Empowering Policyholders: How
IRDAI’s Regulatory Changes are
Revolutionizing Health Insurance

With a vision of ‘insurance for all by 2047’, the health insurance policyholder Regulatory and Development Authority of India (IRDAI) has been working to make insurance products a lot more customer-friendly. Some of the key steps that have been taken are:

1. To ease the load on customers IRDAI has mandated that cashless treatment will be
available to the customer in all hospitals

available to the customer in all hospitals, irrespective of whether the hospital is in the
network of insurer or not. This step will ensure that customers don’t have to dip into their
savings to pay the bill and then follow the tedious reimbursement process. In another move
to make the customer experience better IRDAI has mandated that cashless claims have to
be settled within 3 hours of receipt. This will make sure that unnecessary waiting time is
avoided and the customer does not have to wait for hours to hear back from the insurer.

2. Pre-existing disease period has been brought down from 4 to 3 years. This step balances

the need for prudent underwriting to protect the insurance industry from unfair and
fraudulent claims as well as making sure that insurance policies become fairer to genuine
customers. This step is likely to encourage many people with illnesses to consider taking up
insurance

3. One common complaint that many health insurance policyholder customers have is that they pay for insurance

for years and when the time comes for their health claims the company rejects the claim
citing non-disclosure. While insurance industry data shows that this is something that does
not happen frequently and the Indian insurance industry is overall a fair industry, it cannot
be denied that such instances do occur. To address this issue IRDAI has cut down the
moratorium period to 5 years, which means that if you have been with an insurer for more
than 5 years then the insurer cannot reject a claim on any grounds, except fraud. This step
will also go a long way in assuring the customers that their premiums are not going to waste.

4. Another customer-friendly step that has been undertaken by the IRDAI is that in case the

customer has multiple insurance policies the task of coordinating between insurers is to be
managed by insurance companies and not the customer. A customer can make a claim even
if the policies are with multiple insurers. This step will be of great benefit to customers who
have group insurance policies from their employers as well as their own. This will ensure
that the customer does not have to manage documentation and interact with multiple
people. Customers with top-up policies will also benefit from this.

5. Alternate forms of treatment like ayurvedic, yunani, homeopathy etc, which are collectively

known as AYUSH have been brought at par with allopathy. This means that the claims on an
AYUSH treatment will not be subjected to any special condition or capping.

With all these steps we believe that the insurance industry will gain more trust in the customer’s
mind and encourage them to purchase more insurance.

Secure is designed to provide you and your family with comprehensive, accessible, and affordable healthcare solutions. Whether you’re an individual, a family, or a senior citizen, there’s a plan designed to provide financial security and peace of mind.

Some key reasons why you should choose CarePal Secure are:

• Extensive Coverage: Get access to a wide network of hospitals for cashless treatments, covering everything from regular health check-ups to major hospitalisations.

• No Waiting Period for Essential Coverage: CarePal Secure offers immediate access to essential healthcare benefits so that yCarePal ou can receive critical medical treatment without long approval delays.

• 24/7 Medical Assistance & Claims Support: Our dedicated helpdesk is available round-the-clock to assist you with medical emergencies, claim processing, and consultation bookings.

• Teleconsultations & Healthcare Discounts: Our seamless teleconsultation services allow you to access specialists across 18+ medical fields. Additionally, you can enjoy significant savings on medicines, diagnostic tests, and outpatient care, making quality healthcare more affordable.

• Affordable Plans with Super Top-Up Options: Choose from a range of budget-friendly plans for individuals, families, and seniors. Our super top-up policy for seniors provides additional financial protection, covering larger medical expenses at a lower cost.

• Tax Benefits Under Section 80D: The premiums paid toward CarePal Secure health insurance are tax-deductible, helping you save money while ensuring comprehensive coverage for yourself and your family.

With trusted partners nationwide, CarePal Secure ensures that quality healthcare is always within reach. So what are you waiting for? Join 80,000+ satisfied customers who trust CarePal Secure for their healthcare needs.

Get in touch with us to know the right plan for you.