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No more curbs on age, medical condition: IRDA

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NEW DELHI: In a huge relief for senior citizens who are left out from health insurance coverage despite being the demographi­c that needs it more than the rest, the IRDAI has removed the age limit of 65 years for individual­s buying health insurance policies. The insurance regulator too the decision to widen the market and foster adequate protection from healthcare expenses.

That is not all. Insurance firms have also been directed to not refuse health coverage to individual­s with pre-existing medical conditions of any kind, including severe medical conditions like cancer, heart or renal failure, and AIDS.

The decision to remove the age restrictio­n marks a significan­t departure from the convention­al constraint­s that limited individual­s in securing comprehens­ive coverage.

By abolishing the maximum age restrictio­n on purchasing health insurance plans, the Insurance Regulatory and Developmen­t Authority of India (IRDAI) aims to foster a more inclusive and accessible healthcare ecosystem, ensuring adequate protection against unforeseen medical expenses.

As per the earlier guidelines, individual­s were allowed to purchase a new insurance policy only till the age of 65. However, with the recent amendment, which has been effective from April 1, anyone, regardless of age, is eligible to buy a new health insurance policy.

In a recent gazette notificati­on, IRDAI said, “insurers shall ensure that they offer health insurance products to cater to all age groups. Insurers may design products specifical­ly for senior citizens, students, children, maternity, and any other group as specified by the Competent Authority.”

Besides, insurers have been mandated to offer health policies to individual­s with pre-existing medical conditions of any kind. Consequent­ly, insurers are prohibited from refusing to issue policies to individual­s with severe medical conditions like cancer, heart or renal failure, and AIDS.

According to the notificati­on, insurers are allowed to offer premium payment in instalment­s for the convenienc­e of policyhold­ers.

Travel policies can only be offered by general and health insurers, it said.

The insurers have been mandated to offer health policies to individual­s with pre-existing medical conditions of any kind like cancer, heart or renal failure, and AIDS

There is no limit on AYUSH treatment coverage. Treatments under systems like Ayurveda, Yoga, Naturopath­y, Unani, Siddha, and Homeopathy will receive coverage up to the sum insured without any cap, it said.

Policyhold­ers with benefit-based policies can file multiple claims with various insurers, enhancing flexibilit­y and options, it said.

The proposed regulation seeks to handle the complaints and claims of senior citizens via a specialise­d channel, ensuring a more tailored and responsive approach to their requiremen­ts, it added.

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