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Post-policy health conditions
Why is it in the news ?
- All health conditions arising after the inception of a health insurance policy should be covered and cannot be permanently excluded.
- The recommendation is given by a committee appointed to look into standardisation of exclusions under health insurance policies.
Background
- Exclusions for specific disease conditions are incorporated as permanent exclusions in the policy wordings.
- This result in many claims becoming not payable for diseases being contracted even after the policy has been incepted.
- Specific cases were highlighted where claims were repudiated when the policy has been in force for 6-7 years for conditions such as Parkinson’s, Alzheimer’s, etc.
More in the news
Recommendations of the panel:
- All health conditions acquired after policy inception, such as infertility and maternity should be covered under the policy.
- Thus, exclusion of diseases contracted after taking the policy such as Alzheimer’s , Parkinson’s , AIDs/HIV infection, morbid obesity, etc.,cannot be permitted.
- There should not be any permanent exclusions for any specific disease condition(s), whether they are degenerative, physiological, or chronic in nature.
- There was a need to regularly review the list of permanent exclusions allowed at the time of underwriting.
Source
The Hindu.