What happens on frequent admission to hospitals in older age?
Hi, please guide us through the real-life examples or IRDAI policy for this case when we or our parents get admitted frequently to the hospital due to worsening health conditions in older age.
My curiosity surrounds the following points (don't limit your answer only to them, though)
- Does the insurance company start to find loopholes in the policy claim documentation? So that somehow legally they can prevent disbursal of the claim amount.
- Can they decline cashless admission even at their network hospitals?
- Many policies now offer restoration benefits as a part of the policy. Can they decline/add complexities in such cases?
- Can they disallow the renewal of a policy?
- Are there any regulations/protections for policyholders being provided by IRDAI for such cases?
- Can insurance companies move them to some risky class of individuals? And increase the premium amount at the time of renewal?
- From the insurance provider's perspective - How do they manage this risk associated with their business model?