Heath Cover details to be available in single page from January next year

In addition to having a 15-day window to cancel a policy, come January 1st you will be able to swiftly peruse the small print of a health insurance policy, which will be provided in a straightforward page.

Health insurance policies are expected to become more easily accessible and transparent as a result of a directive from the regulator to provide a sheet that provides a brief overview of the rights of policyholders and basic policy information.

Policyholders will have instant access to important data starting on January 1, 2024, such as coverage specifics, waiting periods, limits, sub-limits, and all exclusions. In addition, health insurance policies will come with a 15-day "free-look" period that consumers can take use of in the event that they feel misled.

Although the insurance contract contains essential information, it is frequently buried in the fine print provisions of the policy. Because insurance plans are contractual in nature, these terms are usually expressed in legalese.

The aim of customer information sheets (CIS), according to the insurance regulator (IRDAI), is to "promote transparency and enhance policyholder awareness regarding their health insurance policies… empowering them with a deeper understanding of their insurance coverage". According to IRDAI, a number of complaints are coming from policyholders and insurers with unequal information.

Insurers claim that this action will lessen the likelihood of intermediaries misrepresenting health insurance. "The regulator wants to lower complaints by raising awareness and transparency. The implementation of the customer information sheet is expected to reduce instances of mis-selling, according to T A Ramalingam, Bajaj Allianz General Insurance's chief technical officer.

Apart from providing fundamental information, the CIS will enlighten clients about their rights by emphasizing ideas like cancellation of the "free-look" period, migration, portability, the moratorium period, instructions on filing claims, and contact details for resolving grievances.

Furthermore, the CIS highlights the policyholder's responsibility to provide relevant health-related information in an open and equitable manner. According to IRDAI, withholding this information could have an effect on claim settlements. It is now required of insurers to get policyholder signatures attesting to their receipt and comprehension of CIS information.

52 lakh health insurance claims were filed in FY22, of which 47.4 lakh were addressed in less than a month and 3.6 lakh in between one and three months, according to IRDAI. Up to two years were allowed for the payment of the remaining claims.