 led to a rise in the insurance payout, causing an increase in the premium amount for group insurance. However, health plans with domiciliary cover, which includes treatment at home, has seen a lesser increase in the premium rate when compared to policies without domiciliary cover. However, the National Insurance Company is providing an affordable premium amount with lower insurance coverage to individuals and retirees who have lost their spouse or survived by a spouse.

-  September 20, 2021

IRDAI extends paperless issuance of health insurance plans till March 2022

The IRDAI has extended the deadline for issuing and processing health insurance in electronic form till March 31, 2022. To ease the difficulty of purchasing health insurance due to the ongoing pandemic, the IRDAI has allowed health and general insurance providers to get policyholder’s signatures through the digital mode. The IRDAI has also mandated insurance companies to send policyholders their insurance documents in electronic form on their registered email ID or mobile number. Previously, this was extended up to September 30, 2021, but due to the continuing situation of the pandemic, the IRDAI has extended it further.

-  September 15, 2021

Rajasthan Government settles health insurance claims under Chiranjeevi Scheme

The health department of the Rajasthan Government introduced the Mukhyamantri Chiranjeevi Swasthya Bima Yojna as a health insurance plan for citizens in May 2021. The plan covers more than 80% of the state’s population. Over 1.6 lakh people have already availed cashless treatment at hospitals under this scheme and the Rajasthan government has started settling these claims. As a result of the second wave of COVID-19, related ailments like mucormycosis have also been added under the health insurance scheme.

-  August 14, 2021

17.94 lakh COVID related health insurance claims settled: Minister of State for Finance

In a written reply to the Lok Sabha regarding a query, Minister of State for Finance, Bhagwat Karad announced that around 17.94 lakh COVID-19 related health insurance claims that amount to about ₹21,837 crore were settled in the last 15 months, till July 15, 2021. As per his statement, the health insurance claims were settled by the insurers as per the terms and conditions of the health insurance policies. He also added that the Insurance Regulatory and Development Authority of India (IRDAI) has also taken several steps to speed up the COVID-19 related health insurance claims.  

-  August 2, 2021

COVID 19 claims expected to exceed 50% of health insurance payouts

The payout for COVID-19 insurance claims is likely to exceed the health insurance claims of other ailments during the first quarter of the current financial year, as per a report by TOI. The report adds that insurance companies have already settled claims of around ₹16,000 Crore and still, the number of COVID-19 related claims continue to rise. It is estimated that COVID-19 claims will exceed 50% of all medical claims. On the other hand, COVID-19 has also led to a direct increase in demand for health insurance, as premiums collected for health insurance have jumped to ₹58,572 Crore.

-  July 26, 2021

Group health insurance premiums rise by 25-30%

Group Health Insurance premiums for employees have risen by a margin of 25-30%. As per a DNA report, most insurance companies have increased insurance premiums for group health insurance policies as claims increased significantly due to COVID-19. The rise in premiums is because of the decreasing level of profits seen by the group health business due to the second wave of the pandemic. The insurance premium hike does not affect individual health insurance plans.

- Jul 08, 2021

COVID-19 second wave: Average ticket size of COVID patients’ health insurance claims goes up 20-50%

As per a report, the average ticket size of health insurance claims for COVID-19 patients has gone up by approximately 20-50% during the second wave of the COVID-19 pandemic. “The average ticket size at Max Bupa Health Insurance has gone up from ₹1.3 Lakhs to ₹1.5 Lakhs,” said the Director of Underwriting at Max Bupa. “The purchase of oxygen cylinders, ventilators, and ICU equipment has led to a surge in the hospital bills, increasing the average ticket size,” he added.

- Jul 05, 2021

IRDAI: Health insurers settled over 15.39 lakh COVID-19 claims as of June ’21

As per the Insurance Regulatory and Development Authority of India (IRDAI), insurance companies have settled 80% of COVID-related claims as of June 22, 2021, after the second wave of COVID-19 hit India in April-May. Insurers received a total of 19.11 lakh COVID-19 health claims, of which, 15.39 lakh claims are successfully settled. The total settlement amount is approximately ₹15,000 crore to date.

- Jun 24, 2021

Include home-based treatments as health insurance add-on, IRDAI directs insurers

The Insurance Regulatory and Development Authority of India (IRDAI), in a circular sent to the insurers on June 22, 2021, directed them to implement the facility of home-based treatments as add-on benefits in health insurance. The committee, back in June 2020, had advised general and health insurance providers to include home-care treatments amidst the pandemic. However, the facility was yet to be available to the public.

- Jun 23, 2021

COVID-19 survivors unlikely to get health insurance immediately

Are you a COVID-19 survivor? Kudos on recovering from COVID-19! We salute your strength. However, as a survivor of this deadly disease, chances are that you might find it difficult to get health insurance in India, at least right away. Lately, insurers have introduced a cooling-off waiting period clause in their health insurance plans for those who plan to seek coverage after recovery. The cooling-off period is about three-six months from the last COVID-negative report.

- April 26, 2021

People porting their health insurance plans for extensive coverage. Here’s why?

