Hyderabad::
The insurnace regulator IRDAI has made it mandatory for all the general insurers to offer a standard health insurance product to customers.
“To enable access to the basic health insurance covers, all insurers will have to offer a standard health insurance product as per the guidelines as may be specified by the IRDAI from time to time,'' said the IRDA while laying out new rules, that have been notified, on Tuesday.
However,other details like premium, sum assured and other terms conditions of such a product are yet to be announced.
For making the health insurnace policies more customer friendly, the IRDAI has now brought in a lot of changes in the health insurnace regulations.
Any of the exclusions in all health insurance policies will be subject to the guidelines as may be specified by the IRDAI from time to time.IRDA has said the renewal premium will not be accepted more than 90 days in advance of the due date of the premium payment.”
The general insurers and health insurers offering indemnity based health covers will have to offer an option to the policyholders to migrate to a suitable alternative health insurance policy available at the time of modification or withdrawal of the policy.
Further, indemnity based health covers offered to specific age groups, students, children under family floater policies, shall also offer an option to such lives to migrate to a suitable alternative.Every policy migrated will be allowed suitable credits for all the previous policy years, provided the policy has been maintained without a break.
All insurers may endeavour to provide coverage for one or more systems covered under “AYUSH treatment” provided, the treatment has been undergone in the hospitals or healthcare facilities subject to the guidelines as may be specified by the IRDAI from time to time.
Insurers may endeavour promoting wellness amongst policyholders of health insurance as per the guidelines as may be specified by the IRDAI from time to time.
“The insured will be informed in writing of any underwriting loading charged as filed and approved under the Product Filing Guidelines over and above the premium and specific consent of the policyholder for such loadings will be obtained before issuance of a policy.
Subject to terms and conditions of the policy contract, reimbursement shall be allowed at any hospital or medical establishment. All such establishments must be licensed or registered as may be required by any Local, State or National Law as may be applicable.”
Authority may require insurers, third party administrators and network providers to comply with data related matters and settlement of claims through electronic means as per the guidelines as may be specified by the IRDAI from time to time.