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.
0 Comments