December 23, 2024
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No more exclusion of cover: IRDAI

IRDAI restricts health insurers from excluding some illnesses

In a progressive approach, IRDA recently restricted health insurance companies from exclusing some illnesses from its cover, some of which include respiratory or skin ailments arising as a result of hazardous workplace conditions; age-related ailments such as cataract surgery, knee-cap replacements, Alzheimer’s and Parkinson’s; and mental illness, stress, psychological and neurodegenerative disorders.

The introduction of standardisation of health norms would come as a breakthrough to bring clarity to the insured persons regarding the applicability of insurance in respect to their diseases/ ailments, said a report by S.S Rana & Co. Further, the health insurance policies would include pre-existing diseases disclosed by the insured persons immediately after the expiry of a waiting period for 48 months (the period which should elapse before the insured becomes entitled to health cover opted for by him/ her) or such lower period as may be stated in the insurance policy.

This initiative by the regulator would result in persons purchasing insurance to obtain the benefits of their policy thereby making the benefits of healthcare available to them, the report said.

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