The Insurance Regulatory and Development Authority of India (IRDAI) is a regulatory entity that supervises India’s insurance sector. IRDAI’s primary purpose is to protect a policyholder’s interest and boost the insurance sector in India. A health insurance policy offers customised coverage for expenses arising out of various medical emergencies. Here are the IRDAI guidelines for health insurance policies. Read on!
Before delving into IRDAI (Insurance Regulatory and Development Authority of India) guidelines for health insurance, it is crucial to know more about the entity. IRDAI is a regulatory body operating under the Finance Ministry of the Government of India. As stated earlier, the entity regulates and provides licenses to insurance companies in the country. IRDAI Act 1999, passed by the Indian Government, led to the formation of this body. Currently, Mr Subhash Chandra Khuntia is the chairperson of IRDAI.
IRDAI has a significant role in regulating and monitoring insurance policy companies under Section 14 of the IRDAI Act, 1999. Some of its essential functions are as follows:
Particular health-related services offered by network hospitals or service providers –
When it comes to health insurance claim settlement, the IRDAI has put the following guidelines in place:
Note: The above IRDAI guidelines for health insurance claim settlement apply to insurance plans purchased from 1st October 2020.
Also Read: Waiting Period In Health Insurance: What Is It & Why Is It Important?
The new guidelines declared by IRDAI in 2020 aim to improve the experience of the health insurance policyholders. It focuses on various aspects such as claim settlement, use of various policies and portability.
Following are the benefits of the new guidelines to health insurance policyholders:
As a smart and responsible policyholder, you should be aware of your rights under the new guidelines set by the IRDAI.
You have the right to:
Also Read: Cashless Health Insurance Policy: Coverage Of Cashless Medical Insurance & Their Types
IRDAI is the supreme Authority that regulates India’s insurance sector to ensure fair business practices and optimum services to policyholders. Hence, before purchasing a health insurance policy, it is crucial for individuals to take a look at the IRDAI guidelines in place to enjoy optimum benefits.
Further, to avail of the best health insurance plans, individuals can turn to Navi health insurance. With paperless claims, an extensive network of cashless hospitals and such benefits, health insurance policies from Navi can be extremely beneficial. Download the Navi app today to know more!
Ans: No, you will not be able to raise a claim with an inactive policy.
Ans: All general insurance firms registered with IRDA offer health insurance in India. For more information, check the official IRDA website.
Ans: An insurer provides a cumulative bonus which is an increased sum insured amount without increasing the premium.
Ans: Yes, there are basic differences between individual and group health insurance policy regulations. However, the principal difference is that an individual health insurance plan will be applicable as long as the policyholder pays the premiums diligently. But under a group health insurance policy, you will get insurance coverage as long as you are employed by the concerned organisation.
Ans: The new rules or guidelines by the IRDAI came into immediate effect from October 1 2020 in India.
Ans: If you think that migrating to a new policy or insurer will be a great choice, you can apply for portability by filling up the IRDAI portability form. You are required to fill out the Form 45 days prior to the renewal of the premium date of the current policy.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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