Health insurance

IN an effort to make the healthcare ecosystem more inclusive and accessible, the Insurance Regulatory and Development Authority of India (IRDAI) has done away with the age limit of 65 years for persons buying health insurance policies. In a recent gazette notification, the insurance regulator has directed insurers to ensure that they offer health insurance products catering to all age groups. They have also been restrained from rejecting claims based on pre-existing conditions. The insurers cannot refuse to issue policies to persons with severe medical conditions like cancer, heart or renal failure and AIDS.

These guidelines are expected to make the elderly better prepared to withstand the shock of unforeseen medical expenses. This is significant in a country whose count of senior citizens is estimated to exceed 20 per cent of the total population by 2050, according to the UN Population Fund. Improved life expectancy, particularly of women, is another key factor that has a bearing on health insurance.

However, there is a dire need to make the insurance products consumer-friendly. Potential customers are often put off by the jargon and the complexities. Trust deficit triggered by the fine print makes them reluctant to buy policies; even when they take the plunge, the policyholders are plagued by doubts and uncertainty. Misinformation or inadequate information about the benefits and risks makes them vulnerable to harassment. Transparency and a hassle-free claim settlement are no less important to win the confidence of customers. At the same time, a stronger mechanism is needed to effectively deal with unscrupulous elements. According to a Deloitte survey (2023), about 60 per cent of Indian insurance companies are witnessing a rapid increase in fraud, especially in the life and health insurance domains. Strict monitoring is needed to curb malpractices such as making false claims, inflating charges for services rendered and billing for medically unnecessary services.

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