News Excerpt:

The Insurance Regulatory and Development Authority of India (IRDAI) has removed the age limit for purchasing health insurance policies, with effect from April 1, 2024.

More about the news:

• Previously, individuals were restricted to buying new insurance policies only until the age of 65.
• With the recent changes, anyone, regardless of age, is now eligible to purchase new health insurance.
• Now Insurers must ensure they offer health insurance products catering to all age groups. 
• They may design products specifically for senior citizens, students, children, maternity, and other groups as specified by the Competent Authority.
• The coverage is subject to offer and acceptance between the Insured and Insurer based on affordability for senior citizens and viability for Insurers

Significance of the move:

• This move by the IRDAI aims to create a more inclusive healthcare ecosystem in India and to encourage insurance providers to diversify their product offerings.
• This may lead to better access to healthcare and reduced burden of medical expenditure for senior citizens.

Other changes introduced:

• IRDAI has also directed health insurance providers to introduce tailored policies for specific demographics, such as senior citizens, and establish dedicated channels for handling their claims and grievances.
• Following the recent notification, insurers are also prohibited from refusing to issue policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS.
• IRDAI has also reduced the health insurance waiting period from 48 months to 36 months. 
• All pre-existing conditions should be covered after 36 months, regardless of whether the policyholder disclosed them initially or not. 
• In other words, health insurers are prohibited from rejecting claims based on pre-existing conditions after these 36 months.
• Insurance companies are barred from introducing indemnity-based health policies, which compensate for hospital expenses. 
• Instead, they are only permitted to provide benefit-based policies, offering fixed costs upon the occurrence of a covered disease.