IRDAI through a Corrigendum dated 28.08.2020 rectifies definition of Pre-Existing Disease under the Master Circular on Standardization of Health Insurance Products

The Insurance Regulatory and Development Authority of India (“IRDAI”) has issued a Corrigendum dated 28th August 2020, rectifying the definition of Pre-Existing Disease under the Master Circular on Standardization of Health Insurance Products dated 22.07.2020.

Refer to the table below for a comparison between the definitions

 

Master Circular on Standardization of Health Insurance Products Master Circular on Standardization of Health Insurance Products – Corrigendum
Pre-Existing Disease (not applicable for Overseas Travel Insurance):

 

Pre-existing Disease means any condition, ailment, injury or disease:

 

a) That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or

 

b) For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy or its reinstatement.

 

(Life Insurers may define norms for applicability of PED at reinstatement).

 

(Note: All existing health insurance products that are not in compliance with this

definition shall not be offered and promoted from 01st October, 2020 onwards)

 

Pre-Existing Disease (not applicable for Overseas Travel Insurance):

 

Pre-existing Disease means any condition, ailment, injury or disease:

 

a)  That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement or

 

b)  For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement.

 

(Life Insurers may define norms for applicability of PED at reinstatement).

 

(Note: All existing health insurance products that are not in compliance with this definition shall not be offered and promoted from 01st October, 2020 onwards)

 

 

Source: Insurance Regulatory and Development Authority of India

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