2/ **Why was this needed**
Every plan has its own independently designed terms and conditions, especially exclusions. 🙄
It was difficult to understand & compare many of these wordings. This also resulted in unpleasant surprises & grievances during claims.
3/ IRDAI has been taking massive efforts to standardize health insurance products, making them easier to understand and compare, helping reducing confusion and grievances.
This is another effort from IRDAI. 💪💪
4/ **Important**
These changes are applicable to all policies - existing and new from today - 1st October 2020.
In case you already own a policy that is due for renewal, these changes may take effect at the time of renewal.
5/ **Standard definitions for 18 exclusions**
IRDAI standardized definitions of the 18 most common exclusions like pre-existing diseases etc.
These terms will now have standard wordings across all health insurance plans across the country.
6/ **Disallow❌ambiguous definitions**
For exclusions that do not form part of the standard definitions - IRDAI now disallows ambiguous words in defining exclusions - for instance, the exclusions now cannot use open-ended words like "such as", "indirectly related to"
7/ **Disallow❌ insurers to put certain exclusions**
Health insurance will now cover treatments like mental illnesses, artificial life maintenance, Internal congenital diseases, genetic disorders (these were earlier excluded)
8/ **8 years⏲️of moratorium**
Earlier, insurers canceled policies, rejected claims on the grounds of misrepresentation even after customers had paid premium for decades.
Now, insurers cannot contest the policy or its declarations after 8 yrs, unless they prove a fraud.
9/ *Widening access to health insurance*
Insurers found it unviable to give insurance with preexisting cover to ppl with a history of Cancer, Epilepsy even with 48 mth waiting period
Now, such people may get access to health insurance with a permanent exclusion on the disease
10/ **Modern😎Treatment like Stem Cell Therapy included**
Many insurers did not cover Oral Chemo, robotic surgeries, stem cell therapy, and many more modern treatments.
IRDAI lists down 12 modern treatments that will now be covered under all health insurance policies.
Agent vs Online - whom do you buy health insurance from?
A debate more complex than Android vs iPhone
I found a reasonable answer to this question through countless interactions with customers over 15+ years of working in insurance distribution.
Here's what I realized.
Online platforms are great for transactional products.
Products where the cognitive load to make decisions is low - where stakes are low, where decisions are reversible.
Simple UX and an efficient call centre do the trick.
But this same thing is not true for complex insurance products like health insurance.
These products have serious nuances that cannot be understood easily.
Personalization, right declarations when buying the policy
Paperwork, follow-up, and dispute management when making claims
4 myths regarding parents' health insurance through an employer you must know.
On the face of it, employer parent's health insurance looks like a no-brainer
✅ No medical tests
✅ No waiting periods
✅ Cover all diseases
✅ Faster claims
To problem kya hain? Read on 😅
𝗠𝘆𝘁𝗵 𝟭: I will remain employed for a good time. So I will always have parents cover
Not really
Note, parents' coverage with those lovely benefits causes major losses to insurers The policy is hence prone to:
a) price hikes
b) reductions in benefits
I have witnessed companies that start with fancy benefits for parents, free.
Then renewal comes
When they realize there is a huge premium hike, the CFO walks in, and rest is history
Just check the pricing history of parents insurance in your company for last 5 years.