5 Big Changes in Health Insurance Regulations You Need to Know

The Insurance Regulatory and Development Authority of India (IRDAI) has made significant changes in the health insurance sector with the release of a new master circular. This circular, which repeals all previous 55 circulars, aims to empower policyholders and enhance the overall health insurance experience.

One of the key features of the new circular is inclusiveness. Insurers are now required to offer a wider choice of products catering to all ages, regions, occupational categories, and medical conditions. Additionally, the age cap on purchasing health insurance policies has been lifted, allowing individuals to buy insurance beyond the age of 65.

Another important change is related to cashless claims. Health insurance companies must now respond to cashless authorisation requests within an hour and approve final authorisation within three hours of receiving discharge requests from hospitals. Any delays beyond this timeframe will result in the insurer bearing additional charges from the shareholder’s fund.

The circular also introduces a grace period for premium payments, allowing 15 days for monthly installments and 30 days for quarterly, half-yearly, or annual payments. Policyholders now have a free look period of 30 days to review policy terms and conditions and can cancel the policy within 7 days of notice in writing, with a refund of the proportionate premium for the unexpired policy period.

These changes are aimed at providing policyholders with a seamless and hassle-free experience when it comes to health insurance. With a focus on inclusiveness, faster claims processing, and improved policy terms, the new master circular is set to enhance the overall health insurance sector in India.