According to IRDA (insurance regulator) regulations, insurance companies cannot individually increase your premium, even if you develop a new illness. Learn what disclosures must be made to the customer during policy renewal, when a claim cannot be rejected, and how to file a complaint with the Insurance Trust.
Many insurance companies today use a “material change” clause, which obliges customers to report any significant changes in their health or lifestyle every year. This is intended to maintain fair and equitable policy coverage, but it also raises concerns among customers about increasing their premiums or resulting in a claim rejection.
Impact of Illness on Claims
People often avoid reporting new illnesses, but experts say that under IRDA (insurance regulator) regulations, illnesses acquired after the insurance purchase must be covered. No new waiting period can be imposed on policy renewals. Claims can only be rejected if fraudulent or intentionally false information is provided.
Premium Increase Rules
The biggest question is an insurance company increase your premium based on your new illness? Insurance experts believe that insurance companies cannot increase premiums for individual customers unless the increase applies equally to all customers. This means that if the company increases premiums, it must apply equally to the entire policy category. Changes to coverage during renewal can only be made if the sum assured is increased.
What Customers Should Do
During the health insurance renewal process, it is extremely important for customers to provide accurate information and understand the rules. Be completely transparent when disclosing any illnesses or changes. Minor illnesses or changes have little impact on premiums, while concealing them can lead to greater problems, such as claim rejections, in the future.
Customers should understand why this information is being requested and avoid sharing unnecessary information when it is not necessary. In case of any issues, a complaint can be filed with the Insurance Ombudsman or the Insurance Trust.
Providing accurate information and understanding the rules not only protects your policy but also ensures better service and coverage in the future.
