What are the major changes made by IRDA to health insurance policies? I am having health cover with ICICI Lombard, how will it impact me?

You are right that the IRDA, the regulating body for insurers, has made some key changes to the health insurance policies with a view to making them more user-friendly. Here are some of the major changes announced.

· IRDA has now asked to introduce a standard health insurance plan for anyone between the ages of 18 and 65 with a basic sum insured ranging between Rs.50,000 and Rs.10 lakh. This plan will be available for lifelong renewal.

· In an interesting shift, the IRDA has stipulate that the regular health insurance plans will also provide coverage for expenses on approved alternative treatments like homeopathy, Ayurveda, Siddha, Unani etc. Of course, the reimbursement will be subject to the sub limits applicable in these cases.

· IRDA has called for extending the waiting period for inclusion of any ailment in the health cover to 4 years from the current limit of 2 years. However, for specific conditions like hypertension (high BP), diabetes and cardiac problems, the waiting period will be reduced to 30 days.

· IRDA has also stipulated that any exclusion from the list of covered ailments will only be done with the prior consent and approval of the insured. This is likely to make the insurance contract more balanced in favour of the insured. Once the policy has completed 8 years of continuous premium payments, the insurance company will not be allowed to question the claim on the grounds of non-disclosure.

· In a move that was long called for, the IRDA has decided to make mental healthcare available to all. As per the new regulations, IRDA has asked insurers to include mental illness coverage in all regular health insurance policies. IRDAI also underlined that insurers cannot deny coverage to policyholders who have used opioids or anti-depressants in the past.

· In a significant shift, the IRDA has also stipulated that any health condition or illnesses acquired after the issuance of policy, apart from those not covered under the policy contract (like infertility and maternity), will now be covered under the policy. Apart from the regular approvals, insurers cannot just keep expanding their list of exclusions from the policy.

In case you are already holding a policy, talk to your financial advisor and also to your insurer and ensure that these changes are implemented in your policy too.