Group CEO of Bajaj Capital, an investment Advisor & Financial Planning firm, while speaking to merinews.com said that health insurance providers will have to follow the new regulations but in case the new regulations increase the operational cost for the companies then they can pass the additional cost to the customers.
“Health insurance companies are bound to follow the regulations. But in the way of following the regulations if they find that their cost is going up, then they can also increase the premiums,” said Anil Chopra, Group CEO, Bajaj Capital.
The major relief, the IRDA guidelines will bring for the customers, is a time bound claim settlement i.e. within the period of 30 days. The regulator has proposed to make it mandatory for the insurer to settle all the claims in a month's time, once the customer submits all the necessary documents.
Health insurance policy holders said that this is a big step towards ending the nightmare of insured people who have to run from pillar to post for many days to get the claim.
“I will only say that this is a great relief to the consumers. I think these guidelines will encourage more people to opt for health insurance,” said Chandra Mohan, a health insurance policy holder.
Anil Chopra also finds the draft guidelines pro-consumer, which will ensure that the customers get all the benefits they are promised during the issuance of the policy.
“Everyone knows that the regulator always think in the interest of the consumers. The new rules are customer friendly. They will make the insurer's services professional and faster along with ensuring that the customers get all the benefits they had been promised. The draft guidelines are pro-consumer,” said Anil Chopra.
IRDA has also made it very clear in its draft guideline that in case a claim is rejected, the insurer has to notify the insured person with in the period of 30 days that too in written. The insurer has to tell the customer about the various reasons of the rejection of his claim.
The guidelines have given a gift to senior citizens also. Notably the consumers who are 55 years or more often complain about the reluctance of the insurance companies towards issuing them policy because the people in this age group is more prone to diseases.
But the IRDA has made it very clear in its proposed set of rules that the companies cannot deny insurance policy to a person up to the age of 65 years. Moreover if the insured senior citizen pays his renewal premium without any break then he could get the insurance benefit for the time period he wants.
Sometimes, some health insurers deny to renew the policy if the insured is not well. The draft guidelines have proper arrangement to tackle this complain also.
IRDA has proposed in its new set of rules that even after the removal of a hospital from the list of preferred service provider, the insurers would have to provide cashless facility to the customers who are availing treatment in that particular hospital.
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