Anushruti Singh
The health insurance sector is undergoing a significant transformation under the latest regulatory norms introduced by IRDAI. These reforms aim to make health policies more accessible, inclusive, and efficient, while shifting the burden of transparency and fraud detection onto insurers. The new IRDAI norms introduce several key changes, including the reduction of the moratorium period to two years, inclusive products for all demographics, and faster claim settlements. With insurers like CarePal Secure embracing technology to meet these standards, policyholders are set to benefit from better coverage, transparency, and a more seamless experience. These reforms mark a significant leap forward for India’s health insurance industry, paving the way for a fairer and more efficient market.
In a one-on-one interview, Pankaj Nawani, the CEO of CarePal Secure, shares insights on how these changes will benefit policyholders and what innovations insurers need to adopt to meet these new standards.
Edited excerpts:
IRDAI has reduced the moratorium period. How will this impact policyholders and what benefits can they expect from this regulatory change?
The reduction of the moratorium period is a big win for policyholders. Instead of waiting three years to have peace of mind, now after just two years, you’re free from the fear of your claim being rejected due to non-disclosure of pre-existing diseases. This alteration will result in greater assurance for policyholders, as it will decrease the unexpected occurrences at the time of making the claims. This change makes the process feel fairer and more straightforward.
Can you elaborate on the shift in fraud burden from policyholders to insurers due to the changes? How will this enhance consumer protection? Also, what about transparency?
Shifting the burden of detecting fraud onto insurers is a welcome change. Previously, if a person missed any detail during the policy sign-up, even unintentionally, it could cost the person their claim. But now, the insurers have to do a more thorough investigation to tell if the thing is fraudulent. It helps consumers and ensures that legitimate claims are not unreasonably rejected. One really good aspect of this change is that now Insurers are likely to invest more in technology to monitor these issues, thus saving everyone in the long run.
If we talk about transparency, with these new IRDAI norms, I expect that insurers will have to step up their transparency game. Customers will likely see clearer communication about how their claims are being handled. With the rise of Insurtech companies, there will be solutions to increase transparency on digital platforms, keeping customers in the loop regarding each step during their claim processing. The aim here is to remove the sense of mystery around the claim process. Insurers will probably be more forthcoming with their settlement data, which should make policyholders feel more confident about their coverage.
What challenges will insurers face in implementing these regulatory changes?
Insurers are going to face a few hurdles here. Adapting to the new transparency and fraud detection requirements won’t be easy, especially for smaller players. They’ll have to invest heavily in new tech solutions and retrain their distribution channels to meet these new regulatory standards. This is a big operational shift and balancing it without raising premiums too much will be tricky. But that’s the cost of ensuring a more consumer-friendly market.
How will these regulatory changes influence the overall insurance landscape, and what innovations can consumers expect from insurers like CarePal Secure?
These regulatory changes are set to significantly reshape the insurance landscape. CarePal Secure will have to adapt quickly, and I foresee a wave of innovation coming our way. There will be a requirement for stronger fraud detection and quicker claim processing. This is when the insurance industry will turn towards AI technology to improve customer standards. Consequently, in order to compete against each other, insurers will have to come up with methods through which they can make the procedure more transparent and user-friendly.
What advice would you offer to policyholders to maximise the benefits from these changes, and how can they navigate the evolving insurance ecosystem?
If you’re a policyholder, now is the time to stay engaged with your insurer. Make sure that you review your policy thoroughly, understand your coverage, and ensure that all your health declarations are accurate. These changes are an opportunity to get better, more secure coverage, but you need to keep yourself informed. Use digital tools to track your claims and policy updates. Also, comparing products across insurers is more important than ever to ensure that you’re getting the best deal under these new norms.
How will the new norms impact premium costs for policyholders?
With all these changes, I wouldn’t be surprised if premiums go up slightly. The costs that insurers will incur to upgrade their systems and implement these new regulations will likely get passed on to the customers in some way. However, I believe the benefits—like more transparency, better fraud protection, and quicker claim processing—will make it worthwhile for policyholders. Ultimately, it’s a trade-off for more secure and reliable coverage.
