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New Provisions by IRDAI: Here's What You Need to Know

Published On Dec 18, 2019 5:30 AM By Sakshi Aggarwal

IRDAI, from time to time, has been making various regulations in order to make the insurance experience smoother and more transparent for the insurance providers as well as the customers. 

We are aware of the insurance regulatory authority IRDAI’s new regulations that may be known as the Insurance Regulatory and Development Authority of India (Health Insurance) (Amendment) Regulations, 2019. 

The Insurance Regulatory and Development Authority of India (IRDAI) has recently notified about several new provisions. Some of them include policyholders choosing their own Third Party Administrator, insurers encouraging wellness among the policyholders etc. 

You may also like to read: IRDAI Offers Relief to Patients, Includes Bariatric Cover Under Health Insurance

Apart from these, there a few more subscriber-friendly provisions in the regulations two of them are explained below. See if they bring any good news for the policyholders. 

1. According to Clause 1 of notification, the following clause will be substituted for Clause (2) of sub-regulation (ii) of regulation 24-“Balance claim or claims disallowed under the earlier chosen policy/policies may be made from the other policy/policies even if the sum insured is not exhausted in the earlier chosen policy/policies. The insurer(s) in such cases shall independently settle the claim subject to the terms and conditions of other policy/policies so chosen.”

Experts believe that it can be considered as a good option for the policyholders as now they can settle a claim from many insurers on a specific condition that the policyholder notifies the insurer about health insurance plans already in use. It will be beneficial for the policyholders if they have an individual health insurance plan along with the one provided by their employers.  

2. As per Clause k of the notification, In sub-regulation (i) of regulation 23, the words “The insured shall be informed in writing of any underwriting loading charged as filed and approved under the Product Filing Guidelines over and above the premium and specific consent of the policyholder for such loadings shall be obtained before issuance of a policy ” shall be omitted. 

As the experts say, loading is known as the additional premium that the customer pays in consideration to pre-existing conditions as defined by the insurance provider. Simply put, loading covers a ‘risky’ individual.  

The provision will do good to the policyholders as it will make the policyholders clear about the coverage they will get and how much loading amount they will have to pay which will be included in the premium amount.     

As a policyholder, purchasing more than one health insurance plan is important. But in order to fully utilise all the health insurance plans, one should ensure that benefits of all the plans differ from each other. Make sure to share all your health-related information and also notify about your existing health insurance plans with the insurer. 

Also Read

IRDAI Approves Reliance Health Insurance’s Operations

All You Need to Know About IRDAI's New Health Insurance Rules

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