It has come to light, recently, that people with health insurance coverage of ₹5 Lakhs to ₹10 Lakhs are actively seeking to port their policy for enhanced sum insured. The reason behind this is the ongoing pandemic in India. Since COVID-19 comes with long-lasting health complications, having an extensive health insurance plan that covers future health issues, even after surviving the disease, is a must. Therefore, people in India are determined to port to health insurance plans with higher coverage.

- April 13, 2021

Comprehensive health insurance is an on-demand insurance product in India

With 2020 drawing people’s attention to their health, Indians have started understanding the importance of having a comprehensive health insurance policy. As per the General Insurance Council, there was a significant rise in the number of health insurance premiums paid between April 2020 and June 2020. It was further observed that health insurance was the highest contributor to the non-life insurance sub-sector, accounting for over 29.7% of the insurance premiums collected in the past year.

- March 18, 2021

Health insurance premium set to increase due to COVID-19

Enhanced health insurance coverage and the ongoing pandemic has increased the number of health insurance claims in India. Till date, insurers have settled up to ₹14,000 crores as part of Covid-19 claims. Moreover, the unprecedented rise in medical inflation has further added to insurers' woes. Considering these factors, insurers are likely to hike health insurance premiums by 10%.

- March 16, 2021

IRDAI about to streamline Covid-19 health insurance and more

The IRDAI (Insurance Regulatory and Development Authority of India) issued a circular with new instructions for health insurance on 13th January, 2021,stating that cashless claims under a health insurance policy should be settled according to the tariff decided upon by the parties in compliance with the provisions of IRDAI (Health Insurance) Regulations, 2016- Regulation 31. Additionally, they urged insurers to have agreements with health providers upon the rates of Covid-19 treatment, in a similar fashion to other diseases. Insurers have also been asked to ensure that a health insurance policy’s reimbursement claims are settled according to terms and conditions of the relevant policy contract.

- January 29, 2021

Latest National Family Health Survey reveals key realities about health insurance cover

The latest National Family Health Survey (NFHS-5) revealed that in the past 5 years, health insurance coverage has increased in a majority of Indian states and union territories. However, most states and UTs still recorded coverage that remains significantly below 50% of the population.

A total of 15 states and UTs have witnessed a health coverage spike. But except for Andhra Pradesh, Assam, Telangana, and Kerala, in all the major states, less than 50% households have at least one member with a health cover.

While health insurance coverage figures might suggest differently, it is also true that schemes such as the Pradhan Mantri Jan Arogya Yojana and other state-launched schemes were widely well-known through awareness campaigns and have provided health benefits to more than 10 crore poor Indian families.

- January 24, 2021

IRDAI set to change the health insurance scenario with new advisory committee

The IRDAI (Insurance Regulatory and Development Authority of India) has set up a Health Insurance Advisory Committee, noting the upward trend in health insurance in the country and expecting it to continue.

The committee will examine key factors including availability and needs of the Indian society. The regulator has also made efforts to ensure orderly growth of the health insurance industry, bringing in greater efficiency, and protecting policyholder interests.

The committee will also suggest an approach on coverage of specific diseases, examine policy conditions, develop a treatment protocol strategy and a rate structure to make health insurance more affordable in India.

- January 19, 2021

Is India’s health insurance sector set for a revolution?

India was recently ranked among the top countries for insurance potential. There has been a significant expansion of the health insurance industry in the country. Following this, the IRDAI has been taking steps to foster this positive growth. 

The IRDAI (Insurance Regulatory and Development Authority of India) has formed a committee of 10 experts and specialist doctors for examining the provision of health insurance products in India. Formulated in January 2021, the move is directed towards protecting the interests of policyholders and driving innovation for new products. 

The said committee is also slated to recommend health insurance products such as expanded coverage for Covid-19, and suggest ways to improve processing of claims..

- January 17, 2021

Clarifies on Revision in Health Insurance Premium by Insurance Regulator

The Insurance Regulatory and Development Authority of India or IRDA has recently clarified that the insurers are permitted to alter the base premium to a maximum of -5% or +5% of the initially approved rate of the premium. This is in compliance with the set guidelines of standardization on exclusions, thereby ensuring sustainability and viability of existing products into a seamless one time transition. 

Furthermore, during the entire year up until 30th November, 2020, the authority of insurance regulatory has revised the alteration of premiums by 5% only in case of five types of health insurance products of health or general insurers which is a part of the periodical alteration of their respective insurance products.

