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Mediclaim changes may help sr citizens

Paying high premium when you’re old and losing out on the benefits of a policy if you have a pre-existing disease are two crucial issues in mediclaim policies.

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IRDA panel to look at high premiums, pre-existing diseases cover

KOLKATA: Paying high premium when you’re old and losing out on the benefits of a policy if you have a pre-existing disease are two crucial issues in mediclaim policies.

But a new definition is being worked out by the insurance industry.

Suresh Mathur, joint director, Insurance Regulatory & Development Authority (IRDA), told DNA Money, “Health insurance has a huge potential.  Ambiguous policy terms have to be avoided, thus making policies more transparent.”

Mathur was in the city to address a seminar on the ‘Changing face of health insurance” organised by the Bengal Chamber of Commerce and Industry on Saturday.

The IRDA, which has formed a six-member committee to look into the issue of senior citizens, is likely to submit its report by the first week of November.

“Various recommendations are being looked at and this would address the woes of senior citizens, who have been hit most by the almost 150-200% rise in annual premiums,” B D Banerjee, advisor, insurance and risk management and one of the members on the senior citizen panel, said.

It is believed that the General Insurance Council is considering an appropriate definition and application of pre-existing illness for the first time.

According to Banerjee, for pre-existing illness, one has to have the correct awareness, or ought to have manifest symptoms or treatment taken at some time or referrals by the physician at some time.

“If I am not aware of any pre-existing disease, why should it be a non-disclosure? Diabetes, hypertension and lipid profile are the dominant cause of cardio-vascular disease and companies could charge an additional premium or load it and then cover it,” Banerjee said.
 
However, some insurance companies have designed pre-existing covers from the third year of mediclaim renewals.
 

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