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Health insurance claims not contestable after 8-yr of premium payment: Irdai

Health insurance claims not contestable after 8-yr of premium payment: Irdai

TIL Desk/Business/New Delhi/ Health insurance companies will not be allowed to contest claims once the premium has been paid for a continuous period of eight years, regulator Irdai said in a fresh set of guidelines.

 Irdai said the objective of the guidelines is to standardise the general terms and clauses incorporated in indemnity based health insurance (excluding personal accident and domestic/overseas travel) products by simplifying the wordings of general terms and clauses of the policy contracts and ensure uniformity across the industry.

“All policy contracts of the existing health insurance products that are not in compliance with these guidelines shall be modified as and when they are due for renewal from April 1, 2021 onwards.

“After completion of eight continuous years under the policy no look back to be applied…After expiry of moratorium period (of eight years) no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract,” Insurance Regulatory and Development Authority (Irdai) said.

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