Irda balm for elders soon

Regulator moots coverage pool for high-risk senior citizens.

Senior citizens, who are aged 80 and above, may bask hassle-free treatment in infirmaries if the authorities accepts the recommendations of the Senior Citizens Health Insurance Committee constituted by the Insurance Regulatory and Development Authority (Irda).

The seven-member committee, which was formed in May to look into issues pertaining to wellness coverage for senior citizens and propose commercially feasible coverage schemes, submitted its recommendations to the coverage regulator last week. The suggestions have got to be approved by the Irda board this week.

Since coverage companies position people who are 80 old age old and above as high-risk entities and make not see profitableness in insuring them, the commission have recommended the formation of a wellness coverage pool to take attention of their claims. The commission have suggested that the pool should be funded by the authorities and 50 per cent of the service taxation on wellness coverage policies should be invested in it.

"We have got recommended a wellness coverage pool, created with active support by the authorities and other stakeholders to take over high-risk cases such as as those above 80 old age of age or a individual with a risk-based burden of 40 per cent and above (for example, people suffering from ailments)," said a member of the committee.

"After every five years, the coverage company can re-examine the insured from the medical point of position and complaint a insurance premium accordingly in lawsuit the senior citizen is establish agony from any disease. The Irda authorization is that they should not lade more than than 75 per cent. In lawsuit the insurance premium have to increase by more than than 40 per cent, he is then classified as a high-risk individual and travels to the pool," explained Type B Vitamin D Banerjee, a member of the committee.

"The cost of the medical diagnostic tests will be borne by the senior citizen and the coverage company in the ratio of 50:50 unlike the present practice, where the senior citizen bears all the charges," added Banerjee.

Based on the senior citizen's wellness coverage policy (Varisht Bima Yojana) launched by National Insurance Company some calendar months ago, the commission have given an declarative insurance premium of Rs 3,000 for a screen of Rs 1 hundred thousand for a healthy individual aged 50 years.

In order to command medical costs, the commission have accepted the introduction of co-payment (the policyholder pays a portion of the claim), bounds and sub-limits. It have suggested that insurance companies loading the insurance premium each year, not exceeding by 2 per cent.

Likewise, they should offer a loyalty price reduction of 1 per cent every twelvemonth so that the effectual addition in insurance premium for a senior citizen come ups to 1 per cent.

At present, coverage companies complaint a insurance premium of over Rs 6,000 to people in the age set of 56 to 60 years. The insurance premium additions according to the age bands. The commission have also suggested discontinuance of the present pattern of coverage companies fixing a insurance premium in age bands.

The commission have also said that coverage companies should not deny coverage to senior citizens unless they are establish agony from an incurable or terminus disease.

The commission have recommended assorted types of screens such as as a infirmary hard cash screen for critical illnesses, cashless hospitalization screen provided the hospitalization is less than 7 days, medical reimbursement covers, screen for all types of diseases having a higher sum of money insured with bounds and sub-limits.