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IRDA proposes changes in new draft health insurance guidelines: Here's what experts say

Updated : June 04, 2019 07:55 PM IST

Insurance Regulatory and Development Authority (IRDA) has proposed some key changes with respect to the inclusions and exclusions in health policy.

These draft norms make it mandatory for insurance companies to cover treatment cost arising from ailments relating to mental illness, depression puberty and menopause among others. The rules also lay down guidelines on covering pre-existing diseases.

B Subramanyam, chief underwriting officer at SBI General and Mahavir Chopra, director - Health & Life at Coverfox Insurance Broking discuss with CNBC-TV18 the key changes proposed.

Here's what they have to say:

Subramanyam: "The very first paragraph of these draft guidelines makes it clear that the objective is to standardise the formats and guidelines from a customer's perspective and these will apply across the board both to multi-line insurers as well as standalone health insurers. So, it is an industry development."

"Invariably when you take health insurance, you are required to make some declarations upfront about any pre-existing conditions, which might be there either to your knowledge or in your absence. Now the regulator is clearing up the thing very clearly. What they are saying is if something has been contracted post taking an insurance policy and you were definitely not aware of it at the time of taking the insurance policy, an insurance company cannot deny you a claim on the grounds of misrepresentation, suppression of facts, etc."

Chopra: "Standardisation will bring in a lot of confidence from customers' point of view to be able to take that leap of faith and buy a health insurance which is very important for the customer."

"What the IRDA or the working group is basically trying to achieve out of all these conditions is that they have talked about and they have said that exclusions now will be disallowed... the larger logic behind this is basically to include certain diseases which were earlier excluded."
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