Health insurance is good news for policy holders. IRDAI, the regulator of the insurance sector, has taken a big decision for the insurance companies in the matter of claim settlement. IRDAI has asked insurance companies to be more transparent in the process of settlement of health insurance claims. Apart from this, the regulator has told the insurance companies that if they reject a claim, then tell the policy holder the obvious reason for it. IRDA stated in the circular that it is mandatory for all insurance companies to set up procedures through which policyholders can get information about various stages of the claim process in a transparent manner.
The Insurance Regulatory and Development Authority of India (IRDAI) said, all insurance companies will have to set up systems whereby the policyholder is informed about the status of claims filed in cashless treatment / insurance company / TPA with the website / portal / app or in any other electronic way. Could get information in
The order will apply to all insurance companies
IRDA said that it should have complete information from the time of application to the time of settlement of claims. The ‘Health Insurance Claims Settlement’ has been issued to Circular Life Insurance, General Insurance and Single Health Insurance Companies (TPA).
Give complete information about settlement of claims
Irda said that if the claims are being settled by the TPA on behalf of the insurance company, then all the information will have to be made available to the policy holders. IRDA has asked the insurance companies to ensure that a claim should not be dismissed on the basis of just ‘prior assumption or conjecture’.
Insurance company will bear the cost of the hospital if sick due to the corona vaccine
Let me tell you that earlier your decision has said that companies will bear the cost of health policyholders on hospitalization due to adverse effects after being vaccinated by COVID-19. Under the Hospitalization Health Insurance Policy, the policy is covered under the terms and conditions of the policy.
At the same time, IRDAI has instructed the health insurance provider not to make any changes in their existing health insurance policies, which would increase the premium of the policyholders. This directive from IRDAI will be applicable to health insurance as well as personal accident insurance and travel insurance.
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