8 years Moratorium Period in General and Health Insurance

8 years Moratorium Period in General and Health Insurance

Once you have paid premiums for a health insurance policy for eight years continuously, your insurer will have to pay all claims as per the policy limits from April 1, 2021 onwards

After the expiry of the eight-year moratorium period no health insurance claim can be contested. The exceptions are proven fraud and permanent exclusions specified in the policy contract.

After completion of eight continuous years under the policy no look back to be applied. This period of eight years is called as moratorium period. The moratorium would be applicable for the sums insured of the first policy and subsequently completion of 8 continuous years would be applicable from date of enhancement of sums insured only on the enhanced limits. After the expiry of Moratorium Period no health insurance policy shall be contestable except for proven fraud and permanent exclusions specified in the policy contract. The policies would however be subject to all limits, sub limits, co-payments, deductibles as per the policy. The moratorium period is applicable for health insurance policies issued by General and Health Insurers.

Source: 

Guidelines on Standardization of Exclusions in Health Insurance Contracts:

Ref. No:IRDAI/HLT/REG/CIR/177/09/2019

Chapter 6 (point 3)

https://www.irdai.gov.in/ADMINCMS/cms/whatsNew_Layout.aspx?page=PageNo3916&flag=1

https://www.moneycontrol.com/news/business/economy/after-eight-year-moratorium-all-health-insurance-claims-to-be-paid-says-irdai-5393951.html

Protection of Policyholders' Interest Regulations, 2017

Insurance Ombudsman, Rules - 2017

Insurance Act, 1938

IRDAI Act 1999