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Changes in health insurance policies from 1st October, 2020

Rida Shaikh

Many new changes are expected to be introduced in the Health Insurance Zone from 1st October, 2020. The new rules will be applicable to the inclusion of more illnesses in the health cover, waiting period after getting the health insurance, and claim rejection by the companies.

Anyhow, the consumer must take note of the fact that the premium paid on health insurance might also go up.

Take a look at the major rules that are expected to kick in from 1st October, 2020:

  • The coverage of the health insurance policies will be broader and more extensive than before. Many more illnesses will be covered under the health insurance policies.
  • The Permanent illness outside the coverage is expected to come down to 17. For instance, if the earlier inclusion was for 30 illness categories, it will be now reduced to 17. As a result of this, the premium might go up.
  • The new rules that are expected to kick in may also cover mental illnesses, psychological illnesses, genetic diseases, etc.
  • No claim to be rejected after eight years. This implies that no claim will be rejected after the user has paid the premium for eight years. Re-evaluation won't be applicable for policies where the consumer has paid the premium for eight years either.
  • There is a possibility of the new rules including coverage on neuro disorder, oral chemotherapy, stem, cell therapy, robotic surgery, etc.
  • Numerous health insurance products are expected to see an upward rise of five to twenty percent premium.
  • There will be no deduction in the ratio. Pharmacy, implant, and diagnostics won't be associated with medical expenses. This implies that you will get the entire claim for the same.
  • But, your claim amount may lessen because of the associated medical expenses.
  • This might be seen in the allocation of expenses for the hospital rent room package. There will be no deduction in the claims for ICU charges.
  • Choice of Company: You are free to choose your claim if you have more than one insurance policy. Once you have exhausted the claim amount from one, you can opt for the remaining amount from the other company.
  • If a consumer is migrating to other companies' products, the older waiting period will be included.
  • The period of rejection or acceptance of claims will be thirty days.
  • Expenses of telemedicine before and after the treatment will be included in the claims. The consumers who have an OPD coverage policy will get a full claim of the policy.


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