Page 132 - Ebook health insurance IC27

The Insurance Times

Renewability clause l The insurer shall renew the policy in usual course.
l Insurer shall not be responsible for delay in

receipt of notice by the insured.
l Company may revise premium rates, terms and

condition of the policy at the time of renewal
l Renewal is not automatic and premium must be

paid before the due date to continue the risk
coverage.
l Sending of renewal notice is not compulsory.

Standardisation initiatives

 After opening of the insurance market many new players have entered in the health
insurance business.

 If the different insurers have different terms and conditions for the policies it will
become very difficult for the consumer to compare between the products of different
companies and take a decision.

 Objective of standardisation initiatives is to help in providing essential standards to
both hospitals and insurancecompanies thatcan further help in bringing understanding
of the insurance products and transparency in the health eco-system.

 At the time of claim settlement also, there would be standard parameters available
which can be used for cross checking the claims and thus reducing disputes at the
time of settlement. Standard guidelines can also enable better assessment of the
insurance sub-limits to be incorporated in policies and also provide a framework
for mutual negotiation on package costs between the payers and the providers.

Standardisation initiative has been the joint effort of clinical experts, insurers,
representatives from IRDA and FICCI to make this initiative meaningful and useful for
the industry.

136 Guide for Health Insurance