Health insurance has always been of critical importance at every stage of your life. Health adversity can strike at most inopportune times, leaving one in mental stress as well as financial debt. Availing health cover is an ideal solution to protect oneself from such situations.
There have been some radical changes in the policy structures in recent years. One of such changes includes standardisation of the exclusions to your policy. The year 2020 has witnessed a few more changes that you must be aware of. Continue reading to know more about the changes in health insurance policies.
Standard health product from April 2020
The new reform by the Insurance Regulatory and Development Authority of India (IRDAI) introduces a standard health plan across all insurance companies. This product will be known as Arogya Sanjeevani policy and will follow the insurance company’s name to be identifiable.
The standout feature of this plan is uniformity across all insurance companies with regards to features, its terms and conditions. As it is a basic plan, it will not be accompanied by any add-ons or differential pricing according to different zones.
It has a favourable impact on us as consumers, and terms will be easy to understand. The Arogya Sanjeevani policy is introduced to increase the affordability of the insurance plans to every individual.
No ambiguity of pre-existing conditions
The previously issued guidelines by IRDAI had defined pre-existing diseases with some ambiguity. As per this definition, it included the diseases occurring within three months of purchasing the policy as a pre-existing ailment. Due to this definition, there were cases of disputes of rejection of claims between the insurers and policyholders.
The latest amendment has cleared this ambiguity and defines a pre-existing ailment as a medical condition that is diagnosed or for which treatment is recommended 48 months before purchasing the policy.
It is a welcome move by IRDAI reducing the cases of rejected claims and clearing any doubts with regards to pre-existing conditions. Shopping for family health insurance becomes easier with the policyholder being aware of the specific inclusions and exclusions in their insurance plan.
Access to blacklisted hospitals during emergencies
The regulator, IRDAI, has allowed the insurance companies to blacklist hospitals. Special permissions are given to the insurers to crackdown erring hospitals. But this situation had started to cause problems for the policyholder in case of emergencies.
To arrive at a middle-ground, the guidelines amended under health insurance policy have permitted the treatment to be availed from these blacklisted hospitals during times of emergency. It becomes crucial to seek timely treatment in case of life-threatening ailments. Thus one can access treatment from such blacklisted hospitals too in severe cases. Your critical illness insurance plan generally includes treatment for cardiac support, and you can avail in times of medical emergency from such hospitals.
These changes are in the interest of the customers, and one can benefit from the amended norms. Make sure you are familiar with these revised norms before buying a health insurance plan.