Health Insurance Companies Cannot Reject Claims After 8 Years of Premium Payment: IRDAI

In its latest circular, the Insurance Regulatory and Development Authority of India (IRDAI) has said that no health insurance claim can be contested by health insurance companies after completion of eight continuous years of premium paid by the policyholder(s). This period of eight years is called a moratorium period.

“After the expiry of Moratorium Period, no health insurance claim shall be contestable except for proven fraud and permanent exclusions specified in the policy contract. The policies would however be subject to all limits, sub-limits, co-payments, deductibles as per the policy contract,” the regulator said.

The guidelines have been issued with the aim to standardise and simplify the general terms and clauses of indemnity-based health insurance products (excluding personal accident and domestic/overseas travel).