Key Updates in Health Insurance Policies:

1. Shorter Waiting Period for Pre-Existing Conditions

The waiting period for pre-existing conditions has been reduced from 48 months to 36 months. After this period, insurance companies cannot reject claims for pre-existing conditions, even if the policyholder didn’t disclose the condition earlier.

2. No Age Limit for Senior Citizens

Before, people over 65 couldn’t buy new health insurance. Now, there’s no age limit, so anyone—regardless of their age—can purchase a health policy.

3. Inclusive Health Coverage

Insurance companies must now offer health insurance to mental health patients, special needs children, transgenders, and people with HIV/AIDS. This makes health insurance more inclusive.

4. No Claim Denials After 5 Years

Insurance companies cannot deny claims after 5 years, even for reasons like non-disclosure or misrepresentation. However, if there’s proven fraud, the claim can still be contested in court.

5. Meaningful Discounts for No Claims

If no claims are made during the year, policyholders can choose between increasing the sum insured or getting a discount on their premium for the next year.

6. Refund Anytime

Policyholders can cancel their policy anytime and get a refund based on how long they used the policy. For example, if you pay Rs. 12,000 in premium and cancel after six months, you’ll get Rs. 6,000 back.

7. Higher Claim Settlement Chances

IRDAI has asked insurance companies to set up a committee called Claims Review Committee (CRC). This committee will review the claims, which are rejected by the insurer.

Further, claim requests can only be rejected after approval of this committee.  Also, insurers will have to give reason for rejection along concerning the specific terms and conditions of the policy document.

8. Smoother Claim Settlement Process

Insurance companies and Third-Party Administrators (TPAs) must collect required documents directly from the hospital, so policyholders don’t have to submit them separately. Also, cashless claims should be processed within 1 hour, and final payments made within 3 hours of discharge.

At Mialtus Insurance Broking Pvt Ltd, we understand the challenges of maintaining good health and the importance of having comprehensive coverage. Contact us for the best health insurance policies and claim services. Our health insurance policies are designed to give you peace of mind, ensuring you and your family are protected during times of illness or medical emergencies. Call us on 8657528106  or visit our website to learn more about our customer-friendly health insurance plans.

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