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Medical Insurance Claims May Cover Preexisting Diseases Too

By pardeep3dec, Section Health
Posted on Mon Oct 08, 2007 at 04:52:38 AM EST

Medical insurance policy holders can now rejoice. Insurance companies are reviewing claims settlement norms in case of preexisting diseases. This means, insurers may soon no longer deprive mediclaim holders for claims under the clause of "non disclosure of diseases".

Accordingly, policyholders who never underwent treatment nor showed symptoms of a disease before signing a policy document are likely to get the medical policy benefits in future.

At present, insurance companies often decline to settle insurance claims in case policyholders are diagnosed to have contracted the disease prior to the signing the mediclaim policy.

This is likely to change. The General Insurance Council of India, in consultation with all insurers, is working on the appropriate definition of preexisting diseases.

"Policyholders who did not undergo any diagnosis or treatment or show indications of a disease prior to the signing of a contract should not be considered in the know of having any preexisting disease," said Mr BD Banerjee, a member of the committee, appointed by Insurance Regulatory and Development Authority (Irda) for examining issues related to health insurance for senior citizens.

He was talking to reporters on the sidelines of an interactive session on health insurance, organised by Bengal Chamber of Commerce and Industry here on Saturday. The seven-member committee is likely to submit its report by the first week of November. It is slated to meet in Mumbai from October 9 to 11.

The insurance regulator was formed by the committee in May this year in the wake of a over 200% hike in premium for medical insurance policies after September 2006. The insurers increased the premium for senior citizens defying the regulator's advice not to hike it more than 70%.

Mr Banerjee felt "most private insurers turn down health policies to people aged above 60. Among the public sector insurers, only Oriental Insurance as of now does not offer health insurance policies to senior citizens. It has, however, applied for a policy for senior citizens to Irda.

Issues relating to health insurance for the elderly need special focus, as they are more vulnerable and fall in a higher risk category.

Source:economictimes,08-10-07

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