Document problem won’t stop in insurance claim, IRDAI’s new guidelines

The Insurance Regulatory and Development Authority of India (IRDAI) said on Tuesday that general insurance companies cannot reject claims in the absence of documents. A master circular has been issued in this regard. This circular contains several important guidelines related to insurance and claims.

What did Irda say?

IRDAI said that it is now possible to provide easy-to-understand insurance products to cater to the individual needs of customers, provide ample choice to customers and enhance their insurance experience. The circular states that no claim will be rejected for lack of documents. Necessary documents should be sought while accepting the proposal. Accordingly, customers may be asked to submit only those documents that are necessary and relevant to the settlement of the claim. In addition, retail customers can cancel the policy at any time by informing the insurer, while the insurer can only cancel the policy based on proof of fraud.

On cashless claim

Regarding health insurance, the insurance company has to decide whether to allow cashless treatment within one hour of the request. Insurers will provide a wide range of options to the insured by offering diversified insurance products for all ages, regions, medical conditions/all types of hospitals and health care providers by providing ‘products/addons/riders’ to suit the affordability of the insured. . The Master Circular also refers to the Customer Information Sheet (CIS), which is provided by the insurance company with each insurance document.

Removed age limit

Recently, the insurance regulator IRDAI has removed the age limit of 65 years for individuals purchasing health insurance policies. As per earlier guidelines, individuals were allowed to purchase new insurance policies only up to the age of 65 years. However, with the latest amendment coming into effect from April 1, anyone of any age is eligible to buy a new insurance policy.

Leave a Reply

Your email address will not be published. Required fields are marked *