Less time to wait for pre-existing conditions and no disagreements following five years of insurance coverage
Beginning in April, claims made five years after purchasing your health insurance will be uncontested since your insurer will not be allowed to deny them on the grounds that you did not disclose any medical issues at the time of purchase.
New and current health insurance policyholders have cause for celebration as we enter a new fiscal year.
Some important standards for health insurance plans have been modified by the Insurance Regulatory and Development Authority of India (IRDAI) as part of its revamp of product regulations across insurance categories.
After five policy years, anxiety-free claims
It has, among other things, shortened the eight-year moratorium period for claims under health insurance policies to five years. The insurer will not be able to contest a policy or claim for non-disclosure or misrepresentation after sixty months of continuous coverage (including portability and migration) unless there is proof of proven fraud. The IRDAI regulations refer to this period of sixty consecutive months as the “moratorium period.”
Stated differently, your insurance company cannot deny claims on the grounds that you withheld information about your health status if you have paid your premiums consistently for five years. For instance, failure to disclose pre-existing conditions, such as diabetes, hypertension, asthma, and so forth, may lead to claim denial even in cases where these illnesses are not linked to your hospital stay. Insurance companies have the authority to refuse claims and revoke policies on the grounds of non-disclosures.
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