New Delhi: The Insurance Regulator and Development Authority of India (IRDAI) has directed insurance companies not to exclude their policyholders from illness due to hazardous work activities, artificial life maintenance, mental illness treatment, age-related degeneration and congenital diseases.
According to the new guidelines, which were released on Monday, insurance companies will also have to cover age-related ailments like cataract, knee-cap replacements, Alzheimer’s and Parkinson’s. They will also have to include respiratory or skin ailments that arise due to work conditions, in case of factory workers working with harmful companies.
Further, if an insurer does not want to cover epilepsy, chronic diseases and HIV/AIDS, the guidelines have specific wordings to be used as well as specific waiting period (30 days-1 year) after which coverage would begin.
The move will greatly benefit those policyholders who disclose pre-existing conditions as the guidelines propose that ‘every health insurance product shall cover all pre-existing diseases disclosed by the policyholder to be insured immediately after the expiry of 48 months waiting period or such lower period as stipulated in the product.’
In the case of a policyholder transferring to a new insurer, the latter cannot set undue waiting periods. On this, the guidelines state that if the person has completed some part of the waiting period, the new insurer can only impose the unexpired waiting period not exceeding 48 months from the date on which the first porting out policy is issued.
The guidelines come after a report was submitted to the IRDAI, in November 2018, suggesting that insurance companies cannot exclude diseases like HIV/AIDS, Alzheimer’s, Parkinson’s and morbid obesity. The report was submitted to the IRDAI by a working committee.
The Insurance Regulator and Development Authority of India is an autonomous, statutory body which regulates and promotes the insurance and re-insurance industries in India. It was established in 1999 and is headquartered in Hyderabad.