Health Insurance: IRDAI mandates additional costs for insurers on late claim settlements

livemint.com:

Also Read: Is a 40-50% hike in annual health insurance premium on renewal possible?The insured can return a health policy with a tenure of one-year and more in the first year in 30 days if she/he does not find it useful and can decide on the order of making claims in the case of having multiple policies. The insurance coverage should be available in all kinds of hospitals including affordable ones and there should be no denial of coverage in emergency situations, IRDAI stated in its master circular issued on May 29.

Most of the changes are applicable with immediate effect unless there is a specific date mentioned for the change.

Also Read: Why health insurance with OPD covers are growing popular in India? Check top plans with OPD cover“The cancellation charges used to be pretty high earlier. This has now changed," said Mahavir Chopra, founder and CEO of Beshak, an online insurance review platform, in a post on X (formerly Twitter).The insurer is required to comply with the award of the ‘Insurance Ombudsman’ within 30 days of the receipt of the award.

If the insurer fails to honour the ombudsman’s award, a penalty of ₹5000 per day shall be payable to the complainant, IRDAI started.

Also Read: 5 key reasons health insurance is crucial for young adults' future security“It was reported that ombudsman judgements were not being implemented by many insurers. There was a need for a penalty," Chopra said.

Claim rejections cannot be done by a single person and has to be done by a three-member product management committee. “Hope this brings some sanity in the ad hoc, arbit (arbitrary rejections) customers experience," Chopra observed.While the portability clause remains more or less the same, IRDAI has put timelines to ensure smooth