Health insurance in new, improved avatar

Opinions expressed in the column are the author and do not represent the Reuters)
"Until now, our focus was to work with Development Authority, but now it's been over ten years and the time for action is the regulatory authority," Hari Narayan, Chairman of the Indian insurance regulatory and Development Authority (IrDA), was quoted as saying recently. And the true form of IRDA has just released its exposure draft of the functioning of health insurance in India.
These draft guidelines, if implemented, go a long way to set up a really useful and effective mechanism for health insurance in India. It has tried to cover all the health insurance plan - from documents and simplify product design with some very useful features to protect policyholder interests of effective and transparent processing of applications, portability, and issues faced by seniors mainly (this is a pain in the area at the moment).
Listed below are the key points of this proposal. In order for the sake of simplicity I have mentioned only in general insurance policies sold to individuals.
- All operating instructions should allow access until the age of 65
- When a proposal is accepted, the policy is not a retirement
- Policies to provide care in hospitals across India, with the exception of the unauthorized
- The insurer shall not be forced to switch to other insured health insurance products, if it hampers the insured
- If the proposal is denied, the reason shall be in writing
- Refund 50 PCT cost of pre-insurance medical examination, if the proposal is approved
- A separate channel to address grievances and pensioners
- If a person has a number of health insurance, the customer has the opportunity to choose an insurer with the claim must be resolved
- A simple document that explains the main features and benefits of the plan is submitted to the customer
- Policy will be new except for fraud or misrepresentation of facts
- Clarify the standards for portability
- Claim Processing Services within 30 days
You can download and read the full instructions by clicking here.
This is really a commendable job of the regulatory authority and to give very clear direction on how the industry wants to flow, with a lot of importance on consumer protection. Consumer protection will increase consumer confidence, which leads to increased growth in the area, which is up to the critical financial situation.


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