The health insurance sector is set to move towards more standardized products and procedures. Insurance Regulatory & Development Authority (IRDA) will come out with guidelines for standard treatment of common diseases, standard claims procedures and standard list of exclusions.
According to Mr J Hari Narayanan, the Standard Treatment Guidelines (STGs) will set guidelines for payouts for different types of surgeries in fixed re-imbursements plans. They would also contain a framework for an appropriate price range. While these moves are not expected to curb the rising costs of treatment in high end hospitalization, they would at least serve as a benchmark for availing treatments.
The guidelines will also list a standard set of exclusions for health insurance plans. So there would be greater awareness and one need to rely only on the fine print of the individual policy for making decisions. Though there is some level of standardization currently one needs to be careful as they might vary from company to company and it is a tough task to know what exactly is being covered and what is not. This will definitely lead to greater transparency for the policy holders.
A standard list of critical illnesses is also being drawn up. 11 illnesses are being considered which include cancer, heart transplant, organ and bone marrow transplant are on the list of standard critical illnesses.
The guidelines are being prepared by IRDA in consultation with FICCI and CII whose inputs are being sought to ascertain the problems being faced by health insurance policy holders. Overall these steps will make health insurance products more standard in nature which eventually benefits the policy holders. Also these steps would assist health insurance portability in a big way.
