IRDAI removes age limits on health insurance purchase

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The Insurance Regulatory and Development Authority of India (IRDAI) has removed the age cap on buying health insurance policies, effective from April 1, 2024.

Earlier, individuals were restricted to purchasing new insurance policies only until the age of 65. However, after the recent changes that have come into effect from April 01, 2024, anyone, regardless of age, is eligible to purchase a new health insurance.

“Insurers shall ensure that they offer health insurance products to cater to all age groups. Insurers may design products specifically for senior citizens, students, children, maternity, and any other group as specified by the Competent Authority” said a notification issued by the IRDAI.

The move by the insurance regulatory body aims to create a more inclusive healthcare ecosystem in India and to encourage insurance provider companies to diversify their product offerings.

IRDAI has also instructed health insurance providers to introduce tailored policies for specific demographics, such as senior citizens, and establish dedicated channels for handling their claims and grievances. “It’s a welcome change since it now opens Avenue for people above 65 to seek health cover. Insurers based on their Board approved Underwriting guidelines can cover people above 65. The coverage is subject to offer and acceptance between the Insured and Insurer based on affordability for the senior citizens and viability for Insurers.” said an Industry Expert.

After the recent notification, the insurers are now also prohibited from refusing to issue policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS.

According to the notification, IRDAI has decreased the health insurance waiting period from 48 months to 36 months. According to the insurance regulator, all pre-existing conditions should be covered after 36 months, regardless of whether the policyholder disclosed them initially or not. Put simply, health insurers are prohibited from rejecting claims based on pre-existing conditions after these 36 months.

The insurance companies are barred from introducing indemnity-based health policies, which compensate for hospital expenses. Instead, they are only permitted to provide benefit-based policies, offering fixed costs upon the occurrence of a covered disease.

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Pooja Gupta

CA Pooja Gupta (CA, ISA, having 15 years of experience. Educator and Digital Creator

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CA Pooja Gupta (CA, ISA, having 15 years of experience. Educator and Digital Creator

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