IRDA issues guidelines to standardize health insurance

The Insurance Regulatory and Development Authority or IRDA, recently, issued guidelines to standardize health insurance in India. The guidelines will standardize definitions of 46 terms that are commonly used in health insurance policies in order to bring uniformity in sales, claims and settlement processes followed by various health insurance firms.

The regulator said the guidelines are meant to reduce ambiguity and enable all stakeholders to provide better services and enable customers to interact more effectively with insurers, third-party administrators and providers.

IRDA also standardized 11 terms used in case of critical illnesses to resolve the differences in the definitions followed by different insurers currently, which has been creating confusion among customers.

Definitions of terms such as accident, co-payment, day care treatment, dependent child, emergency care, grace period, and intensive care unit will be standardized now. Also, definitions of surgery, hospitalization, illness, new born baby, dental treatment, notification of claim, cashless facility and portability, among other terms, will be standardized, IRDA said.

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