Health Insurance Norms to be more Customer-friendly 2022

IRDAI has laid down mandatory guidelines and changes in the health insurance products for the insurers to follow with effect from Jan 1, 2022. The revised policies direct towards coverage for more illnesses and procedures at affordable premiums. The highlights of the new health insurance guidelines are explained below.

Read More

Policybazaar exclusive benefits
  • 30 minutes claim support*
  • 50,000 claims approved in last 15 months*
  • Schedule home visit with our advisors
  • Get a plan based on your medical needs

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Back
All health plans cover Covid-19 treatment
  • 1
  • 2
  • 3
  • 4

Who would you like to insure?

  • Previous step
    Continue
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Previous step
    Continue

      Popular Cities

      Previous step
      Continue
      Previous step
      Continue

      Do you have an existing illness or medical history?

      This helps us find plans that cover your condition and avoid claim rejection

      Get updates on WhatsApp

      What is your existing illness?

      Select all that apply

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step
      Advantages of
      entering a valid number
      You save time, money and effort,
      Our experts will help you choose the right plan in less than 20 minutes & save you upto 80% on your premium

      Coverage for New Ailments

      The regulator has issued specific guidelines related to illnesses like genetic diseases and disorders, behaviour and neurodevelopment disorders, puberty and menopause-related disorders, etc. that will now be included under regular health insurance plans.

      Hereafter, insurers will be barred from not covering illnesses related to hazardous activities. Comprehensive health insurance plans will further include treatment cost for internal congenital diseases, mental illnesses, age-related degeneration, and artificial life maintenance.

      In addition to these, coverage for age-related illnesses like knee-cap replacements, and cataract surgeries will also become a part of the inclusions. Also, people working with harmful chemicals that may impose long term health complications shall be covered for skin and respiratory ailments that may arise due to their working conditions.

      Standardization of the Exclusions

      The Insurance Regulator has also standardized the limitations in health insurance plans that if an insurer does not want to cover specific ailments like chronic kidney diseases, HIV/AIDS, and epilepsy, they must use specific wordings as demarcated by the IRDAI in the policy terms.

      It has also notified the insurers to make the range of waiting period for 30 days to one year, and after that, the coverage will be provided for the illness.

      New Definition of Pre-existing-Diseases

      To ensure adequate insurance coverage to the policyholders suffering from pre-existing diseases, the regulator has mandated the insurers to include permanent exclusions only after taking consent from the customers. No exclusion is allowed apart from those listed by the IRDAI.  As per the new guidelines, all the medical issues suffered after the policy commencement can be claimed by the insured.

      So, the regulator has laid down guidelines regarding the standardization of medical insurance policies; and it has suggested changing the definition of pre-existing diseases (PED) to cater to the customers’ requirements. As per the issued guidelines, any illness that has been diagnosed or medical advice was taken by a doctor 48 months before policy issuance will be classified as Pre-existing Diseases.

      Pre-existing Disease refers to any injury, ailment or medical condition, for which there were symptoms, or was diagnosed, or medical treatment/advice was taken within 48 months prior to the first health insurance policy purchased by the insured and then renewed thereafter.

      Some of the major illnesses that need to be included are AIDS/HIV, Alzheimer, morbid obesity, and Parkinson.

      No Rejection of Claim after 8 Years

      IRDAI stated in June 2019 that if the policyholder has been paying the premium for a medical insurance policy for consecutive eight years, then the insurer cannot reject the claim except for permanent exclusions or any proven fraudulent act.

      This move has been crucial for the honest medical insurance buyers who had to face rejection for certain claims even after paying the premium for a decade. Those 8-years in the proposal are referred to as the ‘Moratorium period.’ In case there is any sub-limit, deductible, and co-payment in the policy, they need to be followed as per the valid policy terms and conditions.

      Paying Medical Insurance Premiums in EMIs

      Amidst the ongoing Coronavirus pandemic, the IRDAI introduced a circular in Jan 2022 suggesting minor modifications in policies filed by both standalone health insurers and general insurers. Furthermore, the circular by the regulator also permitted to pay the health insurance premiums in instalments. However, it is entirely up to the insurers if they want to offer this facility or not.

      The instalments can be paid half-yearly, quarterly, and monthly as decided by the insurance company. So, from now on customers who cannot pay the entire premium in one go, have the choice to pay it in equal instalments over regular intervals during a policy year.

      These were some of the important modifications in terms of health insurance cover that would ensure extensive medical insurance cover to those who are already insured and also the new applicants from Jan 2022.

      Search
      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance articles

      Recent Articles
      Popular Articles
      Should You Buy a Super Top-up Health Insurance Policy?

      18 Jan 2023

      India is abuzz with a variety of health insurance plans to cater
      Read more
      6 Reasons Why Your Cashless Health Claims Can Get Denied

      18 Jan 2023

      Cashless claims are one of the most lucrative benefits of buying a
      Read more
      Check Out the Mandatory KYC Documents for Health Insurance

      30 Dec 2022

      The Insurance Regulatory & Development Authority of India
      Read more
      What to Look for in a Health Insurance for Cancer Plan?

      20 Dec 2022

      Cancer is one of the biggest demons that the world faces today
      Read more
      What are the Factors Affecting Health Insurance Premium?

      20 Dec 2022

      Demand for insurance products in India, especially health
      Read more
      What are the Normal Thyroid Stimulating Hormone (TSH) Levels as Per Age?
      The thyroid gland is an important gland responsible to produce the right amount of hormones for normal body
      Read more
      How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal
      Read more
      Income Tax Slab for Women: Guide to Exemptions and Rebates
      In India, every person who earns beyond a certain limit is liable to pay income tax to the government. The tax
      Read more
      Best Health Insurance Plans for Senior Citizens in 2023
      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance
      Read more
      How Senior Citizens can save Tax with Medical Bills u/s 80 D?
      Senior citizens can save on income tax by availing tax benefits on medical expenses under Section 80D of the Income
      Read more

      top
      Close
      Download the Policybazaar app
      to manage all your insurance needs.
      INSTALL