Irda allows entry in new health products till 65 years

In order to plug the loophole in the system that prevents senior citizens from getting health covers, the Insurance Regulatory and Development Authority (Irda) has asked insurers to permit entry till 65 years under all health policies filed from July 1, 2009.

The move will lead to transparency and help aged people seeking covers get to know the reasons why they have been refused a policy.

“Any proposal for health insurance of senior citizens, denied on any grounds, should be made in writing with reasons furnished and recorded. Such reasons should stand the scrutiny of reasonableness and fairness,” said Irda Chairman J Harinarayan. Irda has said that in case of any differences in product specifications for different age group or for different entry ages, these should be clearly mentioned in the policy document.

Health has been a hugely growing segment of business for general insurers but the companies are unwilling to cover senior citizens fearing huge payouts.

Senior citizens have been complaining about non-availability of health covers and high premium charged by the insurers. Irda has asked insurers to reward those who enter at an early age and renew their policies continuously.

However, the regulator has asked insurers to levy fair, justified and transparent premium on health policies for older section of the society.

Going forward, insurers will bear 50 per cent of the pre-insurance medical examination where products are sold. Insurers will have to pay a penalty if they fail to issue identity cards to policy-holders beyond 30 days from the issue of the policy. In case of third party administrators (TPAs) used by insurers, policyholders will be given an option to change their TPAs 30 days before the renewal date.

In addition, insurers will have to submit product-wise reports, the number of lives covered, as and when asked by the authority. Irda has asked insurers to work towards evolving a mechanism against hospitals, TPAs or policyholders supporting fraudulent claims.