Page 41 - The Insurance Times June 2020

bonus, waiver of waiting period. as per IRDAI all the pending installments from the claim amount
guidelines, provided the policy has been maintained due under the policy.
without a break.
14 Possibility of Revision of Terms of the Policy
12 Moratorium Period Including the Premium Rates
After completion of eight continuous years under the The Company, with prior approval of IRDAI, may revise
policy no look back to be applied. This period of eight or modify the terms of the policy including the premium
years is called as moratorium period. The moratorium rates. The insured person shall be notified three months
would be applicable for the sums insured of the first before the changes are effected.
policy and subsequently completion of 8 continuous
years would be applicable from date of enhancement 15 Free look period
of sums insured only on the enhanced limits. After the The Free Look Period shall be applicable on new
expiry of Moratorium Period no health insurance claim individual health insurance policies and not on renewals
shall be contestable except for proven fraud and or at the time of porting/migrating the policy.
permanent exclusions specified in the policy contract. The insured person shall be allowed free look period of
The policies would however be subject to all limits, sub fifteen days from date of receipt of the policy document
limits, co-payments, deductibles as per the policy to review the terms and conditions of the policy, and
contract. to return the same if not acceptable.

If the insured has not made any claim during the Free
13 Premium Payment in Instalments (Wherever
Look Period, the insured shall be entitled to
applicable)
i. a refund of the premium paid less any expenses
If the insured person has opted for Payment of Premium incurred by the Company on medical examination
on an instalment basis i.e. Half Yearly, Quarterly or of the insured person and the stamp duty charges
Monthly, as mentioned in the policy Schedule/Certificate
or
of Insurance, the following Conditions shall apply
(notwithstanding any terms contrary elsewhere in the ii. where the risk has already commenced and the
policy) option of return of the policy is exercised by the
i. Grace Period of ___ (Note to Insurers: Insurer to insured person, a deduction towards the
proportionate risk premium for period of coveror
specify grace period as per product design) days
would be given to pay the instalment premium due iii. Where only a part of the insurance coverage has
for the policy. commenced, such proportionate premium

ii. During such grace period, coverage will not be commensurate with the insurance coverage during
available from the due date of instalment premium such period;
till the date of receipt of premium by Company. (Note to insurers: Insurer may increase the free
iii. The insured person will get the accrued continuity look period as per the product design)
benefit in respect of the “Waiting Periods”, “Specific 16 Redressal of Grievance
Waiting Periods” in the event of payment of
In case of any grievance the insured person may contact
premium within the stipulated grace Period.
the company through
iv. No interest will be charged If the instalment Website:
premium is not paid on due date.
Toll free:
v. In case of instalment premium due not received
E-mail:
within the grace period, the policy will get
cancelled. Fax :
vi. In the event of a claim, all subsequent premium Courier:
instalments shall immediately become due and Insured person may also approach the grievance cell at
payable. any of the company’s branches with the details of
vii. The company has the right to recover and deduct grievance

The Insurance Times, June 2020 41