Regulations
IRDA proposes uniform definition of key terms in health insurance

IRDA said the 46 standard terms would reduce ambiguity in the health insurance sector and enable all stakeholders to provide better services

New Delhi: The Insurance Regulatory and Development Authority (IRDA) has come out with standard definition of various key terms like critical illness with a view to bring in uniformity and promote health insurance, reports PTI.

 

“Health insurance addresses a major area of public concern. Although it is rapidly growing, access to health insurance still remains limited and add to it complaints especially due to variable interpretations of key policy terms are enormous,” the exposure draft on standardisation in Health Insurance of IRDA said.

 

IRDA has defined 46 commonly used terms in health insurance and standardised 11 critical illness terms.

 

It said the standard terms would reduce ambiguity, enable all stakeholders to provide better services, IRDA said adding that insurers should give all the 46 definitions in the policy document.

 

“In view of resolving the differences in the definitions of terms on critical illnesses adopted by the different insurers which are creating confusion in the minds of consumers and the industry ..., 11 critical illness terms have been standardised to be adopted uniformly across industry,” IRDA said.

 

As per the exposure draft, critical illness includes cancer, first heart attack, kidney failure, stroke, permanent paralysis of limbs, coma, organ transplant and multiple sclerosis.

 

Further, IRDA has allowed insurers to exclude certain diseases, including skin cancer and HIV induced diseases, from the 11 critical illnesses.

 

The exposure draft also listed 203 items, including diaper and internet charges, which are excluded from hospitalisation indemnity products.

 

Further to streamline the claim process, the exposure draft has also suggested a standard agreement between the third party administrator (TPA), the insurer, the hospital and the insurer. It also suggested a common industry wide pre-authorisation and claim form.

 

The regulator has sought feedback from all stakeholders within 10 days, starting from 11th January.

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COMMENTS

aps babu

4 years ago

Most of the Health Insurance plans have an option where sons/daughters as proposer can pay the premium for their parents. Proposer need not be insured and they can claim IT exemption under 80D. Recently I have across PNB-Oriental Royal Mediclaim Plan exclusively for its policy holders without the above option. As a result, there are not many takers for it.

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Stock Guru scam: I-T official took bribe in crores

Yogendra Mittal, an IRS officer of the 2006 batch was booked for criminal conspiracy and under Prevention of Corruption Act. The CBI alleged that illegal gratification taken by the officer could be anywhere between Rs1 to Rs15 crore

New Delhi: The Central Bureau of Investigation (CBI), carried out searches at office and residence of a Deputy Commissioner of Income Tax after registering a case against him for allegedly taking bribe running into crores of rupees during the department’s probe into the Rs500-crore Stock Guru scam, reports PTI.

 

CBI sources said Yogendra Mittal, an IRS officer of the 2006 batch, had conducted search operations at various locations in connection with Stock Guru scam in January 2011 but they were allegedly not genuine.

 

They alleged that illegal gratification taken by the officer could be anywhere between Rs1 to Rs15 crore.

 

The alleged perpetrators of Stock Guru scam—Ulhas Prabhakar Khaire and his wife Raksha—were arrested by Delhi Police's Economic Offences Wing in November last year, nearly 22 months after dubious searches carried out by the Income Tax officer, the sources said.

 

A team of CBI officials searched the residential premises of Mittal at Kaushambi, Ghaziabad as well as his office today, CBI sources said.

 

The officer was booked for criminal conspiracy and under Prevention of Corruption Act. It was alleged that the officer led searches against the company Stock Guru with the intention of extracting illegal gratification, they said.

 

Khaire and Raksha were arrested for allegedly duping around two lakh investors from seven states of nearly Rs493 crore by promising them high returns on their investment through their firm Stock Guru dealing in shares.

 

The couple had floated the firm in 2010 and allegedly lured people to invest in it promising highly lucrative returns of 20% per month followed by a subsequent refund of the principal amount in the seventh month, through source based investments in the share market.

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COMMENTS

Vaibhav Dhoka

4 years ago

Why can't we replicate Karnataka Lok-Ayukta like action throughout India.Only two Lok-Ayuktas seems to be working.They are Karnataka and Madhya pradesh.Because those who are caught know well that nothing will ever happen to them.

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