InvestorQ : What are the new health insurance guidelines issues by the IRDAI?
Nitin Shah made post

What are the new health insurance guidelines issues by the IRDAI?

Answer
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Kunal Verma answered.
3 months ago


The Insurance Regulatory and Development Authority of India (IRDAI), has introduced three new guidelines in June 2020 to insurers offering health insurance products. These guidelines require insurers to make changes in their policies and functioning to make health insurance more user-friendly.

These changes are:
Standardization of important product clauses in the policies so that customers can understand them easily and can compare products across insurers. In this case, insurers are required to use the prescribed standard wordings provided by IRDAI. Additional clauses are allowed to be used in order to provide better clarity for consumers. 

Ensuring insurance coverage for telemedicine, which has gained prominence during present COVID times. Since the Medical Council of India has issued guidelines in March 2020 enabling Registered Medical Practitioners to provide healthcare using telemedicine, insurers have been advised to allow claim settlement for telemedicine consultation wherever normal consultation with a medical practitioner is allowed in the terms and conditions of the policy contract.

To provide more rational and customer-friendly claim deductions. This is especially useful for policy buyers who choose a higher category of hospital services than what is allowed by the prescribed limits on their insurance policy.

All these modifications and guidelines are aimed at making health insurance hassle-free for policyholders. The guidelines shall apply to new health insurance products filed on or after 1st October 2020. While those with existing health insurance can avail of the benefits of these new guidelines on renewal from 1st April 2021.