DYK: the difference between waiting period and survival period?2 min read . Updated: 22 Jul 2015, 06:31 PM IST
An understanding of these terms will help you buy a more effective health insurance or critical illness policy
A health insurance policy is bought to take care of medical expenses. But there are times when your claim will not be accepted. And this happens during waiting period and survival period.
WHAT IS WAITING PERIOD?
A policyholder can’t make a claim as soon as she buys the policy. She has to wait for the waiting period to get over. Waiting period is a standard clause in all health insurance policies, including those from life insurance companies. The clause reduces the insurer’s risk. If a policyholder gets hospitalized during the waiting period, the insurer will not accept a claim.
There are three types of waiting periods pertinent to health insurance policies—initial waiting period, disease specific waiting period and pre-existing ailment waiting period. Let us take a look at what these are.
Initial waiting period: Cover is not provided for any ailment for 30-90 days of buying a health insurance policy. However, in case of an accident, there won’t be any waiting period and you will be covered from day one.
Disease specific waiting period: Insurers specify that for some ailments, a claim will be applicable only after two years of commencement of a policy. These ailments generally include hernia, piles, hyper-tension, ovarian diseases and even diabetes.
Pre-existing ailment waiting period: A policyholder may be suffering from a disease at the time of buying a policy. This is called a pre-existing disease. Some of the pre-existing diseases are not covered for a certain number of years. Therefore, claims arising due to such ailments during the pre-existing disease waiting period will not be accepted by the insurer. This type of waiting period can be of maximum four years.
WHAT IS SURVIVAL PERIOD?
While a basic health insurance policy comes with a waiting period, a critical illness policy comes with a survival period. This is the span of time for which a policyholder has to survive once the critical illness is detected. The survival period is usually of 30 days but can vary from 0-180 days depending on policy and insurer. The survival period is in addition to the waiting period in a critical illness policy, which is generally up to 90 days.
In the case of a critical illness policy, the insurer will pay a defined benefit amount if you are diagnosed with a specified critical illness. Since it is a defined benefit policy, the policyholder will get a lump sum payment after the survival period. This money can then be used to pay for treatment, or as income if the policyholder is unable to work. The policy will be terminated once the payment is made.
WHAT SHOULD YOU DO?
An understanding of these terms will help you buy a more effective health insurance or critical illness policy. You should compare waiting and survival period clauses before buying a policy to know how many days you have to wait before making a claim.