Get <strong>₹5 Lac</strong> Health Insurance starting <strong>@ ₹300/<span>month*</span></strong>
Get ₹5 Lac Health Insurance starting @ ₹300/month*
Get ₹5 Lac Health Insurance starting @ ₹300/month*
250+ Plans 18 Insurance Companies
₹ 5 Lakh Coverage @ ₹ 10/day
7 Lakh+ Happy Customers

*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

IRDA Announced Modifications in Pre-existing Diseases Rules in Health insurance

In a recent announcement, IRDA offers changes in pre-existing disease clauses in order to benefit the policyholders. The Insurance Regulator and Development Authority of India (IRDAI) has advised the health insurance companies and Third Party Administrators (TPA) to make the changes with immediate effect.

The move to amend the definition of pre-existing illnesses in health insurance is to bring simplicity and to make medical insurance in India more customer-friendly.

IRDAI released a circular mentioning the removal of ‘the additional/modified clause’ from the existing description of pre-existing illnesses. This move can actually reduce the health insurance rate of rejection in the future.

In September 2019, IRDAI stated in its circular the inclusion of certain illnesses under medical insurance policy. As per the September circular, certain illnesses that were diagnosed within a span of 3 months of the policy issuance would be considered as pre-existing illnesses and would be covered under the medical insurance policy.

However, in one of their latest circulars dated February 10, 2020, the Insurance Regulator specifies that any disease that has been diagnosed within 6 months of the policy issuance will not be treated as pre-existing diseases. IRDAI also mentioned that these modifications will also be included in the guidelines on standardization in medical insurance policies.

Basically, pre-existing illnesses refer to medical conditions or injury at the time of policy purchase. Health conditions such as blood pressure, diabetes, depression, lupus, epilepsy, sleep apnea, anxiety are called as pre-existing medical conditions.

The insurance regulator also modified the current definitions of pre-exiting illnesses, which are not applicable to international travel insurance. Below are the modifications that follow in the guidelines on the standardization of Exclusions in Health Insurance:

Existing

New

Pre-existing Disease means any condition, ailment, injury or disease:

Pre-existing Disease means any condition, ailment, injury or disease:

a) That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or

a) That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or

b) For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy or its reinstatement

b) For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy or its reinstatement

c) A condition for which any symptoms and or signs if presented and have resulted within three months of the issuance of the Policy in a diagnostic illness or
medical condition.

Deleted

(Life insurers may define
norms for applicability of
PED at Reinstatement)

(Life insurers may define
norms for applicability of
PED at Reinstatement)

Source: IRDAI

IRDAI has advised all the insurance providers and third-party administrators to make amendments and ensure compliance, wherever applicable, with immediate effect

Written By: PolicyBazaar - Updated: 26 April 2020
1,583,792 Confirmed Cases in India*
18,410,580 Confirmed Cases worldwide*
662,356 Confirmed deaths worldwide*
Search
Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.
Sign up for newsletter
Sign up our newsletter and get email about health plans.

You May Also Want to Know About

Best Health Insurance Plans in India

Best Health Insurance Plans in India

Health insurance is amongst the most intricate insurance products, as it comes with numerous riders and benefits, and hence, there are so many variants to it. The insurance marketplace nationwide is quite competitive. You must consider comparing th...
Best Health Insurance Companies in India

Best Health Insurance Companies in India

Every year, a list of top health insurance companies in India is declared which helps in taking the right insurance decision. There are few important features that help it to rate the insurance companies, such as their performances, Incurred Claim ...
Top Maternity Insurance Plans

Top Maternity Insurance Plans

Maternity or pregnancy is an important phase of life, and one needs to prepare in advance to embrace parenthood. Though rearing a child is an expensive affair and may require good financial backup to meet the requirements of a growing baby. From ho...
Top Family Health Insurance Policies in India 2020

Top Family Health Insurance Policies in India 2020

From the air we breathe to the food we eat; everything is intentionally or unintentionally subjected to adulteration. Due to this, the disease rate in India is rising drastically. Naturally, more and more people are visiting hospitals frequently. A...
Health Insurance for Parents

Health Insurance for Parents

Are you planning to buy health insurance for your parents? Well, the Indian Insurance market is currently flooded with healthcare plans specifically designed for senior citizens or elderly parents above 60 years. And many insurance providers also o...