Health Insurance- More benefits now for the Patients ! Make full use of it !

IRDAI- the regulatory authority for all Insurance Plans of various Insurance companies with Life and Non-Life Policy Schemes has been time and again reviewing the policy narratives of the Companies and suggest ways and means to fine tune to the advantage of the policy-holders.

Normally the Health insurance policies armed with fine prints of terms and conditions, used to conveniently exclude claims under some pretext or others. The Policy holders will encounter issues relating to their claims only when they really put up claims and not till then.

Quite recently, IRDAI’s draft exposure calls for ‘NO Exclusion’ of diseases contracted after taking a policy. Normally one year or more-up to 48 months- cooling period is imposed from the date of taking a policy to put up any claim and to cover pre-existing diseases. Under the new guidelines of IRDAi Health Insurance policies will have less exclusions under the proposed rationalization and standardization of exclusions. No exclusions of diseases contracted after taking the  policy,  no exclusion for injury or illness associated with hazardous  activities,  not to exclude mental illness, neuro- degenerative disorders etc.,Age related Mascular degeneration (ARMD), artificial life  maintenance support systems etc also to be covered. Perhaps the Insurance companies may be allowed to enhance the premium rates. Insurance companies cannot deny a claim after 4 years of continuous coverage.

It is always to the advantage of the Policy holder to firmly declare the pre-existing diseases such as high B.P, diabetic levels, thyroid etc., May be the premium may be a little more but coverage will be there. If suppressed, it will lead to rejection in toto. IRDAI has identified 17 existing diseases that can be permanently excluded. Modern methods of treatment and procedures like uterine artery embolisation, balloon sinuplasty,  deep brain stimulation oral chemotherapy, robotic surgeries, bronchical thermoplasty etc are to be covered  with a prior intimation and agreement with the Insurance companies. After eight years no look back can be applied. Of course, fraudulent claims and specified exclusions will be disallowed.

While taking a Health Insurance Policy, it is always better to disclose the exiting diseases, be candid and get clarified all the doubts about inclusions and exclusions that would be pointed out at the time of settling the claim.

So it is prudent to take a Health Insurance well in advance in age as the medical expenses are sky rocketing.

Wish you all a healthy life and happy and profitable Investing!

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