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    Health Insurance Plan for Pre-Existing Conditions

    Last Updated On 18-05-2021

    Alarmingly high levels of stress and anxiety, unhealthy eating habits, little to no time for self-care – aren’t these reasons good enough for you to get yourself and your family a comprehensive health insurance policy? After all, with illnesses and ailments on the uptick, an insurance policy can prove to be your knight in shining armour.

    While most people use an insurance policy to their benefit, there is a fairly large cohort of people who choose to steer clear of health plans. This is all the more ironical because they suffer from an illness or disease but are under the misconception that a pre-existing medical condition does not allow them to be eligible for an insurance policy.

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    The truth, however, is that you can avail of an insurance cover for pre-existing diseases, but after a waiting period of 48 months (in most cases). On completion of this waiting period, you can enjoy coverage benefits under the policy.

    What is a pre-existing disease?

    The Insurance Regulatory and Development Authority of India (IRDAI) defines pre-existing disease as any injury, condition, ailment, or related condition for which signs or symptoms were diagnosed before the policy was purchased and for which medical advice or treatment was received within 48 months prior to the effective date of the policy.

    What does the ‘waiting period’ entail? Can it be lowered?

    While the waiting period to enjoy coverage benefits of a policy (in case of a pre-existing disease) may differ from provider to provider and disease to disease, it typically ranges between 2-4 years. Any medical expense related to the pre-existing disease, if incurred during the waiting period, is not covered under the policy. There are some insurance providers that cut down the waiting period at an extra cost. You can also get instant coverage for a pre-existing disease at a higher premium.

    What to know before buying an insurance policy for a pre-existing disease?

    • It is extremely important to disclose prevailing medical conditions to your insurance provider. An attempt at hiding information can lead to your claims being rejected in the future, purely on the basis of false information provided by you. In order to avoid any claim-related hassles in the future, make sure you give your insurance provider all that they need to know.
    • Look for policies with shorter waiting periods. Compare different health insurance policies and choose one that has the shortest waiting period. If the waiting period can be reduced or waived off at a relatively nominal cost, do not hesitate to take the offer.
    • Not all ailments are categorised as pre-existing illnesses, and every visit to the doctor’s clinic may not be a serious ailment. IRDAI categorises medical conditions and ailments with a long-term effect on a person’s health as a pre-existing illness. Minor medical conditions like cough, cold or fever etc., do not determine a person’s health.
    • While the process of buying insurance for a pre-existing illness or disease is not very different from that of buying a regular one, it can be a slightly more strenuous procedure. For instance, the IRDAI gives insurance companies the right to ask for extra information or documentation in case of a pre-existing ailment. Depending on the information provided to them, they can ask you to get a full medical check-up to evaluate the condition of the ailment.

    You may also receive calls from the insurance company’s doctors purely to help them understand the medical declaration better. But despite all of this, the company has the liberty to reject the application if they do not deem you to be fit.

    While solutions to pre-existing medical diseases exist in the form of these policies, it is always good to start early and buy yourself a health cover at a young age while you are at your healthiest. Chances of you being diagnosed with an illness are minimal when you are young. Additionally, the premium you pay would also amount to a relatively lower cost than when you are older.

    Visit PNB MetLife website to know more about term plan, term insurance & life insurance

    Disclaimer:

    The aforesaid article presents the view of an independent writer who is an expert on financial and insurance matters. PNB MetLife India Insurance Co. Ltd. doesn’t influence or support views of the writer of the article in any way. The article is informative in nature and PNB MetLife and/ or the writer of the article shall not be responsible for any direct/ indirect loss or liability or medical complications incurred by the reader for taking any decisions based on the contents and information given in article. Please consult your financial advisor/ insurance advisor/ health advisor before making any decision.

    PNB MetLife India Insurance Company Limited
    Registered office address: Unit No. 701, 702 & 703, 7th Floor, West Wing, Raheja Towers, 26/27 M G Road, Bangalore -560001, Karnataka
    IRDAI Registration number 117 | CIN U66010KA2001PLC028883
    For more details on risk factors, please read the sales brochure and the terms and conditions of the policy, carefully before concluding the sale.
    Goods and Services Tax (GST) shall be levied as per prevailing tax laws which are subject to change from time to time.
    The marks "PNB" and "MetLife" are registered trademarks of Punjab National Bank and Metropolitan Life Insurance Company, respectively. PNB MetLife India Insurance Company Limited is a licensed user of these marks.
    Call us Toll-free at 1-800-425-6969, Phone: 080-66006969, Website: www.pnbmetlife.com, Email: indiaservice@pnbmetlife.co.in or Write to us: 1st Floor, Techniplex -1, Techniplex Complex, Off Veer Savarkar Flyover, Goregaon (West), Mumbai – 400062, Maharashtra. Phone: +91-22-41790000, Fax: +91-22-41790203.

    AD-F/2021-22/008

    Beware of Spurious Phone Calls and Fictitious / Fraudulent Offers!
    IRDAI is not involved in activities like selling insurance policies, announcing bonus or investments of premium. Public receiving such phone calls are requested to lodge a police complaint.

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