Indian regulator urges insurers to be more transparent

There should be systems for policyholders to track their claims.

The Insurance Regulatory and Development Authority of India (IRDAI) has asked health insurers to be more transparent and to set up systems for policyholders to easily track their claims.

Insurers shall ensure that policyholders are provided with granular details of payments made, amounts disallowed, and the reasons for such as specified in the referred provisions.

In addition, claims repudiation shall not be based on presumptions and conjectures. Whenever a claim is denied or repudiated, insurers must specifically state the reasons for such whilst necessarily referring to the corresponding policy conditions.

Insurers shall also furnish the grievance redressal procedures available with the company and with the insurance ombudsman along with the detailed addresses of the respective offices, IRDAI said.

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