Highlights

  • Health Insurer can't reject claim for non-disclosure after 5 years of policy being in effect: IRDAI
  • Waiting period for pre-existing diseases shortened to three years

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IRDAI tweaks health insurance norms: Entry age to waiting period, here's how the changes will impact you

While IRDAI hasn't set any maximum age limit for health insurance, it remains to be seen, how this will impact policyholders and whether insurers will offer specific products for those above 65 while having an age limit on regular health policies. 

IRDAI tweaks health insurance norms: Entry age to waiting period, here's how the changes will impact you

Beginning first of April, a slew of changes with regard to health insurance have come into effect. Insurance Regulator IRDAI has tweaked certain norms which will be beneficial for policyholders.

Changes in health insurance norms

The moratorium period for claims has been reduced to five years from the eight years earlier. This essentially means that after five years of your policy being in effect, the insurer will not be able to reject your claim on the grounds of any non-disclosure, except fraud that has been established.

Another change is with respect to the waiting period for pre-existing diseases. This is the period during which any illness resulting from a pre-existing condition would not be covered. This period, which was earlier up to four years, has now been shortened to three years.

The new rules do not mention any maximum entry age. The circular says, "Insurers shall ensure that they offer health insurance products to cater to all age groups". It also goes on to say that insurers may design products specifically to cater to specific groups such as senior citizens, students, children etc.

“The maximum age at entry was 65 years for regular health insurance policies. Now, this has been opened up. That is, insurers could decide that their regular policies will be available only for those up to the age of, say, 60 years. Others might have to settle for policies targeted at elderly individuals,” says Hari Radhakrishnan, Regional Director, First Policy Insurance Brokers told Moneycontrol.

While even those above 65 years of age, could get health insurance even earlier; now the regulator has specifically mentioned that all age groups must have access to health products. This means, that insurers cannot cite age as the reason for declining to issue a policy. However, some clarity is required about whether this means that insurers have the option of offering only specific products designed for senior citizens and if that then means that they have the freedom to set age limits for their regular health policies

Frequently Asked Questions

The moratorium period for claims has been reduced to five years from the previous eight years.

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