Irda proposes uniform definition of key terms in health insurance

IRDA has come out with standard definition of various key terms like critical illness with a view to bring in uniformity and promote health insurance.

"Health insurance addresses a major area of public concern. Although it is rapidly growing, access to health insurance still remains limited and add to it complaints, especially due to variable interpretations of key policy terms are enormous," the exposure draft on standardisation in Health Insurance of Irda said.

The Insurance Regulatory and Development Authority (Irda) has defined 46 commonly used terms in health insurance and standardised the definition of11 critical illness.

It said the standard terms would reduce ambiguity, enable all stakeholders to provide better services, Irda said adding that insurers should give all the 46 definitions in the policy document.

"In view of resolving the differences in the definitions of terms on critical illnesses adopted by the different insurers which are creating confusion in the minds of consumers and the industry ..., 11 critical illness terms have been standardised to be adopted uniformly across industry," Irda said.

As per the exposure draft, critical illness includes cancer, first heart attack, kidney failure, stroke, permanent paralysis of limbs, coma, organ transplant and multiple sclerosis.

Further, the insurance regulator has allowed insurers to exclude certain disease, including skin cancer and HIV induced diseases, from the 11 critical illnesses.

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