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Mr J. Hari Narayan

Our Bureau

Hyderabad, April 1 The Insurance Regulatory and Development Authority (IRDA) has tightened norms on renewability and other aspects of health insurance policies to ensure better protection of interests of the policyholders.

In a circular sent to the Chief Executive Officers of all general insurance companies on Wednesday, Mr J. Hari Narayan, Chairman, IRDA, said the insurance companies cannot deny the renewal of a health insurance policy on the grounds that the insured had made a claim/claims in the previous or earlier years.

The insurance companies should not compel the policyholder covered under a specific health insurance product to shift to another product except in specific cases with prior approval of the Authority.

The prospectus of a health insurance policy should contain complete details of the terms of renewal to enable the customer take an informed decision. They should also mention the procedure and terms for enhancing the insured or scope of cover.

All health insurance polices should provide a mechanism to condone delays in renewal for up to 15 days from the renewal due date, so that the insured are treated as ‘continuously covered’ in terms of continuity benefits such as waiting periods and coverage of pre-existing diseases.

Any change in the premium structure or terms of insurance should be done only after obtaining due approval from IRDA. The insurers should also intimate such revisions to all policyholders at least three months prior to the date of renewal of their cover. In the case of group and tailor-made health insurance policies, the policy document should mention the mechanism for continuity of cover being offered by the insurer to the individual members covered under the group insurance, the circular added.

The norms would be applicable to all health insurance policies issued or renewed on or after June 1, 2009.

More Stories on : General Insurance | Regulatory Bodies & Rulings | Health

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