The Insurance Regulatory and Development Authority of India(IRDAI) vide its circular dated 11th June 2020 has issued guidelines on standardization of general clauses in health insurance policy contracts under the IRDAI (Health Insurance) Regulations, 2016. These Guidelines are applicable to all General and Health Insurers offering indemnity based Health Insurance (excluding PA and Domestic / Overseas Travel) products (both Individual and Group).
The objective of these guidelines is to standardize the general terms and clauses incorporated in indemnity based Health Insurance [excluding Personal Accident and Domestic / Overseas Travel] products by simplifying the wordings of general terms and clauses of the policy contracts and ensure uniformity across the industry.
The terms and conditions of the policy shall be a condition precedent to any liability of the Company to make any payment for claim(s) arising under the policy and the policy shall be void and all premium paid thereon shall be forfeited to the Company in the event of misrepresentation, misdescription or non-disclosure of any material fact by the policyholder.
The Company shall settle or reject a claim within 30 days from the date of receipt of last necessary document and the insured person may cancel this policy by giving 15 days written notice.
The insured person will have the option to migrate the policy to other health insurance products/plans offered by the company policy by applying for migration of the policy 30 days before the premium due date of his existing policy.
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