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Insurers To Mandatorily Offer Coverage Against Some Diseases


As part of the exposure draft in respect of standardization of exclusions, the IRDAI has specified that apart from some such ailments i.e. mental illness, genetic disorders and menopause, health insurance companies need to offer coverage for any disease contracted after buying a health insurance policy.

Insurers To Mandatorily Offer Coverage Against Some Diseases

Further, health insurance policies that are not in compliance with the ruling have to take off from the shelf by April 1, 2020.

Under legal mandates, health insurers need to extend coverage to individuals struggling with mental disorders, but even now these insurance companies are offering health covers very selectively.

But providing more clarity on the matter, IRDAI has asked insurers to mandatorily cover mental ailments, neurodegenerative disorders etc. Also, puberty and menopause-related disorders that include menopausal bleeding or flushing will be covered by health insurance plans.

Also, stress-related medication has to be made part of insurance coverage and herein insurers cannot deny offering health insurance coverage on the ground that the patient does not follow medical advice etc.

For life support machines, up till the date, the doctor confirms that the patient is in a vegetative state will be covered. Also, oral chemotherapy and robotic surgeries will be covered by insurance.

Pre-existing diseases will, however, be covered after a maximum waiting period of 2 years.

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