There are some significant changes that took place in 2020 in the health insurance industry such as the launch of new products, the introduction of telemedicine facilities, among others. The Insurance Regulatory Authority of India (IRDAI) also announced several relaxations for customers in 2020 in view of the unprecedented situation prevailing in the country due to the coronavirus pandemic.
Here are the key changes made in the health insurance sector in 2020: Allowance for Paying Insurance Premiums in Installments
IRDAI allowed general and standalone health insurers to give policyholders the option to pay
health insurance premiums in installments. Policyholders can pay their annual health insurance premiums in a monthly, quarterly, or half-yearly basis. Cashless Payment Facilities for Treatment of Coronavirus
IRDAI has asked all hospitals to provide cashless payment facilities for the treatment of coronavirus. The insurance regulator has asked insurance companies to maintain a communication channel with hospitals for prompt resolution of grievances of policyholders. In case of denial of the cashless facility, policyholders can file a complaint by writing to the grievance redressal officer of the insurer.
Launch of Coronavirus Specific Insurance Plans
Insurance companies have launched two standard COVID-19 health insurance policies -- Corona Kavach and Corona Rakshak. While Corona Kavach is a standard indemnity-based COVID-19 policy, Corona Rakshak is a fixed benefit plan.
Corona Kavach has been launched to cover the cost of treatment of any co-morbid conditions, including pre-existing conditions, along with the treatment for the coronavirus infection or disease with the tenure ranging from 3.5 months to 9.5 months.
Health Insurance Policy Proposals Validation Via Digital Means
IRDAI allowed all general and specialised health insurers to validate health insurance
policy proposal forms through digital means in place of physical signatures. The regulator has also given an option to the policyholders to give their agreement to the insurer via a one-time-password, without using a wet signature on the hard copy of the proposal form. Inclusion Of Telemedicine Under Policy
The IRDAI asked insurers to include
telemedicine under the health insurance policy. This means that anyone taking telemedicine consultation from a doctor will be allowed to claim the expenses under a health insurance policy provided the policy covers OPD expenses. Provision of allowing telemedicine will be part of the claim settlement of policy of the insurers and need not be filed separately with the authority for any modification. Inclusion Of Wellness And Preventive Features In Health Policies
IRDAI asked insurance companies to include wellness and preventive features in health policies to encourage the policyholders to stay healthy and minimize the chance of falling sick. As part of promoting wellness and preventive regime, insurers may offer reward points to those policyholders who comply with or meet the set criteria of wellness and preventive features.
Coverage For Uncovered Ailments
According to IRDAI’s guideline, insurance companies cannot exclude diseases like mental illness, stress or psychological disorder, illness contracted due to hazardous activity, treatment like age-related disorder, internal congenital disease, genetic disease, or disorder. Hence, coverage for these diseases which are excluded or are not covered in health insurance products so far will be covered by all insurance companies.
New Pre-Existing Disease (PED) Definition
The In accordance with the issued guidelines, any disease/s or ailment/s that is/are diagnosed by a physician 48 months before the issuance of the health cover can be classified under PED. Also, any disease/s or ailment/s for which any type of medical advice or treatment was recommended by a qualified doctor 48 months before the issuance of the policy can also be qualified under PED. Further, any condition whose symptoms or signs have resulted within three months of the issuance of the policy will also be classified under PED.
definition of pre-existing disease (PED) has been modified to cater to the needs and requirements of customers.