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Health insurers cannot contest claims after 8 years of premium payments

June 17, 2020

Health insurance companies will not be allowed to contest claims once the premiums on a policy has been paid for a continuous period of eight years, the IRDAI states in new guidelines on indemnity based health insurance. This period of eight years is called the moratorium period. The policies would however be subject to all limits, sub limits, co-payments, and deductibles as per the policy contract. The IRDAI said the objective of the guidelines is to the policies and ensure uniformity across the industry.

The guidelines also state, “If any claim made by the insured person, is in any respect fraudulent, or if any false statement, or declaration is made or used in support thereof, or if any fraudulent means or devices are used by the insured person or anyone acting on his/her behalf to obtain any benefit under this policy, all benefits under this policy and the premium paid shall be forfeited.

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