What should you do if you develop a new illness after purchasing health insurance? Learn what a material change clause is.

Many insurance policies contain a clause that can cause problems for you in difficult times. This clause is commonly referred to as a material change clause. According to this, the company can make certain changes at the time of policy renewal.

The purpose of purchasing health insurance is to have the insurance company cover the cost of medical treatment if needed, providing you with financial relief. But did you know that many policies include a clause that can create problems for you in difficult times? This clause is called a material change clause. Recently, Prashant Mhatre, President of the General Insurance Agents Federation Integrated, expressed concern about this clause. He explained that some insurance companies are adding provisions to their health policies that could affect customer rights. So, let us explain what to do if you develop a new illness after purchasing health insurance and what a material change clause is.

What is a Material Change Clause?

According to this clause, if there is a change in your health after purchasing health insurance, such as a new illness, major surgery, or a serious health problem, you must inform your insurance company. This gives the company the right to make certain changes at the time of policy renewal, such as increasing the premium, reducing coverage, or adding new conditions. According to the President of GIAFI, some companies, such as Acko, ICICI Lombard, SBI General, and Juno General Insurance, include this clause in some health policies. However, experts say that if the insurance company uses this clause to increase the premium or reduce coverage after an illness, it could be considered a violation of IRDAI regulations.

What do IRDAI regulations say?

According to IRDAI regulations, health insurance policies are renewable for life.

The insurance company can refuse to renew the policy only in cases of fraud or concealment of information.

Changing policy terms or increasing premiums simply because of a claim or illness is considered illegal.

Any change can only be made if it applies equally to all customers, not just to one individual.

What to do if you develop a new illness?

Inform the insurance company immediately - If you discover a new illness, don't hide it; instead, inform your insurance company in writing. This reduces the likelihood of claim rejection later.

Submit all medical reports - Share your medical report, doctor's prescription, and treatment record with the company.

Inquire with the company in writing - If you develop a new illness, inquire with the insurance company in writing about its impact on your policy. Ask for written information on whether premiums will increase, coverage will change, or any new conditions will be added.

If you find any changes wrong, complain - If the company makes some changes in your policy which you do not find right, then you can file a complaint with IRDAI or Insurance Ombudsman.