“EVOLUTION OF HEALTH INSURANCE REGULATIONS IN INDIA”

Syllabus:

  • GS-3- Insurance and it impact on various sectors of society

Focus :

  • IRDAI abolishes age restriction on health insurance products .
  • Insurers are prohibited from refusing to issue policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS.

Source – IRDAI

Introduction to the Insurance Regulatory and Development Authority of India (IRDAI) Regulations

  • Overview of the Insurance Products Regulations, 2024, which came into force on April 1-Emphasis on the reforms agenda aimed at improving insurance penetration and protecting policyholders’ interests.
Status in India-

  • In India, insurance penetration (premium as %of GDP) which was 2.7% in 2001, steadily increased to 4.2% in 2020 and remained the same in 2021.
  • Insurance density is the proportion of insurance premiums to the overall population.

Key Changes Addressed in the New Regulations

  • Objective of enabling insurers to respond faster to market needs and improve ease of doing business.
  • Focus on enhancing coverage and access in health insurance, with specific provisions to reduce waiting periods and define pre-existing diseases.
  • Importance of treating AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy) treatments on par with other medical options.

Impact on Senior Citizens’ Insurance Coverage

  • Comparison with previous regulations, particularly regarding entry and exit age limits.
  • Analysis of insurers’ response to the regulations and expectations for reformulating products.
  • Establishment of separate channels for addressing health insurance claims and grievances of senior citizens.

Response of Insurance Companies to the New Regulations

  • Discussion on insurers’ approach towards adjusting maximum entry age limits and developing new products.
  • Observations from industry officials regarding the flexibility provided by the regulations.

Significance of the Changes and Considerations for Policyholders

  • Importance of affordability in health insurance premiums for senior citizens.
  • Discussion on the role of IRDAI in maintaining premium stability and incentivizing policyholders.
  • Advice on the timing of purchasing health insurance and considerations for comprehensive coverage.

Future Prospects and Challenges in Health Insurance

  • Evaluation of the impact of regulatory changes on insurance product development.
  • Discussion on the factors influencing the development of products with better features and affordability.
  • Consideration of disease incidence and medical inflation in shaping the future of health insurance in India.

Source:The Hindu  


Mains Practice Question :

 GS-3

” Discuss the key provisions and implications of the Insurance Products Regulations, 2024, introduced by the Insurance Regulatory and Development Authority of India (IRDAI). Evaluate the impact of these regulations on enhancing health insurance coverage and access for senior citizens.” (250 words)