Health Insurance: Big Changes in Health Insurance Rules from January 1

Health Insurance: From the new year January 1, 2024, health insurance plans will be more transparent as well as user-friendly. The Insurance Regulatory and Development Authority (IRDA) has instructed the insurance companies to provide the policy information and claims of the insured on a single sheet.

From the new year January 1 2024, policyholders will have easy access to important information including health insurance coverage details, waiting period, limits, sub-limits and policy exit. In addition, policyholders can take a 15-day ‘free-look’ period at the health insurance cover. During this period, if they feel that the wrong product has been sold, the policy can be cancelled. Although the insurance contract contains basic information, it is printed so well that it is almost unreadable.

Insurance terms are also often written in legalese, which is beyond the comprehension of the common man. IRDA said many complaints are coming due to information disparity between insurers and policyholders. The purpose of the consumer information letter is to “promote transparency and create awareness among policyholders about their health insurance policies,” the insurance regulator said.

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Empowering them with a deeper understanding of their insurance coverage. Introduction of consumer information sheets will help reduce cases of mis-selling. IRDAI said CIS emphasizes the responsibility of policyholders to ensure transparent and fair disclosure of physical health information. Failure to disclose such information may affect claim settlement.

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According to IRDA, there were 52 lakh health insurance claims in the financial year 2012, of which 47.4 lakh claims were resolved within one month and 3.6 lakh between one and three months. The rest of the claims were paid over a period of two years.