Insurance guidelines under HC scanner

The guidelines of the Insurance Regulatory and Development Authority to simplify medical insurance will now be under the Bombay High Court scanner.

The guidelines of the Insurance Regulatory and Development Authority (IRDA) to simplify medical insurance will now be under the Bombay High Court scanner. In a PIL filed by activist Gaurang Damani,the court sought to know if the Union Health Ministry has taken any steps to resolve grievances of health insurance buyers.

Damanis PIL urged the court to direct the authorities to bring about clarity in the insurance documents to let the buyer know the exact amount that he is insured for. The policy holder has absolutely no idea on what the amount of his claim settlement will be, Damani told the court on Monday. In absence of any clear guidelines,the claims are randomly settled, he added.

Damani informed the court that 5.5 crore people availed medical insurance and as on April 1,2010,aggregate claims of Rs 29,000 crore were pending settlement.

When the Division Bench of Chief Justice Mohit Shah and Justice SJ Vajifdar enquired about the guidelines set up by IRDA to regulate and settle insurance,Damani said,The medical insurance has not even been categorised life insurance or non-life insurance and anybody and everybody is offering it. There is complete chaos.

The court was also surprised to know that insurance companies have outsourced their core work to third party agents when legally they have no place in the contract between insurance companies and the policy holders.

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