{"id":9225,"date":"2020-02-29T16:36:50","date_gmt":"2020-02-29T11:06:50","guid":{"rendered":"https:\/\/swaritadvisors.com\/learning\/?p=9225"},"modified":"2020-07-28T18:22:42","modified_gmt":"2020-07-28T12:52:42","slug":"irda-modifies-the-definition-of-pre-existing-diseases","status":"publish","type":"post","link":"https:\/\/swaritadvisors.com\/learning\/irda-modifies-the-definition-of-pre-existing-diseases\/","title":{"rendered":"IRDA modifies the definition of pre-existing diseases"},"content":{"rendered":"\n

Recently, Insurance Regulator and Development Authority of India have released a circular which omits the additional\/modified clause in its existing definition of pre-existing diseases. IRDA modifies the definition of pre-existing diseases to reduce the claim rejection rates in Health Insurance Policies<\/strong> and provide a customer-friendly experience. <\/p>\n\n\n\n

Previously in September, IRDA had amended the definition of pre-existing diseases<\/strong> to include some illness under the policy of Health Insurance<\/strong>. As per that, if certain illnesses are diagnosed within three months of purchasing the health insurance policy, then it will be considered as pre-existing diseases. Thus, it shall be covered under the Insurance Policy<\/strong>. IRDA released the definition under the guidelines of standardization in Health Insurance on 27th September 2019<\/strong>. However, the latest circular has completely revamped the definition. According to it, no such diseases shall be treated as pre-existing diseases<\/strong> even if diagnosed within 3 months or after purchasing the Health Insurance Policy<\/strong> [1]<\/a> .<\/p>\n\n\n\n

Insurance Regulatory and Development Authority of India has initiated a step to constitute a committee that will rationalize and standardize exclusions in Health Policy<\/strong>. The latest circular provides a clear definition of pre-existing diseases. It states that pre-existing disease<\/strong> is an ailment, injury or condition that already exists at the time of purchasing an Insurance Policy. Illness such as Diabetes, Lupus, Epilepsy, Depression, Anxiety, Sleep apnea shall be considered as pre-existing health conditions<\/strong>. Such a move will bring a positive change in regards to policyholders as it removes any ambiguity. <\/p>\n\n\n\n

Modification in the old definition of pre-existing\ndiseases<\/h2>\n\n\n\n

The changes made by IRDAI in the current definition<\/strong> of pre-existing diseases do not apply for Overseas Travel Insurance<\/strong>. Here are the changes:<\/p>\n\n\n\n
\n Old\n Definition<\/strong>\n <\/td>\n New\n Definition<\/strong>\n <\/td><\/tr>
\n Pre-existing disease refers to any\n condition, injury, ailment or disease\n <\/td>\n Pre-existing disease refers to any\n condition, injury, ailment or disease\n  \n <\/td><\/tr>
\n It is diagnosed by a Physician within 48 months before the effective\n date of  Policy issuance by the Insurer\n \n <\/td>\n It is diagnosed by a physician within 48 months before the effective\n date of  policy issuance by the insurer\n <\/td><\/tr>
\n Medical advice\/treatment was\n recommended or received from\/by a physician within 48 months before the\n effective date of the policy or its reinstatement
\n
\n \n <\/td>		\n Medical advice\/treatment was\n recommended or received from\/by a physician within 48 months before the\n effective date of the policy or its reinstatement\n <\/td><\/tr>
\n A condition where any sign or symptom if\n presented and resulted within three months of the Policy issuance in a\n diagnostic illness\/medical condition \n <\/td>\n This clause has been deleted\n <\/td><\/tr>
\n Life insurers may define for applicability of pre-existing diseases\n at  reinstatement
\n
\n \n <\/td>		\n Life insurers may define for applicability of pre-existing diseases\n at  reinstatement
\n
\n \n <\/td><\/tr><\/tbody><\/table>\n\n\n\n

The new definition of pre-existing disease is a condition, injury or ailment that already exists at the time you buy an Insurance Policy.<\/strong> IRDA excludes such diseases from Health Insurance Policy coverage for a waiting period of four years.

All the Insurance providers and third-party administrators must ensure compliance with the immediate effect of IRDAI\u2019s new amendment.<\/div><\/p>\n\n\n\n

Alaso, Read<\/b>:Process of Appointment of Principal Officer for Insurance Web Aggregator<\/a><\/mark><\/p>\n","protected":false},"excerpt":{"rendered":"

Recently, Insurance Regulator and Development Authority of India have released a circular which omits the additional\/modified clause in its existing definition of pre-existing diseases. IRDA modifies the definition of pre-existing diseases to reduce the claim rejection rates in Health Insurance Policies and provide a customer-friendly experience. Previously in September, IRDA had amended the definition of […]<\/p>\n","protected":false},"author":10,"featured_media":9229,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[545],"tags":[],"_links":{"self":[{"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/posts\/9225"}],"collection":[{"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/comments?post=9225"}],"version-history":[{"count":7,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/posts\/9225\/revisions"}],"predecessor-version":[{"id":11959,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/posts\/9225\/revisions\/11959"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/media\/9229"}],"wp:attachment":[{"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/media?parent=9225"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/categories?post=9225"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/swaritadvisors.com\/learning\/wp-json\/wp\/v2\/tags?post=9225"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}