Communication in Health Policies Must be Simple: IRDA

The Insurance Regulatory and Development Authority (IRDA) seek to offer user-friendly communication in health policy documents. In this regard, IRDA standardised terms used in health insurance policy documents. The working group of industry body standardised 20 common terms associated with health insurance, 20 critical illnesses, pre-authorisation forms, claims forms, discharge forms and billing process, besides compiling a list of ordinary exclusions.

As premiums are deregulated, losses for health insurers are major issue due to the price erosion driven by competition. IRDA said that it would surely take action on those insurers which have done faulty pricing policies. According to TPA claims data, the regulator IRDA said that it has received 3,641,585 claims in 2010-11 against 3,365,940 in 2009-10.

IRDA recommended that communication in health insurance policy documents must be understandable to policyholders. About 37% of total complaints in general insurance were from health insurance. So, it is the duty and responsibility of the insurers to make communication on policy-related aspects simple and understandable.

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