UNHAPPY with your mediclaim policy, want to change your insurer? You may soon be able to transfer your mediclaim policy from one insurer to another.
The General Insurance Council (GIC) is in talks with the insurance regulator, IRDA, to introduce mediclaim portability and renewability. Authorities are expected to prescribe a minimum defined cover to enable portability across insurers. Already, GIC has introduced a common definition of pre-existing illnesses and exclusions for all insurers as a first step towards portability.
The determination of pre-existing diseases are a contentious part of mediclaims’ settlement. By introducing a uniform definition of pre-existing diseases, the extent of litigation will come down, experts feel.
KN Bhandari, secretary general, GIC, said, “We are in talks with Irda to introduce mediclaim portability and renewability. A minimum defined cover which will have basic benefits will be arrived upon. It will not be too restrictive, but should be a balance between a high value and a low value policy.”
Pavanjit Singh Dhingra, vice-president, Prudent Insurance Brokers, said, “This is much like the no claims bonus in motor insurance. Policyholders should be able to transfer accumulated benefits. There will be no penalty for transferring your mediclaim policy, unlike now, where policyholders are penalised for making a shift. Besides, if a 50-year-old were to change his insurer, it would be difficult for him to get himself covered from another insurer. The costs of changing the policy would far outweigh the benefits, so policyholders have no incentive to make a change. With portability, they will be able to carry forward benefits. By defining pre-existing diseases, there is no ambiguity left. Further regulations on portability must be spelt out as well.”
According to the GIC, pre-existing diseases have been defined as any condition, ailment or injury or related conditions for which the policyholder had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months prior to the first policy with the insurer. As per exclusion wordings spelt out, the GIC has said that benefits will not be available for any condition as defined in the policy until 48 months of continuous coverage have elapsed, since inception of the first policy with the insurer. These wordings were implemented by all mediclaim policies by all insurers starting June 1, 2008.
After the fourth policy year, an insurance company will have to cover all pre-existing diseases. Prior to this change, insurers defined pre-existing diseases differently. Renewal of old health insurance policies, will adopt the new standard definition of pre-existing diseases.
Further, the GIC is in talks with the Irda about bringing parity between life and non-life companies in terms of health insurance policies issued by both. It does not want migration of policyholders from one segment of the insurance industry to another. But analysts feel that life insurance companies are not too big in the health insurance space. The GIC is also pushing for parity between life and non-life companies for issues including commissions and solvency margin requirements.
The General Insurance Council (GIC) is in talks with the insurance regulator, IRDA, to introduce mediclaim portability and renewability. Authorities are expected to prescribe a minimum defined cover to enable portability across insurers. Already, GIC has introduced a common definition of pre-existing illnesses and exclusions for all insurers as a first step towards portability.
The determination of pre-existing diseases are a contentious part of mediclaims’ settlement. By introducing a uniform definition of pre-existing diseases, the extent of litigation will come down, experts feel.
KN Bhandari, secretary general, GIC, said, “We are in talks with Irda to introduce mediclaim portability and renewability. A minimum defined cover which will have basic benefits will be arrived upon. It will not be too restrictive, but should be a balance between a high value and a low value policy.”
Pavanjit Singh Dhingra, vice-president, Prudent Insurance Brokers, said, “This is much like the no claims bonus in motor insurance. Policyholders should be able to transfer accumulated benefits. There will be no penalty for transferring your mediclaim policy, unlike now, where policyholders are penalised for making a shift. Besides, if a 50-year-old were to change his insurer, it would be difficult for him to get himself covered from another insurer. The costs of changing the policy would far outweigh the benefits, so policyholders have no incentive to make a change. With portability, they will be able to carry forward benefits. By defining pre-existing diseases, there is no ambiguity left. Further regulations on portability must be spelt out as well.”
According to the GIC, pre-existing diseases have been defined as any condition, ailment or injury or related conditions for which the policyholder had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months prior to the first policy with the insurer. As per exclusion wordings spelt out, the GIC has said that benefits will not be available for any condition as defined in the policy until 48 months of continuous coverage have elapsed, since inception of the first policy with the insurer. These wordings were implemented by all mediclaim policies by all insurers starting June 1, 2008.
After the fourth policy year, an insurance company will have to cover all pre-existing diseases. Prior to this change, insurers defined pre-existing diseases differently. Renewal of old health insurance policies, will adopt the new standard definition of pre-existing diseases.
Further, the GIC is in talks with the Irda about bringing parity between life and non-life companies in terms of health insurance policies issued by both. It does not want migration of policyholders from one segment of the insurance industry to another. But analysts feel that life insurance companies are not too big in the health insurance space. The GIC is also pushing for parity between life and non-life companies for issues including commissions and solvency margin requirements.
