Health Insurance: Let us know which rules of health insurance are going to change from 1 October.
The rules related to your health insurance policy are going to change from 1 October. These changes will happen according to the guidelines issued by the Insurance Regulatory and Development Authority (IRDAI). This will bring many benefits to the insured. Now the insured will be able to pay the premium in installments. With this, many new diseases will now be covered in the policy. Let us know which rules of health insurance are going to change from October 1.
Payment of premium in instalments
Premium can be paid in installments – Half-Yearly, Quarterly or Monthly. If you have to pay an annual premium of 12 thousand, then now you can do it in installments at regular intervals in the year.
The claim is not rejected after eight years
According to IRDAI, after completion of eight consecutive years, a health insurance claim cannot be denied, except if a fraud is proven and a permanent exception is stated in the policy contract. However, the policy will be viewed according to all limits, sub-limits, co-payments, deductibility, which are according to the policy contact.
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The insurance company will have to settle or reject the claim within 30 days from the date of receipt of the last required document. If in case of delay in payment of the claim, the insurance company will have to pay interest to the policyholder from the date of receipt of the last required document. This will be two percent more than the bank rate. If the claim is to be investigated, the company will have to complete it within 30 days. If someone has more than one policy, then he will have to make a claim settlement according to the policy terms and conditions.
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Cover for new diseases
The Regulatory Body has issued guidelines which will cover many excluded diseases under a regular health insurance policy. These include age-related degeneration, mental illnesses, internal congenital, genetic diseases will now be covered. Apart from this, there are age-related diseases including cataract surgery and knee cap replacement or skin related diseases which have been caused due to workplace, will also be covered.
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Cover on telemedicine
IRDAI has also directed health and general insurance companies to include telemedicine in the claims settlement policy. The Medical Council of India (MCI) had issued a guideline on ‘Telemedicine’ on 25 March so that the registered doctor can provide health services using telemedicine.
The Insurance Regulatory and Development Authority (IRDA) issued a circular to all health and general insurance companies, stating that the provision of permission for telemedicine would be part of the claims settlement policy of insurance companies. For this, there is no need to give anything to a separate authority for any kind of improvement. However, the rules of monthly/yearly limit etc. of the product will be applicable without any relaxation.
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Rules on the proposed reduction
Insurance companies will no longer be allowed to cover certain medical expenses, including pharmacy and consumables, implants, medical devices and diagnostics. So now health insurance companies cannot recover any expenses for proposed deductions. The regulator has directed the insurance companies not to apply for ICU charges.
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