Genetic Problems to be under Health Insurance

 The insurance firms who denied the insurance claim after IRDA labelled common conditions like high blood pressure and diabetes as genetic disorders have suffered a significant setback. The Insurance Regulatory and Development Authority of India (IRDA) ordered insurers to refrain from denying an insured's insurance claim under the pretext of a "hereditary sickness”. Not only this, the regulator has also said that insurance companies will not keep 'genetic diseases' in the list of diseases out of the insurance coverage even for new customers.

The Delhi High Court decided that the list of "genetic disorders" that insurance firms refuse to cover is too wide, nebulous, and discriminatory, prompting the IRDA's directive. The court ruled that this list also contravenes Article 14 of the Constitution's guarantee of equality.

As per new guidelines issued by IRDAI (Insurance Regulatory and Development Authority of India) Critical diseases will also be covered by medical insurance.

This information is useful to you if you also have medical insurance for your family or yourself. More illnesses can now be treated cashless method through Mediclaim from insurance providers. For the purpose of standardising all mediclaim policies, the Insurance Regulatory and Development Authority of India (IRDAI) has published draft rules.

Under these rules, new illnesses will be included under insurance policies this will be conditions including:-

a.     Mental illnesses

b.    Genetic conditions

c.     Neurological abnormalities

d.    Oral chemotherapy

e.     Robotic surgery, and

f.      Stem cell treatment.

Additionally, there will be a 30-day waiting time for lifestyle disorders including diabetes and hypertension.

There will be no more confusion regarding health insurance:-

The policyholder will spend less time outside the scope of the claim as a result of the shorter waiting period due to new guidelines. The new standards will clear up any uncertainty surrounding health insurance and assist clients in selecting an insurance plan. The insurance company will not be allowed to deny a claim if a policyholder has paid premiums consistently for 8 years, with the possible exception of fraud.

The insurance regulating body IRDAI has maintained a list of 17 ailments that are not covered. Insurance company will not cover the treatment of illnesses including epilepsy, hepatitis B, Alzheimer’s, Parkinson’s, chronic liver and kidney disease, and HIV/AIDS.

The cost of health insurance products will also increase:-

There will be a change in the premium for health insurance products following the release of the list of diseases that are not covered by insurance by all firms. That is, if an insurance has less than 17 exclusions, the premium will be higher. If  on the other hand there are more than 17 diseases that are not covered, the premium would be lower.

The insurance business will need to reapply for approval of the policy if the premium increase exceeds 10%. According to the current plan, IRDAI will now approve all new goods, and by 1 April 2020, all businesses will be required to make their health products in accordance with the new regulations and stop selling the outdated ones.