Insurance companies have certain conditions in place when providing health insurance. They provide information on the waiting period, specifically for pre-existing diseases and diseases falling under a special category. However, the Insurance Regulatory and Development Authority of India (IRDAI) has recently made three key changes in the claim rules related to these aspects. These changes have been implemented to provide more benefits to health insurance takers. Let’s find out the details.
The Insurance Regulatory and Development Authority of India (IRDAI) has some good news for health insurance takers. The IRDAI has clarified that the maximum waiting period for health insurance companies to get complete coverage in case of pre-existing diseases should be reduced from 4 years to 3 years. This means that the maximum waiting period will now be three years. A notification was issued on April 1, 2024, in this regard. The IRDAI (Insurance Products) Regulations 2024 has revised the definition of pre-existing diseases.
According to the notification, pre-existing diseases refer to any condition, illness, injury or disease. Furthermore, the diseases diagnosed within 36 months of taking the insurance or if the doctor recommends treatment for any disease, the diseases not exceeding 36 months will be included in this. However, this definition of pre-existing disease does not apply to overseas travel policies.
When buying insurance policies, insurance companies inquire about health conditions and diseases. If there are diseases that fall under the category of pre-existing diseases, there will be a waiting period. If you fall ill during this waiting period, the insurance will not cover it. With the latest decision taken by IRDAI, the waiting period is reduced by one year. This will benefit many policyholders. Reducing the waiting period from 48 to 36 months will benefit many people, and more people can buy health insurance.
On the other hand, IRDAI has decided to reduce the moratorium period of insurance policies from 8 years to 5 years. If the moratorium period of an active health insurance policy is over, the insurance companies have to settle the claims without any delay or hassle. The newly reduced waiting period rules will apply to new and old policies. Experts say that these new rules will be very useful for first-time policyholders. This benefit will come into effect when the old policies are renewed.
