IRDAI (Insurance Regulatory and Development Authority of India) has eliminated the age limit for purchasing health insurance policies, effective 1 April, 2024, in a move aimed at fostering inclusivity and accessibility in India’s healthcare landscape. Formerly, individuals were constrained by an age cap of 65 years for acquiring new health insurance coverage.
By removing this restriction, IRDAI aims to address the longstanding disparities in healthcare access for senior citizens, who often face barriers in obtaining adequate insurance coverage.
Welcoming IRDAI’s Regulatory Overhaul
Under the revised guidelines, insurers are mandated to develop specialized health insurance products tailored to the unique needs of senior citizens, students, children, maternity cases and other specified demographic groups.
Industry experts have welcomed the regulatory overhaul as a progressive step towards expanding healthcare coverage and mitigating the financial burden of medical expenses for individuals above 65 years of age. Insurers, guided by board-approved underwriting guidelines, are now able to extend coverage to senior citizens based on affordability and viability considerations, thereby enhancing their access to essential healthcare.
The regulatory changes introduced by IRDAI encompass several provisions aimed at safeguarding the interests of policyholders and improving the transparency of insurance offerings. Insurers are now prohibited from rejecting policies for individuals with severe medical conditions such as cancer, heart or renal failure and AIDS. Additionally, the waiting period for coverage of pre-existing conditions has been reduced from 48 months to 36 months, with insurers mandated to provide coverage for all pre-existing conditions after this period, irrespective of initial disclosure. IRDAI has also mandated a transition from indemnity-based health policies to benefit-based policies, ensuring fixed payouts upon the diagnosis of covered illnesses.
Potential Impact on Premiums
Industry experts caution that while the removal of age restrictions expands healthcare coverage to previously excluded demographics, it may lead to higher premiums. Aashish Chaudhry, Managing Director of Aakash Healthcare, acknowledged this concern, stating that “premiums for this demographic may be higher.” Despite this potential drawback, Chaudhry emphasized the significant benefits of cashless insurance access for seniors, children, and maternity cases.
