IRDA Asks Insurers to Introduce Health Cover up to 65 Years

The Insurance Regulator and Development Authority (IRDA), has proposed health insurers to make it mandatory to provide insurance cover to people up to 65 years of age and settle claims within a month.

IRDA in its draft guidelines mentioned that all health insurance companies must provide cashless services to policyholders undergoing treatment in a particular hospital even after that hospital is removed from the preferred list of service providers.

Moreover, IRDA proposed a significant change about portability, which tells that a policyholder can migrate to another health insurance company without losing any benefit. Besides this, it also proposed that special provisions will be introduced for senior citizens whose need for health care is pressing.

Under the proposal norms, it also adds that all insurers must provide relevant information to the customers in a simple language. Every insurer must provide reasons for rejection of claims to the insured person. Insurers should all times update list of network hospitals on their websites and inform their policyholders about the nearest hospital where cashless facility is available.

The guidelines are drafted in such a way to redress the problems of the health insurance sector which came into existence in 2010 after the removal of private hospitals from preferred list by four public sector insurers due to overcharge by them under cashless scheme.

According to IRDA, insurers are allowed to come up with new products like ‘Health-plus Life Combi’ which would be a combination of life and health insurance cover. Currently in India, there are about 7 crore health insurance customers with their premiums adding up more than Rs.11,000 crore.


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