Insurer Cannot Arbitrarily Raise Premium If Policyholder Develops Health Condition Soon After Purchase
Published by Outlook Money
Abhishek Kumar's role: Quoted
Abhishek Kumar explained that premium changes must go through IRDAI's product process and apply to all holders of a product. He said clauses allowing changes after new health conditions conflict with IRDAI rules and selective hikes can be challenged.
What Abhishek Kumar said
Can a health insurer raise my premium just because I developed an illness after buying the policy?
No. Under the regulations, any change in premium has to go through IRDAI's product management committee process, and it must apply equally to everyone who holds that product. An insurer cannot single out a policyholder and raise the premium because of their health condition. A revision has to be applied across the product as a whole, not targeted at one person who fell ill.
My policy asks me to report new health conditions. Does that clause let the insurer change my terms?
Some insurers have added such a clause to their policies. In my view, it contradicts IRDAI's rules, which prohibit an insurer from refusing renewal or changing the policy at renewal on the basis of claims made earlier or changes in health that the policyholder has recently declared. So having this clause in the document does not give the insurer a free hand to alter your cover.
What can I do if my insurer selectively raises my premium or cuts my cover after an illness?
The key protection is that a selective premium hike, or a cut in cover, after an illness can be challenged under IRDAI's renewability protections. This holds even when the policy document contains a material change clause. So a policyholder facing such a hike at renewal does not have to simply accept the new terms; the change can be contested.
In our words, from what he said in the piece. General information, not personal advice.
More of Abhishek's views on insurance
The article explains that health insurers in India cannot raise premiums for one policyholder just because they develop an illness after buying a policy. Any premium revision must apply uniformly to all holders of a product under IRDAI rules, and those facing unfair renewal terms can complain to the regulator or the Insurance Ombudsman.
Publisher source
Insurer Cannot Arbitrarily Raise Premium If Policyholder Develops Health Condition Soon After Purchase