Change in Health Insurance

IRDA (Health) Insurance Regulation, 2013.

These regulations are applicable to all kinds of Health, Personal Accident and Travel Insurance products sold by any Insurance Company (Life or Non-Life) in India. They are applicable from 16th February 2013. All products which do not comply with these regulations have to be withdrawn by 1st October 2013. 

1. Lifetime coverage on all policies has been made mandatory. Wherever a product has a maximum age limit for certain category of people like children or students, the insurance company will offer to migrate the member to another suitable product, by providing suitable credits for all the continuous years of coverage.
2. Entry age bar/limit in health insurance policies would be minimum 65 years. 
3. 30 Days grace period beyond the expiry date of the policy, to renew the same.
4. All Health Insurance policies shall have a Free-Look Period of 15 days from the date the documents are received by the customer.
5. All health policies to have provision for nomination in the proposal form. 
6. Insurance Company has to pay minimum 50% of the Pre-insurance medical checkup, if the proposal is accepted. 
7. Individual claims based loading cannot be applied. Insurance Cos. can only apply loading on the overall portfolio of clients/customers.
8. If a claim falls between 2 policy periods, the customer will get advantage of both years' sum insured. Claim will be paid, deducting the second years premium from the claim amount. For instance, if policy with sum insured is Rs. 3 Lakhs expires on 15th March and there is a hospitalization which happens between 10th March and 20th March. The sum insured would be assumed to be Rs. 6 Lakhs and claims paid. The premium for the subsequent year, if not paid, would be deducted from the final admissible claim amount. 
9. No Claim Bonus would NOT reduce to zero in case of a claim.  They will reduce at the same level it increases when there are no claims.
10. Standardization of Customer Information Summary. One pager summary of benefits, terms and conditions will be issued for each product. This will help customers get a better grasp of the product.
11. Insurance Cos. cannot force a customer to move to another product, if it is disadvantageous to the customer.