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Archive for September, 2020

Changes In Health Insurance Policies

Posted on: September 25th, 2020 by hema kashyap No Comments

From October health insurance policies in India will change in accordance with the guidelines and specifications issued by IRDAI. The changes will be applicable on all existing and new health insurance policies. Here is the list of expected changes:

COVER FOR NEW AILMENTS

Now the health insurance policies will cover:

• Illnesses contracted due to hazardous activity.
• Treatment of mental illness, behaviour and neurodevelopment disorders
• Age-related degeneration and internal congenital diseases
• Artificial life maintenance
• Puberty and menopause-related disorder.

NO REJECTION OF CLAIM AFTER 8 YEARS

If a health insurance policy has completed eight years, i.e., the policyholder has renewed the policy for eight years continuously, a claim cannot be rejected except for proven fraud and permanent exclusions.

NEW DEFINITION OF PRE EXISTING DISEASE (PED)

  1. Any disease/s or ailment/s that has been diagnosed by a physician 48 months before issuance of the
    health cover will be classified under PED.
  2. Any disease/s or ailment/s for which any type of medical advice or treatment was recommended by a
    qualified doctor 48 months before issuance of the policy will be qualified under PED.
  3. Any condition whose symptoms or signs have resulted within three months of the issuance of the policy
    will also be classified under
  4. Pre-existing Diseases.

All health conditions and illnesses suffered after the issuance of policy will be covered under health insurance. Some of the major diseases include Alzheimer, Parkinson, AIDS/HIV and morbid obesity.

PAYING HEALTH INSURANCE PREMIUMS IN EMIS

The regulator has allowed the payment of health insurance premiums in instalments.
The premium mode (frequency) can bemonthly, quarterly or half-yearly.


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IRDAI panel proposes pandemic risk pool with $10bn government guarantee

Posted on: September 19th, 2020 by hema kashyap No Comments

A working group set up by IRDAI has recommended to set up a pandemic risk pool for India.

The report submitted by the group to IRDAI said that the actual pool size will depend on the risks covered and the estimated potential losses. However, in the initial stages, it should have $10bn of hedge as guarantee from the government.

The recommended ‘Indian Pandemic Risk Pool’ will be used to address losses caused to low-income sectors of society and will serve as a medium of providing relief to these sectors by the government in case of any future pandemic events.

The working group also proposed that in the first phase of this pandemic pool implementation business interruption impacting the wages of the MSME sector and migrant workers should be given preference.The total pay-out is expected to be around $10.51bn with the estimate of 40m employees and workers getting benefits and pay-outs limited to a maximum of three months.The report also suggested that in subsequent phases, pandemic coverage will be extended to other lines of business. Consequently the exposure will increase and the government backstop requirement will increase to $17bn .

IRDAI executive director and chairman of the working group Suresh Mathur said the pool would require around 20 to 25 years to grow before it becomes self-sufficient.

According to the report, the government backstop will be utilised only when a pandemic trigger strikes and the pool pay-out is higher than the premiums collected, capacity offered by (re)insurers, capacity offered by other bonds and surplus of the prior years.

The working group suggested that Indian Reinsurer GIC Re which has experience in managing the Indian market terrorism risk pool and the nuclear risk insurance pool in India, would be an apt administrator for the proposed pandemic pool.

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