Senior Citizens Demand Model Health Insurance Policy from IRDA

Resolve to take up harassment and delays in claim settlements from insurance companies.

In a bid to ease the process of securing health insurance and safeguarding their rights, representatives of various senior citizen associations have resolved to represent to the Insurance Regulatory of India (IRDA), to formulate and prescribe a standard health insurance policy to be sold by insurance companies to senior citizens.

Gathering under the aegis of the Social Security Association of India (SSAI), the senior citizens associations noted various issues with health insurance policies for senior citizens including the policy documents, which are often in small print, and use British-era terminology and language that is confusing to policy holders.

While the lack of enough policies in the market to cover the risks faced by senior citizens is a moot point, the high administrative costs, multitude of middlemen – agents and advisors, nexus between hospitals and insurance companies and delayed and harassing settlements of claims, were some of the other issues noted at the General Body Meeting of the SSAI Telangana Chapter here last week.

The meeting was presided by Dr Rao VBJ Chelikani, President SSAI and attended by representatives of the All-India Senior Citizens Confederation (AISCCON), and the Tarnaka Senior Citizens Association among others, a statement from AISCCON said.

Dr. Padmanabha Vyasamorthy of AISCON and Sri. Pudi Srinivasulu, retired Joint  Director, GoAP, made presentations on the issue.

Among other recommendations the meeting resolved to propose the following to the IRDA:

1. Entry Age: Entry should be possible at any age with the premium graduated according to the risk incurred.
2.  Renewal of policy should be indefinite and automatic with no maximum exit age imposed for all those who acquired a policy before 50 years of age. Abuse in any way of this option by the Company in order to get rid of the customer should be severely viewed by the Regulatory Authority, when a complained is lodged either by the concerned party or by any senior citizen organisation or any consumers association.
3. Cashless facility should be automatically extended to hospitalization cases.
4. Reasonable renewal reminders are obligatory. The middlemen also should be held responsible in case of any default.
5. Co-payment may offered as an option involving reduced premiums and to reduce the possibility of abuse by the assured. This can be arranged very easily with regard to non-hospitalisation services.
6. Uniform norms for portability should be laid out by the Regulatory Authority for pre-existing diseases, exclusions, waiting period, bonus accrual, etc., so that there would be fair competition among the companies.
7. Free look up period must be 15 days.
8. Amount of premium should be annually adjusted keeping into account the bonus for no claims, seniority, cost of living index, etc. Under no circumstances, should the increase be more than 50% without the concurrence of the Regulatory Authority.
9. Additional incentives should be given for family insurance, where there are younger members, as well as for Group Insurance facility for members of the federations of seniors’ associations.

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