What are IRDAIs latest norms saying on moratorium and waiting period?

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This new financial year, all health insurance policyholders will have a reason to rejoice! The Insurance Regulatory and Development Authority of India (IRDAI) has significantly overhauled the terms and conditions of health insurance policies in favor of the policyholder.

These revision done by IRDAI will be applicable all the newly issued policies and will also be valid for all existing policies, once they come up for renewal.

Effective April 1st, policyholders will be able to see significant changes in regulations. Firstly, the moratorium period has been shortened, allowing quicker access to benefits. Secondly, the waiting period for pre-existing conditions has been reduced, easing the claim process for those with prior health issues. Lastly, the maximum age limit has been eliminated, ensuring coverage for individuals of all ages.

Let’s know more about the updates- 

Reduced moratorium, reduced claim hassles

You can now make your claims amidst a reduced moratorium period, as IRDAI has reduced the same from eight years to five years time. The regulator noted that five years is reasonable time to acknowledge and determine any pre existing illness. After maintaining continuous coverage for sixty months (which includes portability and migration) in a health insurance policy, insurers cannot contest any policy or claim due to non-disclosure or misrepresentation, except in cases of proven fraud.

This sixty-month duration is termed as the moratorium period. If you have continuously paid your premiums for five years, the insurance company will not be able to reject claims citing failure to disclose your health status.

Pre-existing diseases now have shorter waiting period 

Until March 31st, the waiting period for all pre-existing diseases was four years. Typically, this four-year waiting period was considered the time period within which any medical expenses related to the pre-existing disease would not be borne by the insurer. After the updated regulation of IRDAI, this time period has been shortened to three years. This means that expenses for your pre-existing disease, if any, will be borne by the insurer after 3 years of coverage.

Age limit

Previously, insurance companies were required to provide standard health coverage to individuals only up to the age of 65. However, with the rule change, the condition of maximum age for purchasing a health policy has been eliminated.