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.
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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.
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