Starting next year, policyholders can expect these changes in their insurance policies
At the time of buying an insurance policy, customers tend to face some confusion with regards to understanding features and other terms & conditions. As a result, policyholders skip reading the entire document since it is too esoteric for a guy-next-door or a girl-next-door.
It has been acknowledged by the insurance regulator IRDAI which has issued a diktat to insurers to list out all the basic features of insurance policy in simple words and in a pre-defined format given in customer information sheet (CIS).
The revised format of CIS will come into force from Jan 1 next year.
The regulator directed that insurers are meant to send concise and updated CIS bearing all the relevant information pertaining to policy.
As a matter of fact, a number of complaints were received in relation to asymmetry of information between insurer and policyholders.
The latest set of rules stems from the need to promote transparency and enhance policyholders’ awareness.
The customer information sheet will carry information in a pre-defined format which includes name of insurance product, policy number, type of insurance product, sum insured, policy coverage, exclusions, waiting period, financial limits of coverage, claims procedure, policy servicing, grievances, things to remember and obligations.
The insurers are also supposed to take acknowledgement of policyholders confirming that they have taken note of the details of CIS and received it.
The CIS in health insurance is designed to provide policyholders all important information about their health insurance policy in simple language which includes the following:
A. Name and type of policy
B. Coverage details
C. Waiting Periods
D. Limits and sub limits
E. All exclusions
F. Concepts such as free look cancellation, migration, portability and moratorium period
G. Guidance on procedure for claims submission
H. Contact details/ web links for grievance/complaint filing
“This step is expected to result in better-informed policyholders, reduced disputes and delays, and a seamless health insurance experience for policyholders," reads the IRDAI statement.
Besides, policyholders are also obliged to make transparent and fair disclosures of relevant material information pertaining to their health, as non-disclosure could affect the claim settlement.
Source : Mint