In a relief for senior citizens, the Insurance Regulatory and Development Authority of India (IRDAI) has removed the age limit restriction for buying a health insurance policy, effective April 1.
Earlier, those above 65 years of age were not allowed to purchase a health insurance policy. IRDAI has also reduced the waiting period from 48 months to 36 months to start health insurance coverage for pre-existing medical conditions.
In a recent notification, the insurance sector regulator said that insurers shall ensure that they offer health insurance products to cater to all the age groups.
“Insurers may design products specifically for senior citizens, students, children, maternity and any other group as specified by the Competent Authority. Insurers shall endeavor to offer coverage for persons with all types of existing medical conditions,” the notification said.
With this, now insurers cannot deny a health insurance policy to those having serious medical conditions like cancer, heart and renal failure and AIDS.
Furthermore, health insurers have been asked to cover all types of medical conditions in a patient and not exclude certain “pre-existing” ailments.
What is pre-existing disease?
As part of Guidelines on Standardization, IRDAI has already defined pre-existing disease. Pre-existing disease means any condition, ailment or injury or related conditions for which there were signs or symptoms, or were diagnosed, or for which medical advice or treatment was received within 48 months prior to the first policy issued by the insurer and renewed continuously thereafter.
Here’s what IRDAI said on pre-existing diseases and specific waiting period:
Waiting period for pre-existing diseases disclosed by the persons to be insured, shall be maximum up to 36 months of continuous coverage under the health insurance policy. Insurers may endeavor to have lesser preexisting disease waiting period and specific waiting period in the health insurance products. Provided that the above waiting period norm of pre-existing disease shall not be applicable for overseas travel policies.
Pricing:
Premium shall remain unchanged for the policy term. Insurers may offer facility of premium payment in instalment. Insurers may devise mechanism or incentive to reward policyholders for early entry, continued renewals, favourable claims experience, preventive and wellness habits and disclose upfront such mechanism or incentives in the prospectus and the policy document. Provided that what is proposed to be covered as part of wellness and preventive habits be clearly defined in each and every product.