Hi,
Is it required to disclose any health related issues at the time of renewal (I.e., the health issues that occurred during the policy term that needs to be renewed now).
Can the insurance company reject the renewal of policy if there is a change in health condition that was not existing at time of buying the policy. If yes what can be done about it if the person is a senior citizen and will have difficulty to port or get a new policy.
3 Answers
Hi,
Health insurance is a yearly contract hence renewal is in substance a fresh contract, on the same terms and conditions as were in place in the last year. However, during the year, there may be material changes in your health profile.
If you closely read the policy terms and conditions, it is mentioned that though the insurer will not load the policy due to adverse claims experience (it cannot given the IRDA regulation), it can call for documents/information before agreeing to renew the health insurance policy.
Now, unless the insurer asks, there is no express requirement from the insured end to disclose these changes. However, on the safer side and holding the spirit of the principle of utmost good faith, it is advised to inform the insurer of the same. Let it take a decision on your policy accordingly, rather than face the pain of rejection at the time of claim.
(Courtesy : coverfox.com)
Sreekanth thanks for the inputs. Basis the health changes that you disclose at the time of renewal if the insurance company denies renewal what can the insured person do. Can he take any legal action since when it is needed the most the company is denying continuation of the policy due to health condition not existing at time of buying the policy
Hi,
Kindly note that Health insurance is not a long term contract and it is generally renewed every 1 or 2 years. So, a company can reject the renewal but this may happen very rarely.
Based on previous claims, the insurer can not reject the renewal (unless it is explicitly mentioned in policy wordings).
" The policy terms and conditions remain the same at the time of renewal and as per the IRDA regulations; insurer cannot change that basis an adverse claim experience. As per IRDA regulation, any change in benefits or premium can only be done with the approval of IRDA and has to be informed to the insurer at least three months before renewal.
In such a case, if the revised terms are not acceptable, you have the option to migrate to another similar policy with the same insurer or to port the policy to a new insurer as per the IRDA portability guidelines. "
Also, do note that , unless the insurer asks, there is no express requirement from the insured end to disclose the changed health conditions (if any).
I have a family floater policy, when I renew it, my Insurer has not asked for any information/details on health condition changes.
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