Effective from 1st April 2024, the Insurance Regulatory and Development Authority of India (IRDAI) has removed the age limit for health insurance policies. However, this move may or may not benefit senior citizens.
Previously, IRDAI rule mandated insurers to offer policies to individuals at least till the age of 65 years, as per Health Insurance Regulations 2016. However, these regulations didn’t stop insurers from offering health policies to citizens aged above 65 years.
Now, the IRDAI has removed the mandatory age limit from official rules and asked insurers to provide cover to citizens of all age groups.
“Insurers shall ensure that they offer health insurance products to cater to all the age groups,” the insurance regulator said in a notification dated March 20, 2024.
It further said that insurers may design products specifically for senior citizens, students, children, maternity and any other group as specified by the Competent Authority. Further, “Insurers shall endeavor to offer coverage for persons with all types of existing medical conditions.”
The IRDAI has also introduced a special provision for the benefit of senior citizens. Now, insurance companies are required to set up a separate channel to address health insurance-related claims of senior citizens.
“All insurers shall establish a separate channel to address the health insurance related claims and grievances of senior citizens. The details of such channel shall be available in the website of the insurers,” IRDAI said.
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Will senior citizens benefit the most?
The IRDAI removing the age limit from official rules is a welcome step. The previous rule provided insurers with an excuse to directly deny insurance to individuals aged above 65 years.
However, even as the new rule has become effective, it needs to be seen how it will unfold in the real world. Health Insurance companies would still have the opportunity to reject a policy to those aged above 65 years if their underwriting shows it is too risky to issue policies.
Also Read: Health Insurance Plans for Senior Citizens in India: Full List
Waiting period for pre-existing conditions
The IRDAI’s new regulations aim to make healthcare more compassionate in India. They ensure that people battling serious medical conditions can access health insurance without denial.
Additionally, IRDAI has reduced the waiting period for pre-existing conditions from 48 to 36 months. After the completion of this time period, the insurance provider must cover all pre-existing conditions, irrespective of whether they were disclosed at the time of policy initiation or not.
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