Can medical insurance be rejected
8 months ago
Can medical insurance be rejected for non disclosure of HIV but the patient died in hospital for brain stroke.
A.Dear Client,
Pre Existing Diseases (PED) are covered after completion of a lock-in period that varies depending upon the nature and category of diseases from 24 months to 48 months from the inception of the Health Insurance Policy that is renewed continuously for the lock-in period and thereafter. Insurers cannot refuse to sell you a plan or charge you more just because you have a pre-existing condition such as HIV, cancer, or even asthma. The few insurers provide coverage only to such persons who are already suffering from HIV. In case of the detection of this dreaded disease after a certain period (generally 90 days after the inception of the policy), the coverage ceases to exist and the benefits are withdrawn for non-disclosure of the disease at the time of inception of the policy. Even, non-disclosure of material facts can lead to cancellation of the policy. Material facts are important information that one must not miss to reveal to the insurer as it can influence the insurance company's decision of whether or not to issue the policy. Health insurance companies will not be able to reject your claims if you have continuously been covered for at least eight years. As per IRDA's circular, these norms will be applicable to products filed after 1 October 2019. For existing health contracts, the new rules will come into effect from 1 October 2020. “The health policy would be incontestable except for proven fraud or any permanent exclusions. You may escalate your grievance against the repudiation of the claim by the Insurance Company before the Insurance Ombudsman for redressal failing which you may file a complaint before the Consumer Court.
Pre Existing Diseases (PED) are covered after completion of a lock-in period that varies depending upon the nature and category of diseases from 24 months to 48 months from the inception of the Health Insurance Policy that is renewed continuously for the lock-in period and thereafter. Insurers cannot refuse to sell you a plan or charge you more just because you have a pre-existing condition such as HIV, cancer, or even asthma. The few insurers provide coverage only to such persons who are already suffering from HIV. In case of the detection of this dreaded disease after a certain period (generally 90 days after the inception of the policy), the coverage ceases to exist and the benefits are withdrawn for non-disclosure of the disease at the time of inception of the policy. Even, non-disclosure of material facts can lead to cancellation of the policy. Material facts are important information that one must not miss to reveal to the insurer as it can influence the insurance company's decision of whether or not to issue the policy. Health insurance companies will not be able to reject your claims if you have continuously been covered for at least eight years. As per IRDA's circular, these norms will be applicable to products filed after 1 October 2019. For existing health contracts, the new rules will come into effect from 1 October 2020. “The health policy would be incontestable except for proven fraud or any permanent exclusions. You may escalate your grievance against the repudiation of the claim by the Insurance Company before the Insurance Ombudsman for redressal failing which you may file a complaint before the Consumer Court.
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A.Dear client,
Based on positive HIV and AIDS-related information insurers may deny an individual policy to an affected applicant.
Insurers may use a preexisting condition exclusion to deny HIV or AIDS-related care but only for a maximum period of 12 months.
Based on positive HIV and AIDS-related information insurers may deny an individual policy to an affected applicant.
Insurers may use a preexisting condition exclusion to deny HIV or AIDS-related care but only for a maximum period of 12 months.
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