IRDA removes health insurance age limit, makes big changes in pre-existing disease policies

Previously, there was a restriction on individuals aged 65 and above from acquiring new health insurance policies.

However, recent regulatory adjustments mean that people of any age can now obtain new health insurance coverage.

A notice from IRDAI stresses the need for insurers to expand their services to accommodate various demographic segments, including seniors, students, children, and maternity requirements.

Insurers are urged to create customised products to meet specific age-related needs, fostering inclusivity in healthcare coverage.

This move indicates IRDAI’s commitment to improving the accessibility and affordability of healthcare coverage across all age brackets.

By doing away with age limitations, the regulatory body aims to inspire innovation among insurers, motivating them to diversify and improve their product offerings.

IRDAI also mandates health insurance providers to develop specialized policies for senior citizens with dedicated avenues for handling their claims and complaints.

This proactive approach aims to effectively address the unique healthcare needs of elderly policyholders.

Industry experts have welcomed this regulatory change, recognizing its potential to extend healthcare coverage to individuals over 65.

Insurers, guided by approved underwriting guidelines, can now offer coverage to seniors based on affordability and viability.

In another notable reform, insurers are prohibited from denying policies to individuals with severe medical conditions such as cancer, heart or renal failure, and AIDS.

The notification also reduces the waiting period for coverage of pre-existing conditions from 48 to 36 months.

After this period, all pre-existing conditions must be covered, irrespective of initial disclosure.

Moreover, IRDAI has mandated a shift from indemnity-based health policies, which reimburse hospital expenses, to benefit-based policies, providing fixed payouts upon diagnosis of covered illnesses.

This change aims to enhance clarity and predictability in insurance offerings, ensuring policyholders receive timely and transparent benefits.