Insurance regulator suggests modification in steps for speedy settlement of insurance claims in India. (Photographer: Akio Kon/Bloomberg)

IRDAI May Bar Insurers From Excluding Critical Illnesses From Health Insurance Coverage 

The Insurance Development and Regulatory Authority of India is mulling barring insurers from excluding several critical illnesses such as genetic diseases, neurodevelopment disorders and psychological disorders from health insurance policies.

With the increase in the number of health insurance companies as well as health insurance products in the market, IRDAI in its draft guidelines proposed that the health insurance industry should adopt a uniform approach while incorporating exclusions in health insurance products.

Also read: IRDAI Panel Suggests Steps For Speedy Settlement Of Insurance Claims

The insurance regulator had constituted a working group on the standardisation of exclusions in health insurance contracts. After examining the recommendations of the working group, the regulator has proposed to issue guidelines.

Here are some of the proposed guidelines in the draft:

  • No health insurance policy shall incorporate exclusions in the terms and conditions of the policy contract on diseases contracted after taking the policy.
  • Impairment of persons’ intellectual faculties by the usage of drugs, stimulants or depressants as prescribed by a medical practitioner cannot be excluded.
  • Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders, should not be part of the exclusions listed in the policy.
  • Puberty and menopause-related disorders, age-related mascular degeneration and behavioural and neurodevelopmental disorders too cannot be excluded.

IRDAI has sought comments from the stakeholders till May 31.

Also read: IRDAI Partners With National Health Authority To Study Ayushman Bharat