Out-of-pocket expenses set to fall for policyholders after new Irdai rules

Out-of-pocket expenses of policyholders will reduce as the insurance regulator has asked companies selling indemnity-based health products to not include cost of pharmacy, implants, medical devices, and diagnostics as part of the associated medical expenses. 

Now insures have to define the associate medical expenses which will be deducted proportionately if a person opts for a higher room category than the category that is eligible, according to the terms and conditions of the policy.

Insurers shall not recover any expenses towards proportionate deductions other than the defined ‘associate medical expenses’ while processing claims, the regulator said.