The Insurance Regulatory and Development Authority will soon notify standard terms to be used in health insurance policy contracts.

A set of recommendations in this regard, prepared by a working group constituted by industry bodies, would be referred to the Health Insurance Forum for feedback, Mr J. Hari Narayan, Chairman, IRDA, told newspersons on the sidelines of the first meeting of the Forum here on Thursday.

The working group standardised 20 common terms associated with health insurance, 20 critical illnesses, pre-authorisation and claims forms, discharge summary and billing process, besides compiling a list of ordinary exclusions (from cover), he said.

Referring to losses for health insurers due to price erosion driven by competition, he said though premiums were deregulated, the IRDA could still take action on those insurers with faulty pricing policies.

Earlier, while speaking after formally inaugurating the Forum, he said a separate health insurance vertical would become a reality soon after the passage of the Insurance Amendment Bill.

COMMUNICATION

There is need to make communication in health insurance understandable to policyholders, he said.

In 2011-12, of the total complaints of 92,898 in non-life insurance, 37 per cent emanated from the health insurance segment.

These could have come from lack of understanding of policy-related aspects by policyholders, he said.

“It is the responsibility of the insurers to make communication on policy-related aspects simple,” Mr Hari Narayan said.

Ms J. Meena Kumari, Joint Director – Health, IRDA, said the main concern from a policyholder perspective was lack of trust and uncertainty on whether a claim would ever get paid.

Mr M. Ram Prasad, Chairman, Health Insurance Forum and Member (Non-Life), IRDA, said the forum would function as a consultative body for the regulator, representing interests of all the stakeholders.

> nagsridhu@thehindu.co.in

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