Health Insurance Sector: 8 Key Changes witnessed in 2020 

These are the 8 significant changes in the health insurance sector that were initiated in 2020:

  • IRDA permitted the policyholders an option to pay the premium of their health insurance in installments.
  • IRDA permitted cashless payments in every hospital during the treatment for Covid-19.
  • Launch of two health insurance policies that are coronavirus specific: Corona Rakshak and Corona Kavach.
  • IRDA permitted the proposal forms of health insurance policies digitally.
  • IRDA asked for the inclusion of telemedicine under health insurance policies.
  • IRDA asked to include preventive and wellness features in the health insurance policies.
  • Several ailments that were previously excluded under the health coverage are now included.
  • Definition of Pre-Existing Diseases has been altered to serve the needs of customers.
October 2020: Health Insurance to become customer friendly

The month of October has brought some significant changes in the Insurance industry. IRDAI has recently directed three key changes in the health insurance plans structure in order to make the plans more customer-friendly and provide more benefits to the policyholder. So, what exactly is there in store for you? The very first benefit that new change holds for policyholders is the simplification of clauses for it to be understood by masses. This would help compare plans easily through the clauses. Next positive change brought about IRDAI is making plans more inclusive when it comes to coverage which is expected to increase the popularity of health insurance plans in times of a pandemic. Third very important change is that the proportionate deductions on room rent limits have been made more reasonable. These changes are expected to bring in a sigh of relief for the policyholders.

Good News: Proposal for medical necessities to be fully payable now!

While health insurance is already a relief for the policyholders across the world amidst the pandemic, the new changes announced by the IRDAI are set to make scenarios even more relieving for policyholders with their recent proposal to exclude the costs of diagnostics, medicines and implants from the list of associated medical costs. As these associated medical expenses are considered when insurers compute proportion deductions from hospital bill, this could potentially mean that the health insurance claim amount settled by the insurer could be higher than the usual amount that is settled.

Insurers cannot contest claims after 8 years of premium payment: IRDAI

IRDAI, the insurance regulator in its recent set of guidelines tends to come down on the side of policyholders. The recent set of guidelines announced by IRDAI state that health insurance companies will not be permissible to content or question health insurance claims raised by policyholders once they have been paying the premium amount for a period of 8 years except for those that are proven to be fraudulent and claims around permanent exclusions as mentioned in the policy document. The regulator further stated that the objective behind this approach is to standardize the terms and clauses combined in indemnity-based health insurance plans which exclude domestic/overseas travel and personal accident. This way, IRDAI further simplifies the general terms and clauses and policy wordings to achieve consistency across the insurance industry.

COVID claim amount triples to Rs. 562 Crore in a month - Insurance industry to bear the brunt

While the pandemic is taking a toll on the world, no one is saved from its financial burnt. Where some people are losing their jobs, some are facing major financial adversities due to the stagnant scenarios driven by the pandemic. And, if someone is majorly affected, it’s the insurance industry! While the COVID coverage offered by health insurance plans came a big relief for people around the world, health insurers have faced a major financial brunt. With health insurance claim amounts exceeding to ₹562 crore through a period of less than a month, health insurance companies have indeed felt the heat of the pandemic.

COVID – A Health Insurance business booster

While the pandemic has almost brought the world to a standstill, it has turned the tables for the insurance business. As health insurance covers COVID claims, the pandemic has given a boost to the health insurance business across the world. While the health insurance segment has introduced 500 products in the last 2 decades, the COVID crisis marked the launch of 130 new product in just four months. With this development, this insurance segment has overhauled the motor insurance segment, becoming the largest business in the category of non-life insurance. IRDAI further estimates that the dominance of the health insurance segment over motor will only increase by leaps and bounds by 2020-end

Want to enhance your coverage against COVID? Top-up, Super top-up or Corona Kavach policy, what to choose?

Are you looking for a plan that gives you added financial protection against the pandemic? If you wish to enhance your existing health insurance policy, you have 2 great options – a health insurance top up or Corona Kavach policy. Wondering which one you should choose? Both, the top-up and the Corona Kavach serve different purposes and one must choose the plans wisely, keeping his/her needs and requirements in consideration. While a health insurance top-up plan comes into play when your existing health insurance coverage is exhausted, Corona Kavach policy will only pay for COVID-19 treatment and that too for less than a year. Hence, one must not replace a comprehensive health insurance plan with Corona Kavach but get one in case he/she does not have any medical coverage.

Will your existing health insurance policy cover COVID-19 vaccine?

The hunt for the coronavirus vaccine continues and with many vaccine candidates undergoing trials, this could soon be a reality. But, the question is, will the COVID-19 vaccine be covered under your existing health plan? Typically, health insurance plans cover hospitalization costs and treatment costs, which means, if you were to be hospitalized for COVID-19, your treatment and hospitalization costs would be covered. However, if one needs to get a dose of COVID-19 vaccine, there is no need for hospitalization and in this case, if your plan offers out-patient treatment coverage, it may be covered. Having said that, currently COVID-19 vaccine is not covered under indemnity health plans but could be covered in the plans in the foreseeable future, it being a vital need.

India: COVID-19 boosts health and life insurance

The spurring COVID cases across the world and in our country and the growing awareness of the pandemic have resulted in positive developments for the life and health insurance business. With the nation battling COVID, people turned to life and health insurance plans to seek financial support for fighting the implications of the disease. With COVID claims covered, individuals felt a sense of relief with these plans. A survey carried out by the Insurance Institute of India (III) revealed the surge in demand for life and health insurance due to the increasing awareness for risk and protection. In light of this, the industry must look forward to ramp up digital platforms and surge online selling of insurance plans to leverage the scenario.

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