New Customer-Friendly Developments in Health Insurance Policies From 1st October🌟

Effective from October 1, 2024, health insurance policies are becoming more customer-friendly, making it easier for you to pitch them effectively. Let’s explore these major developments that can help your clients understand the changes better:

1. Reduced Waiting Period ⏳


  • The waiting period for pre-existing conditions has been reduced from 48 months to 36 months.
  • Health insurers can no longer reject claims citing pre-existing conditions after 36 months, regardless of disclosure. This means more peace of mind for policyholders!

2. Senior Citizen Friendly Policies 👵👴


  • There’s no maximum age limit for purchasing a health plan anymore!
  • Previously, individuals could buy a new policy only up to 65 years of age. Now, anyone can get health coverage, regardless of age!

3. Wider Scope of Health Insurance 🌈


  • Health insurers are now required to offer policies to:
    • Mental patients
    • Special children
    • Transgenders
    • Individuals infected with HIV or AIDS
  • This change promotes inclusivity and ensures everyone has access to health coverage.

4. No Claim Denial After 5 Years 📅


  • No claims can be denied after 5 years based on non-disclosure or misrepresentation.
  • However, if there’s any fraud established, claims can still be contested legally even after 5 years.

5. Meaningful Discounts 💰


  • Clients who don’t make a claim within a year can choose to either increase their sum insured or reduce their premium.
  • This policy rewards healthy living and responsible use of insurance.

6. Any Time Refund Policy 💵


  • Policyholders can now discontinue their health policy anytime and get a pro-rata refund.
  • For instance, if a client pays ₹12,000 in premiums and decides to cancel after 6 months, they can receive ₹6,000 back.
  • If a claim request is denied, policyholders can also opt for a refund.

7. High Chances of Claim Requests Being Settled ✔️


  • A Claims Review Committee (CRC) will be established to review rejected claims.
  • Claims can only be denied after CRC approval, with clear reasons provided, ensuring transparency and fairness.

8. Better Claim Settlement Experience 🌟


  • Insurance companies and Third-Party Administrators (TPAs) are now required to collect necessary documents directly from hospitals, easing the burden on policyholders.
  • Cashless claim requests will receive a response within 1 hour, and payment must be completed within 3 hours of discharge.

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