Reduction in Exclusions Announced by IRDAI and Its Effect on Health Insurance Plans – Indian Money
Many people stay away from taking a health insurance plan
because of the exclusions. But now IRDAI has taken a positive step to reduce
exclusions, which is a positive sign that will help in bringing greater
transparency into health insurance plans.
Indian Money CEO reveals
how this reduction in exclusions holds a lot of promise for common people.
Health Insurance
Exclusions
What are the common
health insurance exclusions?
Common exclusions include:
1.
Pregnancy and associated expenditures such as on
vaccination, child birth, and similar other costs do not get immediate
coverage.
2.
Pre-existing diseases have a waiting period between
two to four years prior to start of the coverage and includes diseases such as
high blood pressure and diabetes.
3.
Alternative treatment techniques are not covered
by some insurance providers. These treatments include homeopathy, Ayurveda, unani, etc.
4.
Surgeries such as dental, cosmetic, and joint
replacement surgeries are not covered.
5.
Hospital expenditure consisting of ambulance
fees, room rent, and doctor’s fees come with sub-limits.
6.
Permanent exclusions include HIV, injuries of
war, congenital diseases, and intentional injuries.
7.
Diseases induced by lifestyle like smoking, drugs,
drinking, etc. fall in this category.
According to IndianMoney company Bangalore, IRDAI (Insurance
and Regulatory Development Authority of India) announced its decision about
exclusions on 24th July 2018 which will greatly help in increasing
penetration of health insurance in the country.
Let us now look at this review of exclusions in greater
depth.
IndianMoney.com Review of Health Insurance
Plan Exclusions
IRDAI has set up a 10 member committee which will look into
these exclusions and suggest necessary changes. During its review, the
committee will:
1.
Perform study to examine present exclusions so
that these can be minimized.
2.
Identify exclusions that must continue.
3.
Make terminologies simpler for consumers to
understand.
4.
Examine scope of ailment and individual specific
exclusions (permanent) that are used during underwriting process. This will
help in ensuring that someone’s claim is not denied due to a reason that is not
related to exclusions.
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