Can insurers reject claims after five years?
The Insurance Regulatory and Development Authority of India (IRDAI) has introduced a five-year moratorium period for health insurance policies, effective in 2024. This rule protects long-term policyholders from insurers rejecting claims based on undisclosed pre-existing conditions or misrepresentation. Under the moratorium period, which applies to policies with continuous coverage for 60 months, insurers cannot contest claims related to undisclosed conditions after completing five years of coverage.
However, this protection does not guarantee claim settlement; insurers can still reject claims in cases of fraud. The onus of proving fraud lies with the insurer. If an insurer denies a claim after the moratorium period, policyholders have stronger grounds to challenge the decision before the Insurance Ombudsman or other grievance redressal forums.
Written by urgent.news from The Economic Times's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.