Medical insurance policyholders can now rejoice.
Insurance companies are reviewing claims settlement
norms in case of pre-existing diseases. This means,
insurers may soon no longer deprive mediclaim holders
of claims under the clause of “non-disclosure of diseases”.
Accordingly, policyholders who never underwent
treatment nor showed symptoms of a disease before
signing a policy document are likely to get the medical
policy benefits in future.
At present, insurance companies often decline to
settle insurance claims in case policyholders are
diagnosed with having contracted the disease prior
to the signing the mediclaim policy.
This is likely to change. The General Insurance Council
of India — an association of non-life insurers — in consultation
with all insurance players, is working on the appropriate
definition of pre-existing diseases.
“Policyholders who did not undergo any diagnosis or
treatment or show indications of a disease prior to the
signing of a contract should not be considered in the know
of having any pre-existing disease,” said BD Banerjee, a
member of the committee formed by Insurance Regulatory
and Development Authority (IRDA) to examine issues related t
o health insurance for senior citizens.
The insurance regulator formed the committee in May
this year in the wake of a over 200% hike in premium for
medical insurance policies after September 2006. The
insurers increased the premium for senior citizens ignoring
the regulator’s advice not to hike it more than 70%.
Mr Banerjee said, “Most private insurers turn down health
policies to people aged above 60. Among the public sector
insurers, only Oriental Insurance, as of now, does not offer
health insurance policies to senior citizens. It has, however,
applied for a policy for senior citizens to IRDA.”
Issues relating to health insurance for the elderly need
special focus, as they are more vulnerable and fall in a
higher risk category.
