News Life and Health27 Jul 2018

India:Regulator acts to minimise exclusions in health insurance

27 Jul 2018

Insurance regulator IRDAI has started an exercise to minimise the number of illness/diseases which are not covered under the health insurance policies.

The regulator has set up a 10-member committee which has been asked to submit its report in eight weeks. The panel is headed by Suresh Mathur, Executive Director (Health), IRDAI.

The panel will examine the exclusions that are prevalent in health insurance policies with a view to minimising their number and to enhance the scope of insurance coverage, reports Press Trust of India.

The terms of reference given to the committee include, "Rationalise the exclusions that disallow coverage with respect to new modalities of treatments and technologically advanced medical treatments. Identify the type of exclusions which shall not be allowed".

The committee has also been tasked to examine the scope for "allowing individual specific and/or ailment/disease specific permanent exclusions at the time of underwriting so that the policyholders are not denied health insurance claims unrelated to the exclusions".

The panel will study as well wordings/language of exclusions and standardise the wordings in simple and easily understandable language.

IRDAI said in an order that with the growth in the number of companies providing health insurance, there is an increase in the number of products offered. It is desired that the industry adopt a uniform approach while incorporating exclusions as part of product design as well as for the wording of the exclusions.


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