Insurance Issue of the Week

Insurance Issue of the week-42

If the claim falls under two policy periods-Health Insurance?

If an event of hospitalization is spill over two policy periods and as per practice followed by the Insurer, the claim is settled in the expiring policy as per sum insured available in the policy. To protect the interest of the Policyholder as per Clause 8(d)(iv) of  IRDA (Health) Regulations 2013 the claim is payable after considering the sum insured of two policy periods i.e expiring policy as well as renewed policy. If the policy is not renewed even then the sum insured to be considered of the renewed policy to settle the claim and the premium amount is to be deducted from the claim amount.

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