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The IRDAI has introduced several customer-friendly changes to health insurance regulations, building on previous reforms like removing the entry age limit for buying health policies and reducing the contestable period for claims.

Key updates include:

1. Policyholder Benefits:

    - Policyholders can choose to increase the sum insured or reduce the premium in a no-claim year.

    - They can discontinue their policy anytime and get a pro-rata refund. For example, if a client pays Rs.12,000 in premiums and cancels after six months, they will receive a Rs.6,000 refund.

    - Insurers cannot deny policy renewals based on claims made in previous years, except in cases of fraud or non-disclosure.

2. Cashless Claims:

    - A move towards a 100% cashless claim settlement system.

    - Clear display of claim settlement procedures for both cashless and reimbursement claims.

    - Insurers must collect necessary documents directly from hospitals, reducing the burden on policyholders.

3. Claims Review:

    - No claim can be rejected without the approval of a Claims Review Committee.

    - Insurers face a penalty of Rs.5,000 per day if they fail to implement an ombudsman's order within 30 days.

4. AYUSH Treatments:

    - No limit on the sum insured for treatments under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH).

The IRDAI states these changes aim to empower policyholders, ensuring they receive high standards of care and service while fostering trust and transparency in the health insurance sector.

If you are looking to buy health insurance for you and yours family, call us (+91) 7888672630, and we will help and guide you in selecting the best yet affordable health insurance policy for you and your loved ones...

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