
The Insurance Regulatory and Development Authority of India (IRDAI) has recently removed the age cap on buying health insurance policies, effective from April 1, 2024. Previously, individuals were restricted to purchasing new insurance policies only until the age of 65. However, with the recent changes, anyone, regardless of age, is now eligible to purchase a new health insurance policy.
Inclusive Healthcare Ecosystem and Diversified Product Offerings
The move by the IRDAI aims to create a more inclusive healthcare ecosystem in India and encourage insurance providers to diversify their product offerings. Insurers are now required to offer health insurance products that cater to all age groups, and they may design products specifically for senior citizens, students, children, maternity, and other specified groups.
Tailored Policies for Specific Demographics
In addition to removing the age cap, the IRDAI has instructed health insurance providers to introduce tailored policies for specific demographics, such as senior citizens. This includes establishing dedicated channels for handling claims and grievances of senior citizens. These changes are expected to provide more options and better coverage for individuals in different age groups.
Coverage for Individuals with Severe Medical Conditions
Under the new regulations, insurance companies are now prohibited from refusing to issue policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS. This ensures that individuals with pre-existing conditions have access to health insurance coverage.
Decreased Waiting Period for Pre-existing Conditions
The IRDAI has also decreased the waiting period for coverage of pre-existing conditions from 48 months to 36 months. After 36 months, all pre-existing conditions should be covered, regardless of whether the policyholder disclosed them initially or not. This means that health insurers are now prohibited from rejecting claims based on pre-existing conditions after the 36-month waiting period.
Transition to Benefit-based Policies
Insurance companies are now barred from introducing indemnity-based health policies, which compensate for hospital expenses. Instead, they are only permitted to provide benefit-based policies that offer fixed costs upon the occurrence of a covered disease. This change aims to streamline the insurance offerings and ensure clarity for policyholders.
These recent changes by the IRDAI are expected to have a significant impact on the health insurance landscape in India, providing more options and accessibility for individuals of all age groups [[3]].
I have taken CARE policy three year back I think this rule is applicable to this policy
Applicable at the time of renewal
My wife is a policy holder of star health co.she go through. a treatment in Apollo hospital kolkata it coated ₹98000,although she had insurance of₹ 5 lakh,star health rejected on the ground of pre existence desease because she had an operation of gall blooder7 years back for which I could not produce any paper,if this rule existed that time they could not do it.
Excellent move