Health Insurance rules changing from October 1, 2020 – Details here


New Delhi: Beginning October 1, 2020 a lot of changes may kick in the Health insurance zone. The new rules apply to waiting period after getting health insurance, claim rejection by the companies, inclusion of many more illnesses in the health cover. However, the consumer taking the health insurance must also note that the premium paid on health insurance may also go up.

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Here is looking at some major rules that may to kick in from October 1, 2020

The coverage of health insurance will become wider. Many more illnesses will be covered under the health insurance policy.

Permanent illness outside the cover to come down to 17. If earlier the exclusion was for 30 illness category, it will now be reduced to 17 which means that your premium may go up.

Several health insurance product may see an upward rise of 5 to 20 percent premium.

The new rules may also include coverage on mental illnesses, genetic diseases, physochological illness etc

Neuro disorder, oral chemotherapy, robotic surgery, stem cell therapy etc may be included.

Conditions on pre-existing: Any ailment mentioned by the doctor 48 months ago be categorised as pre-existing. 3 months after issuance of policy, if you develop any symptoms, it will be categorised as pre-existing.

No claim to be rejected after 8 years: No claim will be rejected after 8 years of you paying the premium. No re-evaluation will also be applicable for policies were the consumer has paid premium for 8 years.

There will be no reduction in ratio. Pharmacy, implant and diagnostic will not be associated as medical expenses, which means you will get full claim for the same.

However, your claim amount may reduce, due to the inclusion of associated medical expenses.

This might be seen in allocation of expenses for hospital room rent package. No ratio reduction will be made in claims for ICU charges.

Choice of company: If you have more than one insurance policy, you can choose your claim. After exhausting the claimed amount from one company, you can opt for the remaining amount from the other company.

Rejection or acceptance of claims in 30 days.

While migrating to other companies’ product, older waiting period to be included.

Expenses of telemedicines to be included in claims. These includes telemedicines before and after treatment. Those with OPD coverage policy will get full claims of telemedicines.

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